Химиотерапия: возможные риски при обращении с противоопухолевыми препаратами

В России многочисленные контингенты работников, занятых в сфере здравоохранения, могут подвергаться воздействию противоопухолевых препаратов, многие из которых являются канцерогенными. Загрязнение рабочей среды медицинских работников лекарственными противоопухолевыми препаратами связано с функционированием всей внутрибольничной системы от этапа их доставки до утилизации медицинских отходов. Это подтверждается данными мониторинга загрязнения химиопрепаратами внутрибольничной среды с использованием современных методов анализа, выполненного в разных странах. Результат ежедневной и многолетней профессиональной экспозиции медицинского персонала к химиопрепаратам может реализоваться в виде цитотоксических эффектов, нарушения репродуктивной функции и повышения онкологического риска. Показано увеличение риска врожденных пороков развития у детей, спонтанных абортов у работниц при профессиональной экспозиции к цитостатикам. По данным эпидемиологических исследований, у женского персонала, имевшего контакт с этими препаратами, чаще наблюдалось повышение риска возникновения рака молочной железы и других злокачественных новообразований. Об этом также свидетельствуют данные онкологической заболеваемости фармацевтов и лабораторных работников с возможной профессиональной экспозицией к химиопрепаратам. В России необходимы контроль онкологической заболеваемости у медицинских работников и мониторинг загрязнения химиопрепаратами рабочей среды на постоянной основе, так как проецировать оценки, полученные в других странах, на производственные условия, имеющие место в отечественных онкологических учреждениях, неправомерно. Данные биологического и эпидемиологического мониторинга должны стать основой эффективной профилактики возможных рисков здоровью лиц, работающих с противоопухолевыми препаратами в нашей стране.

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