职业接触抗癌药物护士的外周血淋巴细胞微核组学分析  

Micronucleus analysis of peripheral blood lymphocytes in nurses with occupational exposure to antineoplastic drugs

作　　者：黄超 牛晓威 高朝贤 陈昌蕊 梅小红 周玥杉 黄小红 HUANG Chao;NIU Xiao-wei;GAO Chao-xian;CHEN Chang-rui;MEI Xiao-hong;ZHOU Yue-shan;HUANG Xiao-hong(Zhuhai Campus,Zunyi Medical University,Zhuhai Guangdong,519090,China;Laboratory of Hebei Huaqing Environment Technology Group Co.,Ltd.,Shijiazhuang Hebei,050000,China;Institute of Pathology and Toxicology,Shenzhen Occupational Disease Prevention Hospital,Sheluhen Guangdong,518001,China;Nursing Department,Shenzhen Longgang Central Hospital,Shenzhen Guangdong,518116,China)

机构地区：[1]遵义医科大学珠海校区,广东珠海519090 [2]河北华清环境科技股份有限公司实验室,河北石家庄050000 [3]深圳市职业病防治院病理毒理所,广东深圳518001 [4]深圳市龙岗中心医院护理部,广东深圳518116

出　　处：《职业与健康》2021年第4期458-462,共5页Occupation and Health

基　　金：深圳市卫生计生系统重点学科提升项目(201606053)。

摘　　要：目的通过对配置处理抗癌药物的护士进行外周血淋巴细胞微核组学分析,评估职业暴露于抗癌药物的遗传毒性危害。方法采用目的抽样方法,根据是否接触抗癌药物,选取2019年3—5月在深圳市龙岗中心医院和龙岗区人民医院常规使用抗癌药物治疗的肿瘤内科、血液内科、妇科、输液室、心胸外科以及甲乳外科的82名女性护士为暴露组,选取90名未接触抗癌药物的护士作为非暴露组,问卷调查两组调查对象个人资料,胞质分裂阻滞微核细胞组学试验检测其遗传毒性损伤。结果暴露组平均微核细胞率、平均微核率分别为(5.07±2.62)‰和(5.71±3.29)‰,显著高于非暴露组[(3.70±2.51)‰和(4.06±2.88)‰],差异均有统计学意义(均P<0.05);暴露组平均微核细胞率和平均微核率在不同年龄、工龄、接触抗癌药物年限以及不同专科间比较,差异均有统计学意义(均P<0.05)。结论长期职业接触抗癌药物的护士潜在遗传毒性损伤,危害程度可能随暴露时间的增加而递增,应重视抗癌药物对肿瘤相关科室护士的职业健康危害,建议增加外周血淋巴细胞微核组学体检项目,及时发现异常检测结果,实现预防职业伤害,促进职业健康的目的。Objective By taking the micronucleus analysis of peripheral blood lymphocytes in nurses who prepared and handled antineoplastic drugs,to evaluate the genotoxicity of occupational exposure to antineoplastic drugs. Methods Using the objective sampling method,according to whether they were exposed to antineoplastic drugs,82 nurses occupationally exposed to antineoplastic drugs were selected as the exposed groupfrom the oncology department,hematology department,gynecology department,infusion room,cardiothoracic surgery department,and thyroid and breast surgery department in Shenzhen Longgang Central Hospital and Longgang District People’s Hospital from March to May 2019,and 90 nurses who were not exposed to antineoplastic drugs were selected as the non-exposed group. The personal data of the two groups were collected by questionnaire survey,and the genotoxic damage was detected by cytokinesis block micronucleus cytome assays. Results The average micronucleus cell rate and average micronucleus rate of the exposed group were(5.07±2.62)‰ and(5.71±3.29)‰ respectively,which were significantly higher than those of the non-exposed group[(3.70±2.51)‰ and(4.06±2.88)‰],and the differences were statistically significant significance(both P<0.05). In the exposed group,there were statistically significant differences in the average micronucleus cell rate and average micronucleus rate among groups in different age,years of service,years of exposure to anticancer drugs,and specialties(all P<0.05). Conclusion Long term occupational exposure to antineoplastic drugs has potential genotoxic harm to nurses,and the degree of harm may increase with the increase of exposure time. It is necessary to pay attention to the occupational health harm of antineoplastic drugs to nurses in cancer related departments. It is recommended that the peripheral blood lymphocyte cytokinesis-block micronucl eus cytome assays should be added in the health examination,to find anomaly detection results in time,and achieve the purpose of preventing

关 键 词：职业暴露 抗癌药物 护士 微核 胞质分裂阻滞微核细胞组学试验 遗传毒性 

分 类 号：R181.3+1[医药卫生—流行病学]