Cancer drug exposure reduces fertility in nurses

By Will Boggs, MD

NEW YORK (Reuters Health) - In a study of oncology nurses, skin contact with chemotherapy drugs seemed to increase the time needed to conceive and to also raise the risk of premature delivery, according to a report in the journal Epidemiology.

"Our findings show that even very low (skin exposure to chemotherapy drugs) can cause an elevated risk of a prolonged time to pregnancy, premature delivery, or a low birth weight, even when gloves are worn during work." Dr. Wouter Fransman told Reuters Health.

"We hope that people working with (these) drugs are aware of the potential risks of these agents," Fransman said. "The awareness on how to safely work with these agents and following the right protocols and regulations will minimize exposure and hence reduce health risks."

Fransman from Utrecht University in the Netherlands and colleagues used questionnaires to assess pregnancy outcomes, work-related exposures, and lifestyle factors among 4,393 oncology nurses, 1,519 of whom reported skin exposure to cancer drugs during the course of their work.

On average, nurses with skin exposure to chemotherapy drugs took one month longer than unexposed nurses to get pregnant, the authors report.

Moreover, exposed nurses were twice as likely as unexposed nurses to deliver a low birthweight child, the results indicate.

Skin exposure to chemotherapy drugs also slightly increased the risk of premature delivery, the researchers note, but there was no significantly increased risk of stillbirth, miscarriage, or congenital malformations.

Fransman commented that his group hopes to extend the study to other countries, where exposure levels may differ. "Maybe exposure levels in other countries are much higher, so that we can test our hypothesis that higher exposure levels could lead to fetal loss and congenital malformations."

SOURCE: Epidemiology, January 2007.