抗肿瘤药物职业暴露的研究进展

Research progress of occupational exposure to antineoplastic drugs

随着恶性肿瘤患者数的增加,抗肿瘤药的使用也逐年上升,由此带来的抗肿瘤药职业暴露也随之增多。有研究表明,医务人员在配制、接触抗肿瘤药过程中出现了不同程度的身体损害。短期暴露可致皮肤损害、脱发增多、月经异常、血小板及白细胞减少等危害;长期暴露可致妊娠流产,不孕不育甚至恶性肿瘤的发生。因此,为减少暴露发生,国外提出将工业卫生等级控制运用到医疗卫生行业当中,采用分级管控的方式使抗肿瘤药的暴露风险最小化。根据我国医疗行业的特殊性,应将生物安全柜、隔离器及封闭系统传送设备等作为工程控制,将制定防范政策制度、开展培训教育等作为行政控制以及处理抗肿瘤药时需使用个人防护设备,从而在不同阶段有效地减少抗肿瘤药在医务人员中的职业暴露。

With the increase in the number of cancer patients, the use of antineoplastic drugs has increased year by year,and the occupational exposure of antineoplastic drugs has also increased. Studies have shown that medical staff suffered varying degrees of physical damage in the preparation and contact of antineoplastic drugs. Short-term exposure can cause skin damage, alopecia, menstrual abnormalities, thrombocytopenia and leukopenia. Long-term exposure can lead to abortion, infertility and even cancer. Therefore, in order to reduce the occurrence of exposure, it is shown that applying industrial health level control to the medical and health industry can minimize the exposure risk of antineoplastic drugs by the foreign literatures. According to the particularity of China’s medical industry, the biosafety cabinet, isolator and closed system transmission equipment should be taken as engineering control, the formulation and training of preventive measures should be taken as administrative control and personal protective equipment should be used when dealing with antineoplastic drugs. It would be effectively to reduce the occupational exposure of antineoplastic drugs for medical staff from the different stages.