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Administration of antineoplastic drugs and fecundity in female nurses
Author(s) -
Nassan Feiby L.,
Lawson Christina C.,
Gaskins Audrey J.,
Johnson Candice Y.,
Boiano James M.,
RichEdwards Janet W.,
Chavarro Jorge E.
Publication year - 2019
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.23015
Subject(s) - medicine , pregnancy , confidence interval , body mass index , fecundity , marital status , demography , obstetrics , pediatrics , population , environmental health , genetics , sociology , biology
Background We examined the association between the administration of antineoplastic drugs (AD) and fecundity among female nurses. Methods AD administration and use of exposure controls (EC) such as gloves, gowns, and needleless systems were self‐reported at baseline among 2649 participants of the Nurses’ Health Study 3, who were actively attempting pregnancy. Every 6 months thereafter, the nurses reported the current duration of their pregnancy attempt. Multivariable accelerated failure time models were used to estimate time ratios (TR) and 95% confidence intervals (CI) adjusted for age, race, body mass index, smoking, marital status, hours of work, and other occupational risk factors. Results Mean (standard deviation) age and BMI at baseline were 30.7 years (4.7) and 26.0 kg/m 2 (6.4). Forty‐one percent of nurses reported ever administering AD; 30% only in the past and 11% currently. The former administration of AD (TR = 1.02, 95% CI, 0.93‐1.12) was unrelated to the ongoing duration of pregnancy attempt. Among nurses currently administering AD, those who had administered AD for 6 years and above had a 27% (95% CI, 6%‐53%) longer duration of pregnancy attempt than nurses who never handled ADs in unadjusted analyses. This difference disappeared in multivariable analyses (TR = 1.01, 95% CI, 0.85‐1.21). 93% ( n = 270) of the nurses currently administering ADs reported consistent use of EC. These nurses had a similar median duration of pregnancy attempt to those who never handled AD (TR = 1.00, 95% CI, 0.87‐1.15). Conclusions Administration of ADs did not appear to have an impact on fecundity in a cohort of nurses planning for pregnancy with a high prevalence of consistent ECs. Our results may not be generalizable to women who are less compliant with PPE use or with less availability to ECs. Therefore, it is possible that we did not observe an association between occupational exposure to AD and reduced fecundity because of lower exposure due to the more prevalent use of effective ECs.