Human effect monitoring in cases of occupational exposure to antineoplastic drugs: a method comparison.

Abstract

Objectives-To investigate whether DNA damage increased in subjects possibly exposed to high amounts of antineoplastic agents. Methods-The level of genetic damage was determined in peripheral mononuclear blood cells with the sister chromatid exchange test, the alkaline elution technique, and the cytokinesis block micronucleus test. Results-The supposed increased exposure of the study subjects was caused by a malfunction of a safety hood resulting in leakage of air during preparation of an infusion of an antineoplastic drug. Two months after a new safety hood was installed, the frequencies of micronuclei and sister chromatid exchanges of exposed nurses (n=10) were still significantly increased when compared with a matched control group (p<0.01 and p<0.05, one sided Wilcoxon test, respectively). In a second examination seven months later, the frequency of micronuclei had significantly decreased to control values (p<0.05, one sided Wilcoxon test, n=6). Moreover, the study subjects who smoked (n=8) had significantly increased frequencies of micronuclei and sister chromatid exchanges (p<0.01 and p<0.05, one sided U test, respectively). No diVerences in the rate of DNA damage could be detected with the alkaline elution technique. Conclusions-Control measures on the level of biological eVect should be performed regularly to ensure maximum safety precautions for workers potentially exposed to genotoxic agents.

Genotoxic effects in a population of nurses handling antineoplastic drugs, and relationship with genetic polymorphisms in DNA repair enzymes

“…In a previous work, incorporation of antineoplastic agents by oncology personnel was detected despite standard safety precautions, such as the use of laminar airflow hoods and personal protective clothing [Pethran et al, 2003]. The importance of taking correct safety measures while occupationally handling antineoplastic drugs on the potential genotoxic risk has been revealed in several studies that analyzed individuals with different degrees of protection: the more protective measures were taken, the less genotoxic damage was observed [Oestreicher et al, 1990;Fuchs et al, 1995;Brumen and Horvat, 1996;Kevekordes et al, 1998]. Thus, our data suggest that safety measures adopted by the oncology nurses analyzed are not enough to prevent health hazards related to antineoplastic drug management.…”

Assessment of chemotherapy‐induced DNA damage in peripheral blood leukocytes of cancer patients using the alkaline comet assay

“…As reported by Kevekordes et al [6], the use of the fresh blood has an advantage of detecting acute effects on DNA, while consisting of two thirds of shortliving non-lymphocyte nuclear blood cells (i.e., monocytes and granulocytes). By contrast, the use of isolated long-living peripheral blood lymphocytes enables detection of chronic or subchronic effects in the DNA.…”

“…Various methods of monitoring biological effects have been suggested that should be considered as internal dosimeters in the detection of increased genotoxic and presumably also carcinogenic risks [6]. Among them, there are different cytogenetic techniques that provide information about damage in individual cells: detection of chromosomal aberrations, sister chromatid exchanges, and micronuclei in peripheral blood lymphocytes.…”

Long-term monitoring of sister chromatid exchanges and micronucleus frequencies in pharmacy personnel occupationally exposed to cytostatic drugs

“…The lack of signi®cant dierences in SCE between exposed probands and controls observed in our study is in good accordance with recently published data (Lanza et al 1999, Kasuba et al 1999, and may be related to the use of protective equipment at work that is expected to determine the genotoxic impact of occupational exposure to anticancer drugs. For instance, Kevekordes et al (1998) found signi®cant increases of SCEs and MN frequencies in ten nurses who were considered to be exposed to high amounts of antineoplastic agents, after malfunction of a safety hood. Elevated levels were still observed 2 months later, but had decreased to control values after 9 months.…”