| Objective:1.By monitoring the residual antineoplastic drugs in the environment,evaluating the occupational exposure risk of medical staff,providing a basis for medical institutions to implement scientific monitoring of ADs occupational exposure and optimize the occupational environment.2.To investigate the current status of adverse pregnancy outcomes among medical staff who are occupationally exposed to ADs,and to explore its influencing factors,so as to provide a basis for improving the status of occupational safety of medical staff.Methods:1.Using platinum-based ADs as markers,ICP-MS was used to sample and analyze the occupational environment of medical staff in three public hospitals(A,B,C)in Shenzhen,Guangdong Province.At the same time,the inner and outer sides of gloves and masks of medical staff after the treatment of ADs were detected and analyzed.2.A questionnaire was used to investigate and analyze 235 medical staff from 3 hospitals in Shenzhen who met the inclusion and exclusion criteria.The differences in adverse pregnancy outcomes between the two groups were compared and the factors for adverse pregnancy outcomes were analyzed.Results:1.A certain concentration of platinum-based ADs residues were detected in the occupational environment of the three hospitals.Hospital A is an oncology hospital with a Pharmacy Intravenous Admixture Service(PIVAS),and the positive rate of ADs detection in its was 63.90%.Hospitals B and C are general hospitals without PIVAS,and the positive rate of ADs detection in their sample was 100.00%.On protective equipment,different concentrations of ADs residues could be detected in each layer of protective gloves,and the detected concentration showed a decreasing trend layer by layer.The number of positive samples detected on the inner side of N95 masks and 3M1860 S masks was lower than that of disposable masks,and the difference in the detected concentrations of drugs inside and outside the masks was statistically significant(P<0.05).2.A total of 235 medical staff were investigated,including 119 in the exposure group(153 times of pregnancy)and116 people in the control group(156 times of pregnancy).Adverse pregnancy outcomes occurred in 22 medical staff in the exposure group,and the incidence rate of adverse pregnancy outcomes was 18.49%.In the control group,3 medical staff had adverse pregnancy outcomes,and the incidence rate in the control group was 2.59%.There was a statistically significant difference in the incidence of adverse pregnancy outcomes between the two groups(OR=8.543,95%CI=2.481～29.415,P<0.001).The results of binary logistic analysis on the influencing factors of adverse pregnancy outcomes showed that years of exposure to ADs(OR=1.181,95%CI=1.004～1.389,P<0.05)was a risk factor for adverse pregnancy outcomes in healthcare workers,Participate in courses offered by the hospital(OR=0.185,95%CI=0.036～0.954),department training(OR=0.056,95%CI=0.005～0.633)and exchange of knowledge about ADs related hazards among colleagues(OR=0.094,95%CI =0.015～0.605),Medical staff using N95 and above masks(OR=0.127,95%CI=0.021～0.782)and wearing double latex gloves(OR=0.071,95%CI=0.008～0.612)when dealing with ADs were adverse pregnancy protective factors for outcome,the differences were statistically significant(P<0.05).Conclusion:1.There is ADs pollution in the working environment of medical staff in tumor-related departments.Monitoring and standardization of occupational exposure to ADs should be strengthened and more attention should be deserved to the occupational safety of medical staff.2.Occupational exposure to ADs can increase the risk of adverse pregnancy outcomes for medical staff.Active protective measures should be taken to strengthen safety management and prevention,improve medical staff’s awareness of protection,minimize the occupational hazards caused by ADs,and pay attention to occupational safety. |
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