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Tang Z, Li C, Kang B, Gao G, Li C, Zhang Z (2017) GEPIA: a web server for cancer and normal gene expression profiling and interactive analyses

I'd be inclined to think it was mainly nerves - doctors are frequently quite bad at giving injections or doing any blood work and cause more pain as a result than nurses who are doing it more frequently

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While the flow cytometric apoptosis reduction (3.48%) was not statistically significant, the molecular markers (caspase-3 down 42.7%, PARP down 77.5%, Bcl-2/Bax shift) were all highly significant