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Preventing occupational exposures to antineoplastic drugs in health care settings.
Environ Mol Mutagen 2011 Oct; 52(S1):S28
Introduction: Occupational exposure to antineoplastic drugs has been a concern of healthcare professionals since the 1970s following reports of secondary cancers in patients treated with these drugs. The detection of mutagens in the urine of nurses first alerted healthcare professionals to the potential for exposure to antineoplastic drugs in the workplace. Since many of the anti-cancer drugs cause DNA damage, properly designed tests for genotoxicity can reflect exposure to these drugs. Methods: Peer-reviewed articles dealing with biomarkers of genotoxic damage associated with occupational exposure to antineoplastic drugs published between 1990 and 2011 were reviewed. The studies employed various types of assays for biomarkers of genotoxicity. In addition to urine mutagenicity, biomarkers included chromosomal aberrations, sister chromatid exchanges, induction of micronuclei and DNA damage, plus several miscellaneous endpoints. Results: During this period, 99 studies were identified that evaluated differences in biomarkers of genotoxic damage in healthcare workers as compared to matched control groups. The majority of the studies was cross-sectional in design and often had the limitation of small sample size. Some studies evaluated interventions aimed at reducing exposure to these drugs. Approximately two-thirds of the studies reported an association between occupational exposure to antineoplastic drugs and the biomarker of genotoxicity. In most studies, interventions reduced the frequency of genotoxic damage. Discussion: Although the long-term consequences of the exposure to antineoplastic drugs are not fully understood, given their genotoxic potential, efforts should be undertaken to reduce potential exposure to these drugs in the workplace.
Antineoplastic-agents; Drugs; Health-care-; Health-care-personnel; Medical-care; Medical-personnel; Medical-treatment; Medicinal-chemicals; DNA-damage; Drug-therapy; Biochemical-tests; Biomarkers; Gene-mutation; Genotoxic-effects; Genotoxicity; Bioassays; Urinalysis; Chromosome-damage; Exposure-assessment; Pharmaceuticals; Chemotherapy; Mutagenicity
Healthcare and Social Assistance
Environmental and Molecular Mutagenesis