Micronuclei and chromosome aberrations in subjects occupationally exposed to antineoplastic drugs: a multicentric approach

Moretti, Massimo; Grollino, Maria Giuseppa; Pavanello, Sofia; Bonfiglioli, Roberta; Villarini, Milena; Appolloni, Massimo; Carrieri, Mariella; Dominici, Luca; Stronati, Laura; Mastrangelo, Giuseppe; Barbieri, Anna; Fatigoni, Cristina; Bartolucci, Giovanni Battista; Ceretti, Elisabetta; Mussi, Francesca; Monarca, Silvano

doi:10.1007/s00420-014-0993-y

Cited by 42 publications

(29 citation statements)

References 62 publications

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“…Occupational exposure to antineoplastic agents has been recognized as a potential health hazard since the 1970s, when Falck et al ( showed an association between contact with antineoplastic drugs and increased urinary mutagenicity. Since then, a number of other studies have reported the toxic effects of anti‐cancer drugs on workers around the world (Villarini et al , ; Moretti et al , ).…”

Section: Introductionmentioning

confidence: 99%

Dispersive solid‐phase extraction procedure coupled to UPLC‐ESI‐MS/MS analysis for the simultaneous determination of thirteen cytotoxic drugs in human urine

Fabrizi

Fioretti

Rocca

2016

Biomedical Chromatography

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A fast and easy tailored dispersive solid-phase extraction (d-SPE) procedure has been developed for the determination of 13 cytostatic drugs. Combined with a rapid and simultaneous ultra performance liquid chromatography/tandem mass spectrometry method for residue identification and quantification in urine, it has been fully validated and tested to study a realistic situation in working environment. The target compounds were chosen from the most common classes used in hospitals. The d-SPE adsorbent was obtained mixing Oasis HLB® with C18 and applied to a large volume of sample (10 mL). The electrospray ionization-mass spectrometry acquisition was conducted in a mixed period mode: six acquisition windows were in positive ionization and one in negative (for 5-fluorouracil). The lowest limit of quantification was found at 0.04 μg/L urine for methotrexate. The absolute recovery of cytotoxic drugs was assessed at two concentrations levels and ranged from 67.1% (cytarabine) to 102.3% (etoposide) and from 65.3% (cytarabine) to 101.2% (methotrexate) for the lower and higher levels, respectively, with the relative standard deviation always <12%. This method gives the opportunity to analyze drugs in a wide molecular weight range (from 130 to 853 a.m.u.) and in a complex matrix, such as urine, without losing any of the features that a method intended for trace quantification must have. Copyright © 2016 John Wiley & Sons, Ltd.

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Section: Introductionmentioning

confidence: 99%

Dispersive solid‐phase extraction procedure coupled to UPLC‐ESI‐MS/MS analysis for the simultaneous determination of thirteen cytotoxic drugs in human urine

Fabrizi

Fioretti

Rocca

2016

Biomedical Chromatography

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“…We also have to draw attention to the widespread contamination of the patient toilet before and after drug handling started, as it puts family members at risk of exposure, making this a public health issue as well. These findings raise particular concern, because Moretti et al (13) showed in a recent study that handling cytotoxic drugs, even under controlled conditions, involves a considerable genotoxic risk (13).…”

Section: Figure 4 5-fu Contamination (Ng CM -2 ) Before and After Drumentioning

confidence: 99%

“…Even exposure to doses lower than those received by cancer patients can produce adverse health effects, especially in chronically exposed healthcare workers (13)(14)(15)(16). There have been reports of reproductive toxicity that can result in miscarriage, temporary or permanent infertility, preterm births, congenital malformations, and learning disabilities in the children of the exposed individuals (17,18).…”

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confidence: 99%

Occupational exposure to cytotoxic drugs: the importance of surface cleaning to prevent or minimise exposure

Viegas

Oliveira

Carolino

et al. 2018

Archives of Industrial Hygiene and Toxicology

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Healthcare workers who prepare or administer cytotoxic agents run the risk of exposure, and the risks for health are real even at doses lower than those applied in cancer patients, because, in theory, no dose is safe. The most common and problematic route of exposure is through the skin, especially as work surfaces can remain contaminated even after cleaning. This pilot study aimed to demonstrate the importance of having an effective surface decontamination protocol by determining surface contamination with cyclophosphamide, 5-fluorouracil, and paclitaxel as the most common cytotoxic drugs in an oncology day service. Samples were collected before and after drug handling and analysed with high performance liquid chromatography with diode array detection (HPLC-DAD). Of the 29 samples collected before drug handling 23 were contaminated, five of which with more than one drug. Of the 30 samples collected after drug handling 25 were contaminated, eight of which with more than one drug. The two time points did not significantly differ, which evidences a widespread contamination and ineffective cleaning. This calls for revising the cleaning protocol and handling procedure to place contamination under control as much as possible.

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“…Numerous seminal studies have shown that exposure to antineoplastic medications can result in serious reproductive side effects, such as menstrual abnormalities, infertility, spontaneous abortions, and learning disabilities in the offspring of health care workers who have been exposed . More recent research also has shown that repeated exposure can result in DNA mutations and secondary malignancies . Although it may seem counterintuitive that medications used to treat cancer can also be oncogenic, disruption of DNA is the most common mechanism of action for antineoplastic chemotherapy, which can lead to mutations in healthy cells and result in clonal abnormalities and eventual cancer development…”

Section: Risks Associated With Hd Exposurementioning

confidence: 99%

Applying Hazardous Drug Standards to Antineoplastics Used for Ophthalmology Surgery

Eisenberg¹,

Pacheco²

2018

AORN Journal

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Micronuclei and chromosome aberrations in subjects occupationally exposed to antineoplastic drugs: a multicentric approach

Abstract: Because both MN and CA have been described as being predictive of group-increased cancer risk, our findings point to a need for improving specific safety procedures in handling and administering ANPD.

Cited by 42 publications

References 62 publications

Dispersive solid‐phase extraction procedure coupled to UPLC‐ESI‐MS/MS analysis for the simultaneous determination of thirteen cytotoxic drugs in human urine

Dispersive solid‐phase extraction procedure coupled to UPLC‐ESI‐MS/MS analysis for the simultaneous determination of thirteen cytotoxic drugs in human urine

Occupational exposure to cytotoxic drugs: the importance of surface cleaning to prevent or minimise exposure

Applying Hazardous Drug Standards to Antineoplastics Used for Ophthalmology Surgery

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