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High Blood Pressure and Occupational Exposure to Antineoplastic Agents Among Healthcare Professionals

Tigha Bouaziz Nadia

Abstract


Objective: The aim of our study was to determine prevalence and risk for high blood pressure (HBP) among personnel exposed to antineoplastic agents (drugs, ADs) among healthcare workers. Materials and methods: We conducted a descriptive analytical study of 108 exposed to antineoplastic agents in 5 oncology departments and 326 unexposed subjects. All subjects completed a medical and occupational questionnaire. We estimated exposure to ADs using exposure time and the cytotoxic contact index (CCI). We used the following statistical tests: relative risk, odds ratio, logistical regression and multiple correspondence analysis (CMA). Results: Participants’ (N = 426) mean age was 43.2 ± 9.4 years, and most were female (87%). The overall prevalence of HBP was 13.6 %, 14.8% for exposed subjects and 12.5% for unexposed subjects. It was higher among women (15%), nurses (19%) and exposure time with a statistically significant difference (p << 0.01). Exposure to ADs increased the risk of HBP by 1.5. This risk is higher in men (relative risk, RR = 2.63) and nurses (RR = 1.41). Hypertension prevalence increased with the years of exposure (RR = 1.25; seniority ≥ 20 years). After adjusting for confounding factors logistic regression revealed a significant difference between CCI and HBP (p = 0.01). CMA distinguished between categories and observations of hypertension in the two groups showed an association with hypertension and exposure to ADs. Conclusion: The risk of developing hypertension is moderate among healthcare personnel exposed to Ads in oncology department. It is significantly correlated with occupational category, time of exposure and CCI.


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Utechet Graeva C, McGovern PM, Alexander B, Church T, Ryan A, Polovich M. Occupational exposure to antineoplastic agents, an analysis of health workers and their environment. Workplace Health Safety. 2017; 6 (1): 9–20.

Wester K, Jönsson AK, Spigset O, Druid H, Hägg S. Incidence of fatal adverse drug reactions: a population based study. Br J ClinPharmacol. 2007; 65: 573–579.

Capilla E, Poyet R, Brocq, FX, Pons F, Kerebel S, Jego C, Laurent P, Cellarier GR. Complications cardiaques des médicaments. Presse Med. 2015; 44: 995–1002.

Monsuez J, Rivera S. Complications cardio-vasculaires des thérapies ciblées. AMC Pratique. 2011; 195.

Castel M, Despas F, Modesto A, Gales C, Honton B, Galinier M, Senard JM, Pathak A. Effets indésirables cardiaques des chimiothérapies. Presse Méd. 2013; 42 (1): 26–39.

Porter GA, Bennett WM, Sheps SG. Cyclosporine-associated hypertension. National High Blood Pressure Education Program. Arch Intern Med. 1990; 150: 280–283.

Clyburn EB, DiPette DJ. Hypertension induced by agents and other substances. Semin Nephrol. 1995; 15: 72–78.

Lai KN, Richards AM, Nicholls MG. Drug-induced hypertension. Adverse Drug React Toxicol Rev. 1991; 10: 31–46.

Chu TF, Rupnick MA, Kerkelä R. Cardiotoxicity associated with tyrosine kinase inhibitor sunitinib. Lancet. 2007; 370: 2011–2019.

Zhu X, Stergiopoulos K, Wu S. Risk of hypertension and renal dysfunction with angiogenesis inhibitor sunitinib: systematic review and meta-analysis. Acta Oncol. 2008; 20: 1–9.

Chung R, Tyebally S, Chen D, Kapil V, Walker JM, Addison D, Ismail-Khan R, Guha A, Ghosh AK. Hypertensive cardiotoxicity in cancer treatment—systematic analysis of adjunct, conventional chemotherapy, and novel therapies—epidemiology, incidence, and pathophysiology. J Clin Med. 2020; 9 (10): 3346.

Antineoplastic agents. In: LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. [Online]. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases; 2012. Available at https://www.ncbi.nlm.nih.gov/books/NBK548022/pdf/

Bookshelf_NBK548022.pdf

McDiarmid M, Polovich M, Power L, Connor TH, Weissman TH. Workplace Solutions: Medical Surveillance for Healthcare Workers Exposed to Hazardous Drugs. Washington, DC: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH); 2012. Publication Number 2013–103.

Kusnetz E, Condon M. Acute effects from occupational exposure to antineoplastic agents in a para-professional health care worker. Am J Ind Med. 2003; 44 (1): 107–109.

Ratner PA, Spinelli JJ, Beking K, Lorenzi M, Chow Y, Teschke K, Le ND, Gallagher RP, Dimich-Ward H. Cancer incidence and adverse pregnancy outcome in registered nurses potentially exposed to antineoplastic drugs. BMC Nurs. 2010; 9 (1): 15.

Valanis BG, Vollmer WM, Labuhn KT, Glass AG. Association of antineoplastic drug handling with acute adverse effects in pharmacy personnel. Am J Hosp Pharm. 1993; 50 (3): 455–462.

Cieślicka A, Gębka M, Rząca M, Kocka K, Pietraszek A, Bartoszek A, Charzyńska‑Gula M. The health consequences of occupational exposure to cytostatics among nurses. J Educ Health Sport. 2016; 6 (9): 566–574.

Polovich M. Minimizing occupational exposure to antineoplastic agents. J Infus Nurs. 2016; 39 (5): 307–313.

Walusiak J, Wągrowska-Koski E, Pałczyński C. Health effects of occupational exposure to cytostatics in medical personnel in the light of compulsory prophylactics: a cross-sectional study. Med Pr. 2003; 54 (3): 229–236.

Pucci E, Matozzo F, Luppi P, Micoli G, Sottani C, Minoia C. Headache as a “sentinel” symptom in personnel involved in the preparation and administration of antineoplastic drugs. G Ital Med Lav Ergon. 2005; 27 (4): 412–416.

Tigha N, Tourab D, Nezzal AM. Étude de la morbidité cardiovasculaire chez les infirmiers exposés auxcytostatiques: approche par l’analyse multivariée. Ann Cardiol d’Angéiol. 2016; 65: 179–184.

Szmyd K, Haus O. Cancers among medical personnel exposed to anticancer agents. Med Pr. 2011; 62 (1): 17–21.

Tigha-Bouaziz N, Tourab DJ, Nezzal AM. Exposition professionnelle aux cytostatiques et leurs effets CMR chez le personnel de santé: le point sur la question. Environ Risque Santé. 2017; 16 (5): 491–502. doi: 10.1684/ers.2017.1068.

Inamoto T, Azuma H, Tatsugami K, Oya M, Adachi M, Okayama Y, Sunaya T, Akaza H. Real-world use of sorafenib for advanced renal cell carcinoma patients with cardiovascular disease: nationwide survey in Japan. Expert Rev Anticancer Ther. 2020; 20 (7): 615–623. doi: 10.1080/14737140.2020.1773805.

Szczepaniak P. Breast cancer chemotherapy induces vascular dysfunction and hypertension through a NOX4-dependent mechanism. J Clin Invest. 2022; 132 (13): e149117.

Damrongwatanasuk R, Fradley MG. Cardiovascular complications of targeted therapies for chronic myeloid leukemia. Curr Treat Options Cardiovasc Med. 2017; 19 (4): 24. doi: 10.1007/s11936-017-0524-8.

Matinet B, Rosankis E, Léonard M. Les expositions aux risques professionnels, les produits chimiques. Synthese Stat. 2020; 32: 332.

Bielecky A, Chen C, Ibrahim S, Beaton DE, Mustard CA, Smith PM. The impact of co-morbid mental and physical disorders on presenteeism. Scand J Work Environ Health. 2015; 41 (6): 554–564.

Unmuessig V, Fishman PA, Vrijhoef HJM, Elissen AMJ, Grossman DC. Association of controlled and uncontrolled hypertension with workplace productivity. J Clin Hypertens (Greenwich). 2016; 18 (3): 217–222.

NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021; 398 (10304): 957–980.

Perry L, Gallagher R, Duffield C, Sibbritt D, Bichel-Findlay J, Nicholls R. Does nurses' health affect their intention to remain in their current position? J Nurs Manag. 2016; 24 (8): 1088–1097.

U.S. Department of Health and Human Services; National Institutes of Health, National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE), Version 5.0. Available at https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/CTCAE_v5_Quick_Reference_8.5x11.pdf [Accessed November 25, 2022].

UrbanettoJde S, Prado Lima Figueiredo AE, da Silva Gustavo A, Bosi de Souza Magnago TS, Pinheiro da Costa BE, Poli-de-Figueiredo CE. Arterial hypertension in nursing personnel of an emergency hospital. Int J Nurs Pract. 2015; 21 (4): 433–442.

Taleb A, Benrazkallah L, Benzian W, Mezian A. Hypertension artérielle, lombalgie et facteurs psychosociaux au travail. Arch Mal Prof. 2005; 66: 45–50.

Taleb A, Mohammed Brahim B, Benrezkallah L, Mahi Benkalfat FZ. Exposition au bruit, environnement psychosocial et hypertension en milieu de travail. Arch Mal Prof. 2003; 64: 246–252.

Gallagher R, Perry L, Duffield C, Sibbritt D, Ying Ko C. The health of working nurses: hypertension prevalence, awareness, treatment and control by medication. J Nurs Manag. 2018; 26 (4): 403–410.

Souza VB, Silva EN, Ribeiro ML, Martins Wde A. Hypertension in patients with cancer. Arq Bras Cardiol. 2015; 104: 246–252.

Tini G, Sarocchi M, Tocci G, Arboscello E, Ghigliotti G, Novo G, Brunelli C, Lenihan D, Volpe M, Spallarossa P. Arterial hypertension in cancer: the elephant in the room. Int J Cardiol. 2019; 281: 133–139.

Guha A, Armanious M, Fradley MG. Update on cardio-oncology: novel cancer therapeutics and associated cardiotoxicities. Trends Cardiovasc Med. 2019; 29: 29–39.

Sagstuen H, Aass N, Fosså SD, Dahl O, Klepp O, Wist EA, Wilsgaard T, Bremnes RM. Blood pressure and body mass index in long-term survivors of testicular cancer. J Clin Oncol. 2005; 23: 4980–4990.

Dahlberg SE, Sandler AB, Brahmer JR, Schiller JH, Johnson DH. Clinical course of advanced non-small-cell lung cancer patients experiencing hypertension during treatment with bevacizumab in combination with carboplatin and paclitaxel on ECOG 4599. J Clin Oncol. 2010; 28: 949–954.

Spano JP, Falandry C, Chaibi P, Freyer G. Current targeted therapies in breast cancer: clinical applications in the elderly woman. Oncologist. 2011; 16: 1144–1153.

Miller K, Wang M, Gralow J, Dickler M, Cobleigh M, Perez EA, Shenkier T, Cella D, Davidson NE. Paclitaxel plus bevacizumab versus paclitaxel alone for metastatic breast cancer. N Engl J Med. 2007; 357: 2666–2676.

Ozcan C, Wong SJ, Hari P. Reversible posterior leukoencephalopathy syndrome and bevacizumab. N Engl J Med. 2006; 354: 980–982.

Zhao T, Wang X, Xu T, Xu X, Liu Z. Bevacizumab significantly increases the risks of hypertension and proteinuria in cancer patients: a systematic review and comprehensive meta-analysis. Oncotarget. 2017; 8: 51492–51506.




DOI: https://doi.org/10.37628/ijcn.v9i1.2324

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