title: Reproductive health risks associated with occupational exposures to antineoplastic drugs in health care settings: a review of the evidence.
abstract: OBJECTIVE
  Antineoplastic drugs are known reproductive and developmental toxicants. Our objective was to review the existing literature of reproductive health risks to workers who handle antineoplastic drugs.
  
  
  METHODS
  A structured literature review of 18 peer-reviewed, English language publications of occupational exposure and reproductive outcomes was performed.
  
  
  RESULTS
  Although effect sizes varied with study size and population, occupational exposure to antineoplastic drugs seems to raise the risk of both congenital malformations and miscarriage. Studies of infertility and time to pregnancy also suggested an increased risk for subfertility.
  
  
  CONCLUSIONS
  Antineoplastic drugs are highly toxic in patients receiving treatment, and adverse reproductive effects have been well documented in these patients. Health care workers with long-term, low-level occupational exposure to these drugs also seem to have an increased risk of adverse reproductive outcomes. Additional precautions to prevent exposure should be considered.
authors.affiliation: From THC-Research Biologist, Division of Applied Research and Technology (Dr Connor) and CCL-Lead Health Scientist, Division of Surveillance Hazard Evaluations & Field Studies (Dr Lawson), National Institute for Occupational Safety and Health, Cincinnati, Ohio; Clinical Associate Professor, Byrdine F. Lewis School of Nursing and Health Professions (Dr Polovich), Georgia State University, Atlanta; and Division of Occupational and Environmental Medicine (Dr McDiarmid), University of Maryland School of Medicine, Baltimore.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Connor
authors.forename: Christina C
authors.initials: CC
authors.lastname: Lawson
authors.forename: Martha
authors.initials: M
authors.lastname: Polovich
authors.forename: Melissa A
authors.initials: MA
authors.lastname: McDiarmid
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D006268:Health Facilities; D006282:Health Personnel; D006801:Humans; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects*; D012098:Reproduction / Q000187:drug effects; D060728:Reproductive Health
chemical_list: D000970:Antineoplastic Agents