Genotoxicity assessment in oncology nurses handling anti-neoplastic drugs

Abstract

Many anti-neoplastic drugs are used globally during chemotherapy in the treatment of cancer. However, occupational exposure to anti-cancer drugs can represent a potential health risk to humans. Investigations on the genotoxicity of these drugs are inconsistent. Further, information on the genotoxic potential of anti-neoplastic drugs in medical personnel from India is not available. Hence, the aim of this study was to carry out genotoxicity monitoring of nurses from the oncology department of a hospital in South India, occupationally exposed to anti-neoplastic drugs under routine working conditions. The level of genome damage was determined in whole blood with the comet assay as well as micronucleus test (MNT) and in buccal epithelial cells with MNT alone of 60 nurses handling anti-neoplastic drugs and 60 referents matched for age and sex. Urinary cyclophosphamide (CP), used as a marker for drug absorption, was also measured in the urine of the nurses. The DNA damage observed in the lymphocytes of exposed nurses was significantly higher than the controls. Similarly, a significant increase in micronuclei (MN) frequency with peripheral blood lymphocytes and buccal cells was observed in the exposed nurses compared to controls (P < 0.05). Multiple regression analysis showed that occupational exposure and age had a significant effect on mean comet tail length as well as on frequency of MN. The mean value of CP in urine of the nurses handling anti-neoplastic drugs was (mean +/- standard deviation; 0.44 +/- 0.26 microg/ml). Our study has shown that increased genetic damage was evident in nurses due to occupational exposure to anti-neoplastics. This data corroborate the need to maintain safety measures to avoid exposure and the necessity of intervention in the case of exposure when using and handling anti-neoplastic drugs.

Chromosomal damage among medical staff occupationally exposed to volatile anesthetics, antineoplastic drugs, and formaldehyde

“…The International Agency for Research on Cancer (IARC) has classified many antineoplastic agents as class 1 human carcinogens (eg, cyclophosphamide, etoposide, busulfan, melfalan), class 2A probably carcinogenic to humans (eg, azacitidine, cisplatin, doxorubicine) or class 2B possibly carcinogenic to humans (bleomycin, dacarbazine, mitoxantrone, mitomycin) (20). Occupational exposure to antineoplastic agents has been shown to result in an increased frequency of total chromosomal aberrations (CATot) in PBL, as documented by a number of studies (2,(21)(22)(23)(24)(25)(26). Interestingly, nurses occupationally exposed to antineoplastic drugs showed an elevated level of not only chromatid-type aberrations (CTA) (induced by most chemical clastogens), but also chromosome-type aberrations (CSA), such as chromosome breaks and dicentric chromosomes, which is typical of radiation exposure (23).…”

Biological Effect Monitoring in Peripheral Blood Lymphocytes from Subjects Occupationally Exposed to Antineoplastic Drugs: Assessment of Micronuclei Frequency

“…No statistically significant differences in MN frequencies between hospital personnel occupationally exposed to ANPDs and nonexposed subjects were found in some studies 11−15) , while, in others, higher frequencies of MN were found in either lymphocytes 16−19) or exfoliated buccal cells 15,16) from healthcare workers preparing and/or administering ANPDs. The conclusions of these studies were often contradictory, probably because of uncertainties concerning exposure level 20) or because effective protective measures were differently adopted 21) .…”

Histological and immunohistochemical study of cyclophosphamide effect on adult rat testis

“…12,13 Due to its extensive use in clinics, it possesses occupational exposure to the health care professionals. 14 Fukushima et al reported that many alkylating agents; chemotherapeutic drugs have been found to produce infertility as a result of impaired sperm production. 15 This…”