Adverse Effects of Handling Systemic Anticancer Therapy: A Comparative Analysis Among Nursing Officers in Two Selected Hospitals in Sri Lanka.

Abstract

Background: Despite safety measures, chronic low-dose occupational exposure to systemic anticancer therapy (SACT) negatively affects healthcare workers. Nurses are at a greater risk of exposure and related adverse effects (AE) due to their frequent and multiple roles in handling SACT. Objective: To assess the adverse effects of handling SACT among nurses compared to controls Methods: A comparative analysis was conducted among randomly selected volunteer nurses. The exposure and non-exposure groups comprised nurses working at the National Cancer Institute Sri Lanka (NCI) (n=132), and the National Hospital Sri Lanka (NHSL) (n=136), respectively. A pre tested and self-administered questionnaire with 50 items was utilized to assess AE, including their prevalence, frequency, severity, and distress. Nurses with chronic diseases and those handling hazardous drugs, except for SACT, were excluded. Descriptive and inferential statistics were analyzed with SPSS version 25.0. Results: Participants' mean±SD age was 31.74±5.7 in NCI and 31.26±6.83 in NHSL. SACT handling roles included intra venous chemotherapy administration (88.6%), other chemotherapy types (61.4%), drug dilution (72.7%), waste management (65.2%), and excreta handling (51.5%). The exposure group had higher rates of headache (93.9% vs 76.5%), dizziness (64.4% vs 22.1%), nausea (36.4% vs 24.3%), skin irritation (96.2% vs 25.7%), and menstrual irregularity (31.9 vs 22.2%). The exposure experienced miscarriages (8.6%), preterm labor (3%), low birth weight (2.6%), fatal death (1.7%), and sub-fertility (1.5%) while those are no reported with in the non exposure group. Exposure group showed higher mean value for prevalence (5.64±3.77 vs 3.56±3.17) of common adverse effects along with higher mean values of frequency, severity, and distress. Independent sample t-tests indicated significant differences between the two groups (p=0.000 each) in these aspects (prevalence, frequency, severity, and distress of AE). Conclusions: Compared to controls, headache, dizziness, skin irritation and reproductive AE are high with handling SACT. Periodical surveys and strategies need to be implemented to enhance occupational health safety among nurses in handling SACT.