Assessment of primary, oxidative and excision repaired DNA damage in hospital personnel handling antineoplastic drugs.
The International Agency for Research on Cancer has classified several antineoplastic drugs in Group 1 (human carcinogens), among which chlorambucil, cyclophosphamide (CP) and tamoxifen, Group 2A (probable human carcinogens), among which cisplatin, etoposide, N-ethyl- and N-methyl-N-nitrosourea, and Group 2B (possible human carcinogens), among which bleomycins, merphalan and mitomycin C. The widespread use of these mutagenic/carcinogenic drugs in the treatment of cancer has led to anxiety about possible genotoxic hazards to medical personnel handling these drugs. The aim of the present study was to evaluate work environment contamination by antineoplastic drugs in a hospital in Central Italy and to assess the genotoxic risks associated with antineoplastic drug handling. The study group comprised 52 exposed subjects and 52 controls. Environmental contamination was assessed by taking wipe samples from different surfaces in preparation and administration rooms and nonwoven swabs were used as pads for the surrogate evaluation of dermal exposure, 5-fluorouracil and cytarabine were chosen as markers of exposure to antineoplastic drugs in the working environment. The actual exposure to antineoplastic drugs was evaluated by determining the urinary excretion of CP. The extent of primary, oxidative and excision repaired DNA damage was measured in peripheral blood leukocytes with the alkaline comet assay. To evaluate the role, if any, of genetic variants in the extent of genotoxic effects related to antineoplastic drug occupational exposure, the study subjects were genotyped for GSTM1, GSTT1, GSTP1 and TP53 polymorphisms. Primary DNA damage significantly increased in leukocytes of exposed nurses compared to controls. The use of personal protective equipment (i.e. gloves and/mask) was associated with a decrease in the extent of primary DNA damage.
Department of Medical-Surgical Specialties and Public Health University of Perugia, Via del Giochetto, 06122 Perugia, Italy.
Milena
M
Villarini
Luca
L
Dominici
Renza
R
Piccinini
Cristina
C
Fatigoni
Maura
M
Ambrogi
Gianluca
G
Curti
Piero
P
Morucci
Giacomo
G
Muzi
Silvano
S
Monarca
Massimo
M
Moretti
D000970:Antineoplastic Agents / Q000032:analysis* / Q000633:toxicity*; D002173:Cancer Care Facilities; D020552:Comet Assay; D003561:Cytarabine / Q000032:analysis / Q000652:urine; D004249:DNA Damage / Q000235:genetics*; D005472:Fluorouracil / Q000032:analysis; D005838:Genotype; D051549:Glutathione S-Transferase pi / Q000235:genetics; D005982:Glutathione Transferase / Q000235:genetics; D006801:Humans; D007558:Italy; D009741:Nursing Staff, Hospital; D016273:Occupational Exposure / Q000032:analysis* / Q000706:statistics & numerical data; D012150:Polymorphism, Restriction Fragment Length; D012044:Regression Analysis; D018709:Statistics, Nonparametric; D016159:Tumor Suppressor Protein p53 / Q000235:genetics
D000970:Antineoplastic Agents; D003561:Cytarabine; D005472:Fluorouracil; D051549:Glutathione S-Transferase pi; D005982:Glutathione Transferase; D016159:Tumor Suppressor Protein p53; C495901:TP53 protein, human; C413545:glutathione S-transferase T1; C496556:GSTP1 protein, human