title: DNA and chromosomal damage in medical workers exposed to anaesthetic gases assessed by the lymphocyte cytokinesis-block micronucleus (CBMN) assay. A critical review.
abstract: The lymphocyte cytokinesis-block micronucleus (CBMN) assay has been applied in hundreds of in vivo biomonitoring studies of humans exposed either environmentally or occupationally to genotoxic chemicals. However, there is an emerging need to re-evaluate the use of MN and other biomarkers within the lymphocyte CBMN cytome assay as quantitative indicators of exposure to main classes of chemical genotoxins. The main aim of the present report is to systematically review published studies investigating the use of the lymphocyte CBMN assay to determine DNA damage in subjects exposed to anaesthetic gases. We also compared performance of the CBMN assay with other DNA damage assays employed and identified strengths and weaknesses of the published studies. We have retrieved 11 studies, published between 1996 and 2013, reporting MN associated with occupational exposures (operating room personnel). The individual job categories were often described (anaesthesiologists, technicians, radiologists) among cases, as well as duration of exposure. All studies reported the compounds present at the workplace and, in some instances, the exposure levels were measured. Controls were usually recruited among personnel at the hospital not exposed to anaesthetics or they were healthy unexposed subjects from general population. The number of investigated subjects, due to the character of the occupation, was relatively smaller than those investigated in other occupational monitoring settings. Overall, the majority of the studies were age- and gender- matched (or investigated only males or females) while less attention was given to lifestyle confounders. Appropriate measurement of exposure, available in approximately half of the studies only, was compromised by the lack of the personal dosimetry-based determinations. In all studies, higher MN frequencies were observed in exposed individuals. The meta-analysis of mean MN frequency of combined studies confirmed this tendency (log mean ratio=0.56 [0.34-0.77]; P=3.51×10-7). Similar differences between the exposed and controls were also observed for other biomarkers.
authors.affiliation: Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Videnska 1083, 142 00 Prague, Czech Republic; Institute of Biology and Medical Genetics, 1st Medical Faculty, Charles University, Albertov 4, 128 00 Prague, Czech Republic; Biomedical Centre, Faculty of Medicine in Pilsen, Charles University in Prague, 323 00 Pilsen, Czech Republic. Electronic address: pvodicka@biomed.cas.cz.
authors.forename: Pavel
authors.initials: P
authors.lastname: Vodicka
authors.affiliation: Clinic of Occupational Medicine and Toxicology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava and University Hospital Martin, Kollarova 2, 03601 Martin, Slovakia.
authors.forename: Ludovit
authors.initials: L
authors.lastname: Musak
authors.affiliation: Human Genetics Foundation (HuGeF) Turin, via Nizza 52, 10126 Turin, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fiorito
authors.affiliation: Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Videnska 1083, 142 00 Prague, Czech Republic; Institute of Biology and Medical Genetics, 1st Medical Faculty, Charles University, Albertov 4, 128 00 Prague, Czech Republic.
authors.forename: Veronika
authors.initials: V
authors.lastname: Vymetalkova
authors.affiliation: Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Videnska 1083, 142 00 Prague, Czech Republic; Institute of Biology and Medical Genetics, 1st Medical Faculty, Charles University, Albertov 4, 128 00 Prague, Czech Republic; Biomedical Centre, Faculty of Medicine in Pilsen, Charles University in Prague, 323 00 Pilsen, Czech Republic.
authors.forename: Ludmila
authors.initials: L
authors.lastname: Vodickova
authors.affiliation: Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Videnska 1083, 142 00 Prague, Czech Republic; Human Genetics Foundation (HuGeF) Turin, via Nizza 52, 10126 Turin, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Naccarati
mesh_terms: D018685:Anesthetics, Inhalation / Q000009:adverse effects*; D002869:Chromosome Aberrations; D048749:Cytokinesis; D006282:Health Personnel; D006801:Humans; D008214:Lymphocytes / Q000187:drug effects* / Q000648:ultrastructure; D016273:Occupational Exposure
chemical_list: D018685:Anesthetics, Inhalation
keywords: Anaesthetics gas exposure; Genotoxicity; Micronuclei; Operating room personnel