The Occupational Hazards of Exposure to Antineoplastic and Chemotherapy Drugs in Nurses. A systematic review

Background: By increasing the incidence of cancer, the use of antineoplastic drugs and consequently, oncology nurses’ exposure to the drugs during daily activities has increased. Because of the importance of professional Nurses' health, the purpose of this study is to answer the question of what risks contact with antineoplastic and chemotherapy drugs in nurses?        Method: Studies on the hazards exposure to antineoplastic drugs in nurses were summarized. The articles were written in English and Farsi published between 1950 and 2018, were identified in Databases Web of Knowledge, Scopus, PubMed, Cochrane Library and Embase, Science Direct ،Springer، Google scholar، SID، Irandoc، Iran Medex, Magiran, using the following keywords "Chemotherapy Adverse Events for the Nurse", "Occupational Hazards of Anti Neoplastic drugs”, ", "Chemotherapy / Nursing Side Effects" and "Occupational Hazards for Nurses".  Findings: In 49 studies, the complications of exposure to antineoplastic drugs in nurses were reported including spontaneous abortion, preterm labor and fertility disorder, embryo abnormalities and low birth weight, cell nucleus damage, chromosomal changes and gene mutations, various cancers especially leukemia, allergic reactions (rash, redness, hair loss, nausea and vomiting, headache, weakness, Vertigo, edema), the presence of mutagenic factors in urine, liver and kidney damage, and menstrual dysfunction have been reported. Conclusion: The current review suggests that exposure to antineoplastic drugs can be cause threatening and dangerous complications for Nurses. The high prevalence of these can be due to a lack of personal safety equipment for handling the drugs, nurses’ inadequate knowledge and attitude toward, a lack of safe handling guidelines in chemotherapy.