Multicentre study for the evaluation of mutagenic/carcinogenic risk in nurses exposed to antineoplastic drugs: assessment of DNA damage

Occup Environ Med. 2013 Nov;70(11):789-94. doi: 10.1136/oemed-2013-101475. Epub 2013 Aug 16.

Abstract

Objectives: People who handle antineoplastic drugs, many of which classified as human carcinogens by International Agency for Research on Cancer, are exposed to low doses in comparison with patients; however, the long duration of exposure could lead to health effects. The aim of this work was to evaluate DNA damage in white blood cells from 63 nurses who handle antineoplastic drugs in five Italian hospitals and 74 control participants, using different versions of the Comet assay.

Methods: Primary DNA damage was assessed by using the alkaline version of the assay on leucocytes, whereas to detect DNA oxidative damage and cryptic lesions specifically, the Comet/ENDO III assay and the Comet/araC assay were performed on leucocytes and lymphocytes, respectively.

Results: In the present study, no significant DNA damage was correlated with the work shift. The exposed population did not differ significantly from the reference group with respect to DNA primary and oxidative damage in leucocytes. Strikingly, in isolated lymphocytes treated with araC, lower data dispersion as well as a significantly lower mean value for the percentage of DNA in the comet tail was observed in exposed participants as compared with the control group (p<0.05), suggesting a potential chronic exposure to crosslinking antineoplastic drugs.

Conclusions: Although stringent rules were adopted at national and international levels to prevent occupational exposure to antineoplastic drugs, data reported in this study support the idea that a more efficient survey on long-lasting exposures at very low concentrations is needed.

Keywords: Antineoplastic drugs; Comet assay; Occupational exposure.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents / toxicity*
  • Carcinogens*
  • Case-Control Studies
  • Comet Assay
  • Cytarabine / pharmacology
  • DNA Damage*
  • DNA*
  • Female
  • Hospitals*
  • Humans
  • Leukocytes
  • Lymphocytes
  • Mutagens*
  • Nurses*
  • Occupational Diseases / genetics
  • Occupational Exposure / adverse effects*
  • Occupational Exposure / analysis
  • Oxidative Stress
  • Risk Assessment
  • Work

Substances

  • Antineoplastic Agents
  • Carcinogens
  • Mutagens
  • Cytarabine
  • DNA