title: Genotoxic Monitoring of Nurses Handling Cytotoxic Drugs.
abstract: OBJECTIVE
  Several biomarkers may be used to detect harmful exposure and individual susceptibility to cancer. Monitoring of biomarkers related to exposure may have a significant effect on early detection of cell transformation, thereby aiding the primary prevention of various chronic and malignant diseases. Nurses who handle cytotoxic drugs are exposed to carcinogenic agents, which have the potential to interrupt the cell cycle and to induce chromosomal aberrations. The presence of high chromosomal aberrations indicates the need for intervention even when exposure to these carcinogens is low.
  
  
  METHODS
  Nationally representative samples of 552 nurses were investigated by a follow-up monitoring system. The measured biomarkers were clinical laboratory routine tests, completed with genotoxicological (chromosome aberrations [CAs] and sister chromatid exchanges [SCEs]) and immunotoxicological monitoring (ratio of lymphocyte subpopulations and lymphocyte activation markers) measured on peripheral blood lymphocytes. Results were compared to the data of 140 healthy, age-matched controls.
  
  
  RESULTS
  In nurses exposed to cytostatics, we observed a significantly increased frequency of CAs and SCEs compared with those in the controls. Cytostatic drug exposure also manifested itself in an increased frequency of helper T lymphocytes. Genotoxicological and immunotoxicological changes, as well as negative health effects (i.e., iron deficiency, anemia, and thyroid diseases), increased among cytostatic exposed subjects.
  
  
  CONCLUSIONS
  These results raised concerns about the protection of nursing staff from chemical carcinogens in the working environment.
authors.affiliation: Semmelweis University, Institute Public Health, Budapest, Hungary.
authors.forename: Anna
authors.initials: A
authors.lastname: Tompa
authors.affiliation: Department of Geno- and Immune-toxicology, National Public Health Center, National Directorate of Chemical Safety, Budapest, Hungary.
authors.forename: Anna
authors.initials: A
authors.lastname: Biró
authors.affiliation: Department of Geno- and Immune-toxicology, National Public Health Center, National Directorate of Chemical Safety, Budapest, Hungary.
authors.forename: Mátyás
authors.initials: M
authors.lastname: Jakab
keywords: Chromosome aberrations; cytostatics; genotoxicological monitoring; health status; immunotoxicology; risk assessment; sister chromatid exchange; unscheduled DNA synthesis