title: Micronuclei and chromosome aberrations in subjects occupationally exposed to antineoplastic drugs: a multicentric approach.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Pharmaceutical Sciences, University of Perugia, Via del Giochetto, 06122, Perugia, Italy, massimo.moretti@unipg.it.
authors.forename: Massimo
authors.initials: M
authors.lastname: Moretti
authors.forename: Maria Giuseppa
authors.initials: MG
authors.lastname: Grollino
authors.forename: Sofia
authors.initials: S
authors.lastname: Pavanello
authors.forename: Roberta
authors.initials: R
authors.lastname: Bonfiglioli
authors.forename: Milena
authors.initials: M
authors.lastname: Villarini
authors.forename: Massimo
authors.initials: M
authors.lastname: Appolloni
authors.forename: Mariella
authors.initials: M
authors.lastname: Carrieri
authors.forename: Laura
authors.initials: L
authors.lastname: Sabatini
authors.forename: Luca
authors.initials: L
authors.lastname: Dominici
authors.forename: Laura
authors.initials: L
authors.lastname: Stronati
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mastrangelo
authors.forename: Anna
authors.initials: A
authors.lastname: Barbieri
authors.forename: Cristina
authors.initials: C
authors.lastname: Fatigoni
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Bartolucci
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Ceretti
authors.forename: Francesca
authors.initials: F
authors.lastname: Mussi
authors.forename: Silvano
authors.initials: S
authors.lastname: Monarca
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000652:urine; D015415:Biomarkers / Q000652:urine; D002869:Chromosome Aberrations / Q000139:chemically induced*; D003520:Cyclophosphamide / Q000032:analysis; D004249:DNA Damage; D004784:Environmental Monitoring / Q000379:methods; D005260:Female; D006801:Humans; D007558:Italy; D008214:Lymphocytes / Q000187:drug effects; D048629:Micronuclei, Chromosome-Defective / Q000139:chemically induced*; D009741:Nursing Staff, Hospital; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D009859:Oncology Nursing
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D003520:Cyclophosphamide