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

• Published in: International archives of occupational and environmental health Vol. 88; no. 6; pp. 683 - 695
• Main Authors: Moretti, Massimo, Grollino, Maria Giuseppa, Pavanello, Sofia, Bonfiglioli, Roberta, Villarini, Milena, Appolloni, Massimo, Carrieri, Mariella, Sabatini, Laura, Dominici, Luca, Stronati, Laura, Mastrangelo, Giuseppe, Barbieri, Anna, Fatigoni, Cristina, Bartolucci, Giovanni Battista, Ceretti, Elisabetta, Mussi, Francesca, Monarca, Silvano
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2015; Springer Nature B.V
• Subjects: Adult; Antineoplastic Agents - adverse effects; Antineoplastic Agents - urine; Antineoplastic drugs; Biological effects; Biomarkers - urine; Biomonitoring; Chromosome aberrations; Chromosome Aberrations - chemically induced; Cyclophosphamide - analysis; Detoxification; DNA Damage; Drugs; Earth and Environmental Science; Environment; Environmental Health; Environmental Monitoring - methods; Female; Health risks; Hospitals; Humans; Italy; Lymphocytes; Lymphocytes - drug effects; Micronuclei, Chromosome-Defective - chemically induced; Nurses; Nursing Staff, Hospital; Occupational exposure; Occupational Exposure - adverse effects; Occupational Exposure - analysis; Occupational hazards; Occupational health; Occupational Medicine/Industrial Medicine; Oncology Nursing; Original Article; Rehabilitation; Safety; Italy; MED, Italy; Antineoplastic drugs; Genotoxic hazard; Micronuclei; and; Occupational exposure; polymorphisms; Chromosome aberrations
• ISSN: 0340-0131; 1432-1246; 1432-1246
• DOI: 10.1007/s00420-014-0993-y

Objectives Recently published works showed that occupational exposure to antineoplastic drugs (ANPD) is still frequent in hospital settings, despite significant safety policy improvements. The aim of this study was to assess the current level of occupational exposure to ANPD and any potentially associated cytogenetic damages in hospital nurses routinely handling ANPD. Methods Occupationally ANPD-exposed ( n  = 71) and ANPD-unexposed ( n  = 77; control) nurses were recruited on a voluntary basis from five hospitals in Northern and Central Italy. Evaluation of surface contamination and dermal exposure to ANPD was assessed by determining cyclophosphamide (CP) on selected surfaces (wipes) and on exposed nurses’ clothes (pads). The concentration of unmetabolized CP—as a biomarker of internal dose—was measured in end-shift urine samples. Biomonitoring of genotoxic effects (i.e., biological effect monitoring) was conducted by analyzing micronuclei (MN) and chromosome aberrations (CA) in peripheral blood lymphocytes. Genetic polymorphisms for enzymes involved in metabolic detoxification (i.e., glutathione S -transferases) were analyzed as well. Results We observed a significant increase in MN frequency (5.30 ± 2.99 and 3.29 ± 1.97; mean values ± standard deviation; p  < 0.0001) in exposed nurses versus controls, as well as in CA detection (3.30 ± 2.05 and 1.84 ± 1.67; p  < 0.0001), exposed subjects versus controls. Our results provide evidence that, despite safety controlled conditions, ANPD handling still represents a considerable genotoxic risk for occupationally exposed personnel. Conclusions 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.