title: 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.
authors.affiliation: Toxicology Unit, Biology Division, Indian Institute of Chemical Technology, Hyderabad 500 007, Andhra Pradesh, India.
authors.forename: P V
authors.initials: PV
authors.lastname: Rekhadevi
authors.forename: N
authors.initials: N
authors.lastname: Sailaja
authors.forename: M
authors.initials: M
authors.lastname: Chandrasekhar
authors.forename: M
authors.initials: M
authors.lastname: Mahboob
authors.forename: M F
authors.initials: MF
authors.lastname: Rahman
authors.forename: Paramjit
authors.initials: P
authors.lastname: Grover
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000633:toxicity* / Q000652:urine; D015415:Biomarkers / Q000652:urine; D016022:Case-Control Studies; D020552:Comet Assay; D003520:Cyclophosphamide / Q000652:urine; D004247:DNA / Q000187:drug effects*; D004249:DNA Damage; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000187:drug effects; D048629:Micronuclei, Chromosome-Defective / Q000187:drug effects; D015162:Micronucleus Tests; D009061:Mouth Mucosa / Q000187:drug effects; D009152:Mutagenicity Tests; D009369:Neoplasms / Q000188:drug therapy / Q000451:nursing; D016273:Occupational Exposure; D009859:Oncology Nursing
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D003520:Cyclophosphamide; D004247:DNA