Abstract

Health professionals, especially nurses are exposed to antineoplastic drugs used in the treatment ofthe cancer. As the antineoplastics are known to becarcinogenic, teratogenic and mutagenic to humans, the occupational exposure is important. Thiscross-sectional study, carried out in 2002-2003, wasrealised in order to evaluate the exposure by the“Cytotoxic Contact Index” CCI , the research ofcytotoxics excreted in urines General UnknownScreening Method GUS , complaints and blood analysis. CCI revealed that 44.1% of the nurses were moderatly, 41% were highly exposed. The analysis of the urines with GUS method didn’t show anycontamination. Headache, hair loss and weaknesswere the most reported complaints. The blood analysis revealed elevated monocytes 51.7% andlower hemoglobin 23.3% values. The measureswhich should be taken according CCI for 85% ofthe nurses were the use of a vertical laminar airflow VLAF hood but only 50% of the nurses usedproper cabins. Only 38.2% of the nurses were usinggloves, working suit, goggles/surgical mask. Although the contamination wasn’t shown by GUS method which could be due the limitation of the method, the results emphasize the necessity of improving personal protection of nurses occupationallyexposed to cytostatic drugs and support the importance of biological monitoring

Keywords

• Antineoplastics,cytotoxics,occupational exposure,nurse

ANTİNEOPLATİKLERLE ÇALIŞAN HEMŞİRELERDE MARUZİYETİN DEĞERLENDİRİLMESİ

Abstract

Sağlık çalışanları, özellikle hemşireler kanser tedavisinde kullanılan antineoplastik ajanlara maruz kalmaktadır. Antineoplastikler karsinojenik, teratojenik ve mutajenik oldukları için mesleki maruziyet önemlidir. 2002-2003 yıllarında yapılan bu kesitsel çalışma, Antineoplastik Temas İndeksi ATİ , idrarda atılan sitotoksiklerin araştırılması Bilinmeyenlerin Genel Taranması Yöntemi GUS , yakınmalar ve kan tetkikleri üzerinden maruziyeti değerlendirmek üzere gerçekleştirilmiştir.ATİ hemşirelerin %44.1’inin orta, %41’inin yoğun düzeyde maruz kaldığını ortaya koymuştur. İdrar analizleri herhangi bir kontaminasyon göstermemiştir.Başağrısı, saç dökülmesi ve halsizlik en fazla bildirilen yakınmalardır. Kan tetkikleri yüksek monosit %51.7 ve düşük hemoglobin %23.3 değerleri ortaya koymuştur. ATİ’ye göre alınması gereken önlemler hemşirelerin %85’i için laminar dikey akımlı kabinlerin kullanımı olmasına rağmen hemşirelerin ancak %50’si uygun kabin kullanmaktaydı. Hemşirelerin yalnız % 38.2’si eldiven, önlük ve gözlük/cerrahi maske takmaktaydı. GUS yöntemi ile kontaminasyon gösterilmemesi yöntemin sınırlılığına bağlı olabileceğinden, bulgular sitotoksik ilaçlara mesleki olarak maruz kalan hemşirelerin kişisel korunmalarının geliştirilmesi ve biyolojik izlemin desteklenmesinin önemini vurgulamaktadır.

Keywords

• Antineoplastikler,sitotoksikler,mesleki maruziyet,hemþire

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