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Sessink PJ, Tans B, Spriet I, Devolder D. Longitudinal evaluation of environmental contamination with hazardous drugs by surface wipe sampling. J Oncol Pharm Pract 2023:10781552231205481. [PMID: 38115732 DOI: 10.1177/10781552231205481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Exposure of healthcare workers to hazardous drugs can lead to adverse health effects supporting the importance of a continuous monitoring program, for example, by taking surface wipe samples. The objective was to describe the results of repeated monitoring of contamination with hazardous drugs on multiple surfaces in a hospital pharmacy and at two wards using standardized preparation techniques and cleaning procedures. METHODS Twelve surfaces in the hospital pharmacy and at two wards were sampled and analyzed for contamination with the hazardous drugs cyclophosphamide, doxorubicin, 5-fluorouracil, gemcitabine, methotrexate, and paclitaxel. The drugs were prepared with a closed-system drug transfer device (CSTD). Sampling of the drugs was performed in four trials during eight months. Liquid chromatography tandem mass spectrometry was used for the analysis of the drugs. RESULTS During the four trials, contamination with five of the six hazardous drugs was found on half of the surfaces in the pharmacy and in a ward. Seventeen out of 288 possible outcomes were positive (6%), with the biological safety cabinet grate (n = 6) and scanner (n = 5) most frequently contaminated. The highest level of contamination was observed on the pass-thru window (cyclophosphamide: 2.90 ng/cm2) and the touch screen of the Diana device (5-fluorouracil: 2.38 ng/cm2). Both levels were below the action level of 10 ng/cm2. CONCLUSIONS The long-term use of a CSTD in combination with appropriate cleaning has proven effective in achieving low levels of surface contamination with hazardous drugs.
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Affiliation(s)
| | - Birgit Tans
- Pharmacy Department, University Hospitals Leuven, Leuven, Belgium
| | - Isabel Spriet
- Pharmacy Department, University Hospitals Leuven, Leuven, Belgium
| | - David Devolder
- Pharmacy Department, University Hospitals Leuven, Leuven, Belgium
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Ndaw S, Remy A. Occupational Exposure to Antineoplastic Drugs in Twelve French Health Care Setting: Biological Monitoring and Surface Contamination. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4952. [PMID: 36981860 PMCID: PMC10049707 DOI: 10.3390/ijerph20064952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
Antineoplastic drugs used in the treatment of cancers have an intrinsic toxicity, because of their genotoxic, teratogenic, and carcinogenic properties. Their use is recognized as an occupational hazard for healthcare workers (HCWs) who may be exposed. The purpose of this article is to present biological- and environmental-monitoring data collected in twelve French hospitals over eight years. Urine samples were collected from a wide range of HCWs (250 participants) from pharmacy and oncology units, including physicians, pharmacists, pharmacy technicians, nurses, auxiliary nurses, and cleaners. The investigated drugs were cyclophosphamide, ifosfamide, methotrexate, and α-fluoro-β-alanine, the main urinary metabolite of 5-fluorouracil. Wipe samples were collected from various locations in pharmacy and oncology units. More than 50% of participants, from all exposure groups, were contaminated with either drug, depending on the unit, the day, or the task performed. However, workers from oncology units were more frequently exposed than workers from pharmacy units. Significant contamination was detected on various surfaces in pharmacy and oncology units, highlighting potential sources of exposure. Risk-management measures should be implemented to reduce and maintain exposures at lowest-possible levels. In addition, regular exposure assessment, including biological and environmental monitoring, is recommended to ensure the long-term efficiency of the prevention measures.
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Kim S, Park S, Oh JH, Lee SS, Lee Y, Choi J. MicroRNA-18a regulates the metastatic properties of oral squamous cell carcinoma cells via HIF-1α expression. BMC Oral Health 2022; 22:378. [PMID: 36064348 PMCID: PMC9442921 DOI: 10.1186/s12903-022-02425-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/31/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Rapid metastasis of oral squamous cell carcinoma (OSCC) is associated with a poor prognosis and a high mortality rate. However, the molecular mechanisms underlying OSCC metastasis have not been fully elucidated. Although deregulated expression of microRNA (miRNA) has a crucial role in malignant cancer progression, the biological function of miRNA in OSCC progression remains unclear. This study aimed to investigate the function of miRNA-18a in OSCC metastatic regulation via hypoxia-inducible factor 1α (HIF-1α). METHODS miRNA-18a-5p (miRNA-18a) expressions in patients with OSCC (n = 39) and in OSCC cell lines (e.g., YD-10B and HSC-2 cells) were analyzed using quantitative real-time polymerase chain reaction. HIF-1α protein expressions in OSCC cells treated with miRNA-18a mimics or combined with cobalt chloride were analyzed using western blotting. The miRNA-18a expression-dependent proliferation and invasion abilities of OSCC cells were analyzed using MTT assay, EdU assay, and a Transwell® insert system. RESULTS miRNA-18a expression was significantly lower in OSCC tissue than in the adjacent normal tissue. In OSCC cell lines, HIF-1α expression was significantly decreased by miRNA-18a mimic treatment. Furthermore, the migration and invasion abilities of OSCC cells were significantly decreased by miRNA-18a mimics and significantly increased by the overexpression of HIF-1α under hypoxic conditions relative to those abilities in cells treated only with miRNA-18a mimics. CONCLUSIONS miRNA-18a negatively affects HIF-1α expression and inhibits the metastasis of OSCC, thereby suggesting its potential as a therapeutic target for antimetastatic strategies in OSCC.
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Affiliation(s)
- Shihyun Kim
- Department of Oral Pathology, College of Dentistry, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung-si, Gangwon-do, Republic of Korea
| | - Suyeon Park
- Department of Oral Pathology, College of Dentistry, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung-si, Gangwon-do, Republic of Korea
| | - Ji-Hyeon Oh
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, Republic of Korea
| | - Sang Shin Lee
- Department of Oral Pathology, College of Dentistry, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung-si, Gangwon-do, Republic of Korea
| | - Yoon Lee
- Department of Conservative Dentistry, College of Dentistry, Gangneung-Wonju National University, Gangneung, Republic of Korea
| | - Jongho Choi
- Department of Oral Pathology, College of Dentistry, Gangneung-Wonju National University, 7 Jukheon-gil, Gangneung-si, Gangwon-do, Republic of Korea.
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Verscheure E, Creta M, Vanneste D, Vanoirbeek J, Zakia M, Abdesselam T, Lebegge R, Poels K, Ghosh M, Duca RC, Godderis L. Quantification of three antineoplastic agents in urine using the UniSpray ionisation source. J Chromatogr B Analyt Technol Biomed Life Sci 2022; 1205:123331. [PMID: 35752139 DOI: 10.1016/j.jchromb.2022.123331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/27/2022] [Accepted: 06/06/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Many guidelines and safety measures led to a decrease in exposure to antineoplastic agents. Since healthcare workers are often exposed to lower concentrations than patients, a sensitive method is needed to quantify occupational exposure. OBJECTIVE The aim of this study was to develop and validate a sensitive method for simultaneous detection and quantification of cyclophosphamide, ifosfamide and paclitaxel in urine by use of UPLC-MS/MS with a UniSpray ionisation source. METHODS Compounds were extracted from urine using Novum simplified liquid extraction cartridges, separated on a C18 column, ionised by a UniSpray ionisation source and detected with MS/MS. In the second part of the study, a field study was performed to assess occupational exposure to antineoplastic agents. RESULTS Eighty-three samples from healthcare workers were analysed and resulted in seventeen samples containing quantifiable concentrations of at least one compound. In conclusion, a sensitive method for simultaneous detection and quantification of cyclophosphamide (LLOQ 0.05 ng/mL), ifosfamide (LLOQ 0.3 ng/mL) and paclitaxel (LLOQ 0.7 ng/mL) was developed and validated.
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Affiliation(s)
- Eline Verscheure
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Matteo Creta
- Unit Environmental Hygiene and Human Biological Monitoring, Department of Health Protection, Laboratoire National de Santé (LNS), Dudelange, Luxembourg
| | - Dorian Vanneste
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Jeroen Vanoirbeek
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Meziane Zakia
- Centre Hospitalo-universitaire, Service Médicine du Travail, Université Abou Bekr Belkaid Tlemcen, Tlemcen, Algeria; Faculty of Medicine, TOXICOMED Research Laboratory, Université Abou Bekr Belkaid Tlemcen, Tlemcen, Algeria
| | - Taleb Abdesselam
- Centre Hospitalo-universitaire, Service Médicine du Travail, Université Abou Bekr Belkaid Tlemcen, Tlemcen, Algeria; Faculty of Medicine, TOXICOMED Research Laboratory, Université Abou Bekr Belkaid Tlemcen, Tlemcen, Algeria
| | - Robin Lebegge
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Katrien Poels
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Manosij Ghosh
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Radu-Corneliu Duca
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; Unit Environmental Hygiene and Human Biological Monitoring, Department of Health Protection, Laboratoire National de Santé (LNS), Dudelange, Luxembourg
| | - Lode Godderis
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium; Idewe, External Service for Prevention and Protection at Work, Heverlee, Belgium.
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Nurses' internal contamination by antineoplastic drugs in hospital centers: a cross-sectional descriptive study. Int Arch Occup Environ Health 2021; 94:1839-1850. [PMID: 34021808 DOI: 10.1007/s00420-021-01706-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/09/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to assess internal antineoplastic drugs (ADs) contamination in the nursing staff in French hospital centers, using highly sensitive analytical methods. METHODS This cross-sectional study included nurses practicing in care departments where at least one of the five ADs studied was handled (5-fluorouracil, cyclophosphamide, doxorubicin, ifosfamide, methotrexate). The nurses study participation lasted 24 h including collection of three urine samples and one self-questionnaire. All urine samples were assayed by ultra-high-performance liquid chromatography-tandem mass spectrometry methods with very low value of the lower limit of quantification (LLOQ). RESULTS 74 nurses were included, 222 urine samples and 74 self-questionnaires were collected; 1092 urine assays were performed. The percentage of nurses with internal AD contamination was 60.8% and low levels of urinary concentrations were measured. Regarding nurses with internal contamination (n = 45), 42.2% presented internal contamination by methotrexate, 37.8% by cyclophosphamide, 33.3% by ifosfamide, 17.8% by 5-fluorouracil metabolite and 6.7% by doxorubicine. Among the positive assays, 17.9% (n = 26/145) were not explained by exposure data from the self-questionnaire but this could be due to the skin contact of nurses with contaminated work surfaces. CONCLUSIONS This study reported high percentage of nurses with internal ADs contamination. The low LLOQ values of the used analytical methods, allowed the detection of ADs that would not have been detected with the current published methods: the percentage of contamination would have been 17.6% instead of the 60.8% reported here. Pending toxicological reference values, urine ADs concentrations should be reduced as low as reasonably achievable (ALARA principle).
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Semail NF, Abdul Keyon AS, Saad B, Noordin SS, Nik Mohamed Kamal NNS, Mohamad Zain NN, Azizi J, Kamaruzaman S, Yahaya N. Analytical method development and validation of anticancer agent, 5-fluorouracil, and its metabolites in biological matrices: An updated review. J LIQ CHROMATOGR R T 2020. [DOI: 10.1080/10826076.2020.1781654] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Nadhiratul-Farihin Semail
- Integrative and Regenerative Medicine Clusters, Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia, Kepala Batas, Penang, Malaysia
| | - Aemi Syazwani Abdul Keyon
- Department of Chemistry, Faculty of Science, Universiti Teknologi Malaysia, Johor Bahru, Johor, Malaysia
- Centre for Sustainable Nanomaterials, Ibnu Sina Institute for Scientific and industrial Research, Universiti Teknologi Malaysia, Johor Bahru, Johor, Malaysia
| | - Bahruddin Saad
- Fundamental and Applied Science Department, Universiti Technologi Petronas, Seri Iskandar, Perak Darul Ridzuan, Malaysia
| | - Siti Salmah Noordin
- Integrative and Regenerative Medicine Clusters, Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia, Kepala Batas, Penang, Malaysia
| | - Nik Nur Syazni Nik Mohamed Kamal
- Integrative and Regenerative Medicine Clusters, Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia, Kepala Batas, Penang, Malaysia
| | - Nur Nadhirah Mohamad Zain
- Integrative and Regenerative Medicine Clusters, Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia, Kepala Batas, Penang, Malaysia
| | - Juzaili Azizi
- Centre for Drug Research, Universiti Sains Malaysia, Minden, Penang, Malaysia
| | - Sazlinda Kamaruzaman
- Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, Serdang, Selangor Darul Ehsan, Malaysia
| | - Noorfatimah Yahaya
- Integrative and Regenerative Medicine Clusters, Advanced Medical and Dental Institute (AMDI), Universiti Sains Malaysia, Kepala Batas, Penang, Malaysia
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Gupta S, Das D, Mitra PK, Halder S, Datta AK. Assessment of Cytotoxicity Induced by Hazardous Chemotherapeutic Drugs Cyclophosphamide and 5-Fluorouracil in Allium cepa Assay for Ecological Safety. CYTOLOGIA 2020. [DOI: 10.1508/cytologia.85.151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Marler-Hausen T, Holt C, Headley C, Sessink P. Use of a closed-system drug transfer device reduces contamination with doxorubicin during bolus injection. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2020; 29:S15-S21. [PMID: 32463759 DOI: 10.12968/bjon.2020.29.10.s15] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Administration of doxorubicin via bolus injection may result in environmental contamination and a risk of nurses becoming exposed. Small spills are frequently observed by nurses when syringes are connected to, and disconnected from, infusion lines. AIMS The effect of a closed-system drug transfer device (CSTD) on the release of doxorubicin was studied during administration via bolus injections. METHODS 10 administrations with the currently used technique and 10 administrations using the CSTD were compared by analysis of doxorubicin contamination on gauze pads, tissues and gloves. FINDINGS Using the current technique, contamination was found during nine administrations, which was mainly on the gauze pads and, to a lesser extent, on the tissues and gloves, indicating release of doxorubicin during administration. With use of the CSTD, contamination was found only on one pair of gloves. CONCLUSION Use of a CSTD significantly decreased the number of spills and level of contamination compared with the currently used technique and, consequently, the use of such devices offers a safer working environment for nurses.
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Affiliation(s)
| | - Chris Holt
- Pharmacy Quality Assurance Lead, University College London Hospital
| | - Christine Headley
- Sister, Teenage and Young Adult Day Care, University College London Hospital
| | - Paul Sessink
- Chemist and Managing Director, Exposure Control Sweden, Bohus-Björkö, Sweden
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Occupational Exposure in Health Care Personnel to Antineoplastic Drugs and Initiation of Safe Handling in Hong Kong: A Literature Review. JOURNAL OF INFUSION NURSING 2020; 43:121-133. [PMID: 32287167 DOI: 10.1097/nan.0000000000000361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Despite the benefits for patients as cancer treatment, antineoplastic drugs may cause adverse effects not only in patients but also in health care personnel. Apart from minor symptoms, antineoplastic agents can cause serious health problems. However, protection from occupational exposures to antineoplastic drugs varies between pharmacy staff and nurses. While protection used for pharmacy staff are more advanced, personal protective equipment seems to be the only protection for most nurses around the world. Exposure can never be totally prevented, but it should be minimized at all costs. Guidelines and recommendations have been published; however, these guidelines do not have legal enforcement power. This article aims to provide a literature review on the occupational exposure of health care personnel to antineoplastic drugs and to reflect the current status in Hong Kong.
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Palamini M, Dufour A, Therrien R, Delisle JF, Mercier G, Gagné S, Caron N, Bussières JF. Quantification of healthcare workers' exposure to cyclophosphamide, ifosfamide, methotrexate, and 5-fluorouracil by 24-h urine assay: A descriptive pilot study. J Oncol Pharm Pract 2020; 26:1864-1870. [PMID: 32138611 DOI: 10.1177/1078155220907129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The objective of this pilot study was to determine the frequency of urination and the concentration of four hazardous drugs (cyclophosphamide, ifosfamide, methotrexate, and fluorouracil) in workers' 24-h urine samples in relation to exposure to traces with hazardous drugs. METHODS The study was conducted in three healthcare centers in the region of Montréal, Quebec, Canada. We recruited healthcare workers (nurses and pharmacy technicians) assigned to the hematology-oncology department. Each participant was asked to collect all urine voided during a 24-h period, to fill out an activity journal documenting tasks performed and to document the use of personal protective equipment. Samples were analyzed for cyclophosphamide, ifosfamide, methotrexate, and alpha-fluoro-beta-alanine (FBAL, the main urinary metabolite of 5-fluorouracil). Drugs were quantified by ultra-performance liquid chromatography-tandem mass spectrometry (positive electrospray MRM mode). RESULTS Eighteen healthcare workers (10 nurses and 8 technicians) were recruited and provided consent to participate. Urine samples were obtained between 1 September and 30 September 2019. The number of urinations over the 24-h collection period ranged from 3 to 11 per participant. A total of 128 urine samples were analyzed for the 18 workers. All urine samples were negative for the four antineoplastics tested. CONCLUSION No traces of cyclophosphamide, ifosfamide, methotrexate, or FBAL were found in the 24-h urine samples of 18 healthcare workers practicing in three healthcare facilities in Quebec. Although it was feasible to collect 24-h urine samples in this research project, it appears unrealistic to do so recurrently as part of a large-scale surveillance program.
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Affiliation(s)
- Marie Palamini
- Unité de Recherche en Pratique Pharmaceutique, Département de Pharmacie, CHU Sainte-Justine, Montréal, Canada
| | - Annick Dufour
- Département de Pharmacie, CISSS de la Montérégie-Centre, Québec, Canada
| | | | - Jean-François Delisle
- Unité de Recherche en Pratique Pharmaceutique, Département de Pharmacie, CHU Sainte-Justine, Montréal, Canada
| | - Geneviève Mercier
- Direction des Soins Infirmiers, CHU Sainte-Justine, Montréal, Canada
| | - Sébastien Gagné
- Centre de Toxicologie du Québec, Institut National de Santé Publique du Québec, Québec, Canada
| | - Nicolas Caron
- Centre de Toxicologie du Québec, Institut National de Santé Publique du Québec, Québec, Canada
| | - Jean-François Bussières
- Unité de Recherche en Pratique Pharmaceutique, Département de Pharmacie, CHU Sainte-Justine, Montréal, Canada.,Faculté de Pharmacie, Université de Montréal, Montréal, Canada
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Shu P, Zhao T, Wen B, Mendelsohn-Victor K, Sun D, Friese CR, Pai MP. Application of an innovative high-throughput liquid chromatography-tandem mass spectrometry method for simultaneous analysis of 18 hazardous drugs to rule out accidental acute chemotherapy exposures in health care workers. J Oncol Pharm Pract 2019; 26:794-802. [PMID: 31483750 DOI: 10.1177/1078155219870591] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Despite safe handling guidelines published by several groups, health care worker exposure to hazardous drugs continues to occur due to suboptimal engineering controls and low use of protective equipment. Simple, multi-target and specific analytical methods are needed so that acute exposures to these drugs in the workplace can be assessed rapidly. Our aim was to develop an analytical method for simultaneous detection and quantification of widely used cancer drugs to rule out accidental acute chemotherapy exposures in health care workers. METHODS We examined the feasibility of alternate high-performance liquid chromatographic-tandem mass spectrometry methods to simultaneously detect eighteen chemotherapy analytes in plasma and urine. The linear concentration ranges tested during assay development were 0.1-50 ng/mL. After development of a multi-analyte assay protocol, plasma samples (n = 743) from a multi-center cluster-randomized clinical trial (n = 12 sites) of an hazardous drug educational intervention were assayed. Confirmatory assays were performed based on the individual acute-spill case-histories. RESULTS An innovative HPLC-multiple reaction monitoring-information dependent acquisition-enhanced production ion (MRM-IDA-EPI) analytical method was developed to simultaneously detect: cytarabine, gemcitabine, dacarbazine, methotrexate, topotecan, mitomycin, pemetrexed, irinotecan, doxorubicin, vincristine, vinblastine, ifosamide, cyclophosphamide, vinorelbine, bendamustine, etoposide, docetaxel, and paclitaxel. The retention times ranged from 4 min to 13 min for the analytical run. The limit of detection (MRM-IDA-EPI) and limit of quantitation (MRM) was 0.25 ng/mL and 0.1 ng/mL, respectively for most analytes. No detectable plasma concentrations were measured at baseline, post-intervention and in cases of documented acute spills. Use of a secondary tandem mass spectrometry approach was able to successfully rule out false positive results. CONCLUSIONS Development of a sensitive high-throughput multi-analyte cancer chemotherapy assay is feasible using an MRM-IDA-EPI method. This method can be used to rapidly rule out systemic exposure to accidental acute chemotherapy spills in health care workers.
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Affiliation(s)
- Pan Shu
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, Ann Arbor, MI, USA
| | - Ting Zhao
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, Ann Arbor, MI, USA
| | - Bo Wen
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, Ann Arbor, MI, USA
| | | | - Duxin Sun
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, Ann Arbor, MI, USA
| | | | - Manjunath P Pai
- Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, MI, USA
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Tanguay C, Bussières JF. A response to the letter to the editor on Biomonitoring great, but do it the right way! Re: Poupeau et al. Pilot study of biological monitoring of four antineoplastic drugs among Canadian healthcare workers. J Oncol Pharm Pract 2019; 25:252-253. [DOI: 10.1177/1078155218761801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- C Tanguay
- Département de Pharmacie, Unité de Recherche en Pratique Pharmaceutique, CHU Sainte-Justine, Montréal, Québec, Canada
| | - JF Bussières
- Département de Pharmacie, Unité de Recherche en Pratique Pharmaceutique, CHU Sainte-Justine, Montréal, Québec, Canada
- Faculté de Pharmacie, Université de Montréal, Montréal, Québec, Canada
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Wang Z, Yang Y, Zhang F, Li M, Chen J, Man H, Jiang W, Zhang R, Gao S, Chen W. A direct, sensitive and efficient method for determination of alpha-fluoro-beta-alanine in urine: Evaluating the influence of magnesium isoglycyrrhizinate on excretion in rat model. J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1102-1103:17-22. [PMID: 30366208 DOI: 10.1016/j.jchromb.2018.10.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 10/09/2018] [Accepted: 10/17/2018] [Indexed: 12/11/2022]
Abstract
Alpha-fluoro-beta-alanine (FBAL), the final metabolite of capecitabine, is a toxic compound excreting with urine. Magnesium isoglycyrrhizinate injection is a traditional Chinese medicine prescribed with capecitabine as a hepatoprotective agent. The purposes of this study are to develop an ultra-high performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) method for direct, efficient and sensitive determination of FBAL in urine and explore the influence of magnesium isoglycyrrhizinate on the excretion of FBAL in rat model. The method development and validation were successfully achieved. The run time was 3 min based on an HILIC column and linear range was 0.02-10.00 μg/mL. The mass detection was completed using electrospray ionization in positive ionization mode with a multiple reaction monitoring mode. A simplified sample pretreatment procedure was performed by direct dilution using 50% acetonitrile aqueous solution with the matrix effect range 48.98%-52.10% and the recovery range 78.68%-83.28%. The intra-day and inter-day precision and accuracy were <11% and within ±6%, and the stability, specificity, carry-over, dilution effect and linearity all conformed to the criterions. This study presented preliminary results that the influence of magnesium isoglycyrrhizinate on the excretion of FBAL was insignificant in rats based on this new developed method.
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Affiliation(s)
- Zhipeng Wang
- Department of Pharmacy, Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
| | - Yang Yang
- Department of Pharmacy, Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
| | - Feng Zhang
- Department of Pharmacy, Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
| | - Mingming Li
- Department of Pharmacy, Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
| | - Jing Chen
- School of Chemistry and Biology, Yichun College, Yichun City, Jiangxi Province 336000, PR China
| | - Huan Man
- School of Chemistry and Biology, Yichun College, Yichun City, Jiangxi Province 336000, PR China
| | - Wei Jiang
- Department of Pharmacy, Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China
| | - Rui Zhang
- School of Chemistry and Biology, Yichun College, Yichun City, Jiangxi Province 336000, PR China
| | - Shouhong Gao
- Department of Pharmacy, Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China.
| | - Wansheng Chen
- Department of Pharmacy, Changzheng Hospital, Second Military Medical University, Shanghai 200003, PR China.
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Sottani C, Grignani E, Zaratin L, Santorelli D, Studioso E, Lonati D, Locatelli CA, Pastoris O, Negri S, Cottica D. A new, sensitive and versatile assay for quantitative determination of α-fluoro-β-alanine (AFBA) in human urine by using the reversed-phase ultrahigh performance-tandem mass spectrometry (rp-UHPLC-MS/MS) system. Toxicol Lett 2018; 298:164-170. [PMID: 30315949 DOI: 10.1016/j.toxlet.2018.10.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 09/25/2018] [Accepted: 10/08/2018] [Indexed: 11/26/2022]
Abstract
A method for the quantitation of α-fluoro-β-alanine (AFBA), the main metabolite of capecitabine (Cape) and 5-fluoruracil (5-FU), is described. Among antineoplastic drugs (ADs), 5-FU and Cape (the new oral prodrug) are the most commonly applied drugs in cancer therapy. The main objective of this study was to develop a reliable method that would be easy to run on a reversed-phase UHPLC system coupled to tandem mass spectrometry. AFBA was derivatized with Sanger's reagent to ensure complete yield of a stable 2,4 dinitrophenil-α-fluoro-β-alanine derivative. This method was based on the use of a mixed-mode anion exchange solid phase extraction enabling urinary extracts to be clear of endogenous interferences affecting quantitative results. The assay was validated in human urine according to FDA criteria with the use of a labeled internal standard (β-alanine-d4) to minimize experimental error. Good accuracy and precision were demonstrated by determining spiked urine QC samples in four consecutive days. The recovery of AFBA was between 70.0 and 82.6%, with a matrix effect that was 12.8%-18.5%. The lower limit of quantitation (LOQ) was 0.5 ng/mL with a coefficient of variation of 5.3%. This assay was successfully applied to determine the levels of this metabolite in a large number of urine samples taken from personnel who were occupationally exposed to ADs.
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Affiliation(s)
- Cristina Sottani
- Environmental Research Center, ICS MAUGERI SPA SB, Institute of Pavia, IRCCS, Pavia, Italy.
| | - Elena Grignani
- Environmental Research Center, ICS MAUGERI SPA SB, Institute of Pavia, IRCCS, Pavia, Italy
| | - Laura Zaratin
- Environmental Reasearch Center, ICS Maugeri SPA SB, Institute of Padova, Italy
| | - Donatella Santorelli
- Environmental Research Center, ICS MAUGERI SPA SB, Institute of Pavia, IRCCS, Pavia, Italy
| | - Emanuele Studioso
- Environmental Research Center, ICS MAUGERI SPA SB, Institute of Pavia, IRCCS, Pavia, Italy
| | - Davide Lonati
- Poison Control Center and National Toxicology Information Center, IRCCS Maugeri Foundation Hospital, Pavia, Italy
| | - Carlo A Locatelli
- Poison Control Center and National Toxicology Information Center, IRCCS Maugeri Foundation Hospital, Pavia, Italy
| | - Ornella Pastoris
- Department of Forensic Medicine, Pharmacology and Toxicology, University of Pavia, Pavia, Italy
| | - Sara Negri
- Environmental Research Center, ICS MAUGERI SPA SB, Institute of Pavia, IRCCS, Pavia, Italy
| | - Danilo Cottica
- Environmental Research Center, ICS MAUGERI SPA SB, Institute of Pavia, IRCCS, Pavia, Italy
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15
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Ndaw S, Hanser O, Kenepekian V, Vidal M, Melczer M, Remy A, Robert A, Bakrin N. Occupational exposure to platinum drugs during intraperitoneal chemotherapy. Biomonitoring and surface contamination. Toxicol Lett 2018; 298:171-176. [PMID: 29852276 DOI: 10.1016/j.toxlet.2018.05.031] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/25/2018] [Accepted: 05/23/2018] [Indexed: 10/14/2022]
Abstract
BACKGROUND Hyperthermic intraperitoneal chemotherapy (HIPEC) has been introduced over the last decade for the treatment of peritoneal carcinomatosis. In this procedure, heated cytotoxic drugs are administered directly into the abdominal cavity, ensuring cancer cells to be exposed while reducing systemic toxicity. More recently, pressurized intraperitoneal aerosol chemotherapy (PIPAC), where the chemotherapeutic drug is injected into the peritoneal cavity as an aerosol under pressure, has been proposed to patients in palliative situation, as a new approach. The amount of drug used is up to 10 fold lower than in HIPEC. The use of cytotoxic drugs poses an occupational risk for the operating room personnel. This study investigated the potential exposure of the medical staff by biomonitoring and surface contamination measurements, during a HIPEC procedure and a PIPAC procedure. METHOD Wipe samples were collected from various locations in operating rooms including gloves, hands, devices and floor. Urines samples were collected from 10 volunteers of the medical staff and from a control group. The platinum analysis was performed by inductively coupled plasma mass spectrometry. RESULTS Significant contaminations were observed on the floor, gloves, shoes and devices. However, urinary platinum was below the limit of quantification (<10 ng/L) for more than 50% of samples from the healthcare workers performing HIPEC and PIPAC. Concentrations did not differ significantly from those reported for the control group. CONCLUSION There appears to be little risk of exposure to platinum drugs during HIPEC and PIPAC providing the adequate safety measures are implemented.
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Affiliation(s)
- S Ndaw
- Institut National de Recherche et de Sécurité INRS, Toxicology and Biomonitoring Department, Vandoeuvre, France.
| | - O Hanser
- Institut National de Recherche et de Sécurité INRS, Toxicology and Biomonitoring Department, Vandoeuvre, France
| | - V Kenepekian
- Centre Hospitalier Lyon Sud, Pierre-Bénite, France
| | - M Vidal
- Centre Hospitalier Lyon Sud, Pierre-Bénite, France
| | - M Melczer
- Institut National de Recherche et de Sécurité INRS, Toxicology and Biomonitoring Department, Vandoeuvre, France
| | - A Remy
- Institut National de Recherche et de Sécurité INRS, Toxicology and Biomonitoring Department, Vandoeuvre, France
| | - A Robert
- Institut National de Recherche et de Sécurité INRS, Toxicology and Biomonitoring Department, Vandoeuvre, France
| | - N Bakrin
- Centre Hospitalier Lyon Sud, Pierre-Bénite, France
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16
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Dhersin A, Atgé B, Martinez B, Titier K, Rousset M, Sidatt Cheikh El Moustaph M, Verdun-Esquer C, Molimard M, Villa A, Canal-Raffin M. Biomonitoring of occupational exposure to 5-FU by assaying α-fluoro-β-alanine in urine with a highly sensitive UHPLC-MS/MS method. Analyst 2018; 143:4110-4117. [DOI: 10.1039/c8an00479j] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
5-Fluorouracil (5-FU) is one of the most widely antineoplastic drugs handled by healthcare professionals.
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Affiliation(s)
- Alice Dhersin
- Laboratoire de Pharmacologie Clinique et Toxicologie
- 33076 Bordeaux
- France
- INSERM U1219
- Université de Bordeaux
| | - Benoît Atgé
- Laboratoire de Pharmacologie Clinique et Toxicologie
- 33076 Bordeaux
- France
- INSERM U1219
- Université de Bordeaux
| | - Béatrice Martinez
- INSERM U1219
- Université de Bordeaux
- 33076 Bordeaux
- France
- Univ. of Bordeaux
| | - Karine Titier
- Laboratoire de Pharmacologie Clinique et Toxicologie
- 33076 Bordeaux
- France
| | - Marine Rousset
- Laboratoire de Pharmacologie Clinique et Toxicologie
- 33076 Bordeaux
- France
- INSERM U1219
- Université de Bordeaux
| | | | - Catherine Verdun-Esquer
- INSERM U1219
- Université de Bordeaux
- 33076 Bordeaux
- France
- Service de Médecine du Travail et de Pathologies Professionnelles
| | - Mathieu Molimard
- Laboratoire de Pharmacologie Clinique et Toxicologie
- 33076 Bordeaux
- France
- INSERM U1219
- Université de Bordeaux
| | - Antoine Villa
- Consultation de Pathologie Professionnelle
- GH Fernand Widal-Lariboisière-Saint Louis
- 75010 Paris
- France
| | - Mireille Canal-Raffin
- Laboratoire de Pharmacologie Clinique et Toxicologie
- 33076 Bordeaux
- France
- INSERM U1219
- Université de Bordeaux
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Lepage N, Canal-Raffin M, Villa A. Propositions pour la mise en œuvre d’une surveillance biologique de l’exposition professionnelle aux médicaments anticancéreux. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2017. [DOI: 10.1016/j.toxac.2017.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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18
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A review of high performance liquid chromatographic-mass spectrometric urinary methods for anticancer drug exposure of health care workers. J Chromatogr B Analyt Technol Biomed Life Sci 2017; 1060:316-324. [PMID: 28654869 DOI: 10.1016/j.jchromb.2017.06.028] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 06/14/2017] [Accepted: 06/17/2017] [Indexed: 12/15/2022]
Abstract
This review describes published high performance liquid chromatography/mass spectrometry (HPLC-MS) methods for the determination of anticancer drugs in human urine as non-invasive tool for monitoring of health care worker exposure to antineoplastic and cytotoxic drugs. HPLC-MS is a sensitive and specific method for analysis of anticancer drugs and their metabolites in biological fluids. In this review, a tabular summary and overview of published HPLC-MS methods are presented, as well as future trends and limitations in this area of research.
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Böhlandt A, Sverdel Y, Schierl R. Antineoplastic drug residues inside homes of chemotherapy patients. Int J Hyg Environ Health 2017; 220:757-765. [PMID: 28372941 DOI: 10.1016/j.ijheh.2017.03.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 03/07/2017] [Accepted: 03/15/2017] [Indexed: 10/19/2022]
Abstract
Chemotherapy treatment of cancer patients has shifted from inpatient to outpatient administration. Thus, family members are potentially exposed to cytotoxic drug residues from patients' excretions inside their homes. The study's aim was to evaluate the surface contamination and the potential uptake of antineoplastic drug residues by family members at home of chemotherapy patients. Overall, 265 wipe samples from 13 homes were taken at two times after chemotherapy from different surfaces (toilet, bathroom, kitchen). 62 urine samples were collected from patients and family members on three days. Samples were analyzed for cyclophosphamide, 5-fluorouracil (urine: FBAL) and platinum (as marker for cis-, carbo- and oxaliplatin). Substantial contamination was found on every surface type (PT: 0.02-42.5pg/cm2, 5-FU: ND-98.3pg/cm2, CP: ND-283.3pg/cm2) with highest concentrations on toilet and bathroom surfaces. While patients' urinary drug concentrations often were elevated for more than 48h after administration, no drug residues were detectable in the family members' urine. This study provided an insight in the exposure situation against antineoplastic drug residues at home of chemotherapy patients. As contamination could be found on various surfaces adequate hygienic and protective measures are necessary to minimize the exposure risk for cohabitants.
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Affiliation(s)
- Antje Böhlandt
- Occupational, Social and Environmental Medicine, LMU Munich, Germany.
| | - Yulia Sverdel
- Occupational, Social and Environmental Medicine, LMU Munich, Germany.
| | - Rudolf Schierl
- Occupational, Social and Environmental Medicine, LMU Munich, Germany.
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20
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Poupeau C, Roland C, Bussières JF. [Not Available]. Can J Hosp Pharm 2016; 69:376-387. [PMID: 27826155 PMCID: PMC5085322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND There is increasing evidence that traces of hazardous drugs occur in the urine of health care professionals who are exposed to these drugs. OBJECTIVE To review the scientific literature regarding urinary monitoring of health care professionals exposed to antineoplastic drugs through their work. DATA SOURCES A search of PubMed using the Medical Subject Headings 'occupational exposure' and 'antineoplastic agents' and of Google Scholar using the terms 'antineoplastic', 'urine', and 'occupational exposure'. STUDY SELECTION AND DATA EXTRACTION The analysis covered all articles in English or French pertaining to health care professionals exposed to hazardous drugs in the workplace, published from January 1, 2010, to December 31, 2015. Articles that did not discuss the results of urine tests and those concerning veterinarians, as well as literature reviews, editorials, letters to the editor, and conference abstracts, were excluded. DATA SYNTHESIS Twenty-four articles were retained. The studies were conducted in 52 health care institutions in 7 countries. They included 826 workers exposed to hazardous drugs and 175 controls, specifically nurses (n = 16 studies), pharmacists (n = 10), pharmacy technicians (n = 8), physicians (n = 7), health care aides (n = 2), and others (n = 8). Various analytical methods were used to quantify the presence of 13 hazardous drugs, primarily cyclophosphamide (n = 16 studies), platinum-based drugs (n = 7), and alpha-fluoro-beta-alanine, a urine metabolite derived from 5-fluorouracil (n = 3). The proportion of workers with positive results ranged from 0% (n = 10 studies) to 100% (n = 4). Considering only those studies that allowed calculation of the rate of workers with at least one positive urine sample (n = 23), the total proportion was 21% (173/809 workers, for all methods and drugs combined). CONCLUSION Twenty-four studies on urine monitoring were conducted in 7 countries between 2010 and 2015. In several studies, no traces of drugs were detected in urine.
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Affiliation(s)
- Céline Poupeau
- est une assistante de recherche, Unité de recherche en pratique pharmaceutique, Centre hospitalier universitaire Sainte-Justine, Montréal, Québec. Elle est aussi une étudiante dans le programme D.Pharm. dans la Faculté des Sciences Pharmaceutiques et Biologiques de Nancy, Université de Nancy 1, Nancy, France
| | - Christel Roland
- est une assistante de recherche, Unité de recherche en pratique pharmaceutique, Centre hospitalier universitaire Sainte-Justine, Montréal, Québec. Elle est aussi une étudiante dans le programme D.Pharm. dans la Faculté des Sciences Pharmaceutiques et Biologiques de Lille, Université Lille 2 Droit et Santé, Lille, France
| | - Jean-François Bussières
- B. Pharm., M. Sc., MBA, FCSHP, est chef, Unité de recherche en pratique pharmaceutique et Départment de pharmacie, Centre hospitalier universitaire Sainte-Justine, et professeur titulaire de clinique, Faculté de pharmacie, Université de Montréal, Montréal, Québec
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21
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Surveillance biologique de l’exposition professionnelle au 5-fluoro-uracile, un médicament anticancéreux. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2016. [DOI: 10.1016/j.toxac.2016.03.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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22
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Poupeau C, Tanguay C, Plante C, Gagné S, Caron N, Bussières JF. Pilot study of biological monitoring of four antineoplastic drugs among Canadian healthcare workers. J Oncol Pharm Pract 2016; 23:323-332. [DOI: 10.1177/1078155216643860] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose There are health risks to workers occupationally exposed to antineoplastic drugs. We hypothesized that implementing a biological monitoring program would be feasible. The goal was to present the results of our pilot cross-sectional study of biological monitoring of four antineoplastic drugs. Methods We recruited workers from the hematology–oncology department and control workers in a mother–child university health center. This study was preceded by an information period during which we aimed at enhancing the workers’ awareness and knowledge of the risks of occupational exposure. Participants filled out a journal containing activities performed and personal protective equipment worn. One urine sample was collected at the end of their shift. Samples were analyzed by UPLC/MS-MS for the presence of cyclophosphamide, ifosfamide, methotrexate, and alpha-fluoro-beta-alanine (5-fluorouracile’s main urinary metabolite). Results The participation rate was 85.7% (102/119). No urine sample had detectable concentrations of any of the four drugs evaluated (0/101; 0/74 nurses, 0/11 pharmacists, 0/9 pharmacy technicians, and 0/7 doctors). In the 5 days before sampling, 67/92 (72.8%) hematology–oncology participants performed at least one activity with antineoplastic drugs. Nurses wore all of the recommended protection for technical activities (86.2%), but rarely for non-technical activities (14.9%). Pharmacists and pharmacy technicians wore all of the recommended protection for all activities (100.0%). Conclusions This pilot study had a good participation rate. The absence of positive samples was a good indication that the measures in place ensured workers’ safety, even though we found areas where the worker protection can be enhanced.
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Affiliation(s)
- Céline Poupeau
- Pharmacy Department and Pharmacy Practice Research Unit, CHU Sainte-Justine, Canada
| | - Cynthia Tanguay
- Pharmacy Department and Pharmacy Practice Research Unit, CHU Sainte-Justine, Canada
| | | | - Sébastien Gagné
- Centre de toxicologie du Québec, Institut national de santé publique du Québec, Canada
| | - Nicolas Caron
- Centre de toxicologie du Québec, Institut national de santé publique du Québec, Canada
| | - Jean-François Bussières
- Pharmacy Department and Pharmacy Practice Research Unit, CHU Sainte-Justine, Canada
- Factulty of pharmacy, Université de Montréal, Canada
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23
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Baghdady YZ, Schug KA. Review of in situ derivatization techniques for enhanced bioanalysis using liquid chromatography with mass spectrometry. J Sep Sci 2015; 39:102-14. [DOI: 10.1002/jssc.201501003] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 10/02/2015] [Accepted: 10/02/2015] [Indexed: 11/05/2022]
Affiliation(s)
- Yehia Z. Baghdady
- Department of Chemistry and Biochemistry; The University of Texas at Arlington; Arlington TX USA
| | - Kevin A. Schug
- Department of Chemistry and Biochemistry; The University of Texas at Arlington; Arlington TX USA
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24
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Hon CY, Barzan C, Astrakianakis G. Identification of Knowledge Gaps Regarding Healthcare Workers' Exposure to Antineoplastic Drugs: Review of Literature, North America versus Europe. Saf Health Work 2014; 5:169-74. [PMID: 25516807 PMCID: PMC4266773 DOI: 10.1016/j.shaw.2014.06.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 05/27/2014] [Accepted: 06/02/2014] [Indexed: 01/20/2023] Open
Abstract
We have been examining the issue of healthcare workers' exposure to antineoplastic drugs for nearly a decade and have observed that there appears to be more publications on the subject matter originating from Europe than from North America. The concern is that findings from Europe may not be generalizable to North America because of differences in handling practices, regulatory requirements, and training. Our objective was to perform a literature review to confirm our observation and, in turn, identify gaps in knowledge that warrants addressing in North America. Using select keywords, we searched for publications in PubMed and Web of Science. All papers were initially classified according to the originating continent and then categorized into one or more subject categories (analytical methods, biological monitoring, occupational exposure, surface contamination, and probability of risk/exposure). Our review identified 16 papers originating from North America and 55 papers from Europe with surface contamination being the subject matter most often studied overall. Based on our results, we are of the opinion that North American researchers need to further conduct dermal and/or urinary drug contamination studies as well as assess the exposure risk faced by healthcare workers who handle antineoplastic drugs. Trends in exposure levels should also be explored.
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Affiliation(s)
- Chun-Yip Hon
- School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada ; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Cris Barzan
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada ; Prevention Division, WorkSafeBC, Vancouver, British Columbia, Canada
| | - George Astrakianakis
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
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25
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Kováčik J, Klejdus B, Babula P. Oxidative stress, uptake and bioconversion of 5-fluorouracil in algae. CHEMOSPHERE 2014; 100:116-123. [PMID: 24380438 DOI: 10.1016/j.chemosphere.2013.11.074] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 11/25/2013] [Accepted: 11/29/2013] [Indexed: 06/03/2023]
Abstract
Impact of cytostatic drug 5-fluorouracil (FU) and its metabolite 2-fluoro-3-alanine (FA) on green alga Scenedesmus quadricauda was studied. FA elevated fluorescence signal of reactive oxygen species (ROS) more pronouncedly than FU at 1 and 10 μM doses while both ROS and reactive nitrogen species (RNS/NO) increased more expressively in 100 μM FU treatment. Cellular damage staining (Acridine Orange and Calcofluor White) did no reveal substantial difference between FU and FA. Majority of free amino acids including proline was unaffected after 24h of exposure. FA depleted ascorbate peroxidase activity more than FU therefore ascorbate content (AsA) was less affected while FU stimulated glutathione reductase activity less than FA and therefore glutathione (GSH) was more depleted. Both compounds accumulated concentration-dependently with higher absolute FA amounts but FU conversion to FA was also detected. We subsequently influenced 100 μM FU- and FA-induced changes using known ROS (DTT - dithiothreitol) and RNS/NO (SNP - sodium nitroprusside and PTIO - 2-phenyl-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide) modulators and results showed that PTIO depleted NO and elevated ROS while the opposite was found after SNP and DTT addition. Changes of lipid peroxidation (using BODIPY staining) confirmed that FU and FA toxicity is related to alteration of ROS/RNS balance.
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Affiliation(s)
- Jozef Kováčik
- Institute of Chemistry and Biochemistry, Faculty of Agronomy, Mendel University in Brno, Zemědělská 1, 613 00 Brno, Czech Republic.
| | - Bořivoj Klejdus
- Institute of Chemistry and Biochemistry, Faculty of Agronomy, Mendel University in Brno, Zemědělská 1, 613 00 Brno, Czech Republic
| | - Petr Babula
- Department of Natural Drugs, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences Brno, Palackeho 1/3, 612 42 Brno, Czech Republic
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26
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Novel chiral derivatization reagents possessing a pyridylthiourea structure for enantiospecific determination of amines and carboxylic acids in high-throughput liquid chromatography and electrospray-ionization mass spectrometry for chiral metabolomics identification. J Chromatogr A 2013; 1296:111-8. [DOI: 10.1016/j.chroma.2013.03.019] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 03/09/2013] [Accepted: 03/11/2013] [Indexed: 11/22/2022]
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27
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Mochizuki Y, Inagaki S, Suzuki M, Min JZ, Inoue K, Todoroki K, Toyo'oka T. A novel derivatization reagent possessing a bromoquinolinium structure for biological carboxylic acids in HPLC-ESI-MS/MS. J Sep Sci 2013; 36:1883-9. [DOI: 10.1002/jssc.201300083] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 03/25/2013] [Accepted: 03/27/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Yuko Mochizuki
- Laboratory of Analytical and Bio-Analytical Chemistry; School of Pharmaceutical Sciences, University of Shizuoka; Suruga-ku Shizuoka Japan
| | - Shinsuke Inagaki
- Laboratory of Analytical and Bio-Analytical Chemistry; School of Pharmaceutical Sciences, University of Shizuoka; Suruga-ku Shizuoka Japan
| | - Mayu Suzuki
- Laboratory of Analytical and Bio-Analytical Chemistry; School of Pharmaceutical Sciences, University of Shizuoka; Suruga-ku Shizuoka Japan
| | - Jun Zhe Min
- Laboratory of Analytical and Bio-Analytical Chemistry; School of Pharmaceutical Sciences, University of Shizuoka; Suruga-ku Shizuoka Japan
| | - Koichi Inoue
- Laboratory of Analytical and Bio-Analytical Chemistry; School of Pharmaceutical Sciences, University of Shizuoka; Suruga-ku Shizuoka Japan
| | - Kenichiro Todoroki
- Laboratory of Analytical and Bio-Analytical Chemistry; School of Pharmaceutical Sciences, University of Shizuoka; Suruga-ku Shizuoka Japan
| | - Toshimasa Toyo'oka
- Laboratory of Analytical and Bio-Analytical Chemistry; School of Pharmaceutical Sciences, University of Shizuoka; Suruga-ku Shizuoka Japan
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28
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Mochizuki T, Taniguchi S, Tsutsui H, Min JZ, Inoue K, Todoroki K, Toyo’oka T. Relative quantification of enantiomers of chiral amines by high-throughput LC–ESI-MS/MS using isotopic variants of light and heavy l-pyroglutamic acids as the derivatization reagents. Anal Chim Acta 2013; 773:76-82. [DOI: 10.1016/j.aca.2013.02.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 02/07/2013] [Accepted: 02/16/2013] [Indexed: 11/27/2022]
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Fluorouracil in the environment: analysis, occurrence, degradation and transformation. J Chromatogr A 2013; 1290:62-72. [PMID: 23578484 DOI: 10.1016/j.chroma.2013.03.046] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 03/14/2013] [Accepted: 03/15/2013] [Indexed: 11/20/2022]
Abstract
5-Fluorouracil (5-FU) is a fluorinated pyrimidine analogue important in the treatment of cancer whose fate in the environment is yet to be fully addressed. Due to its high polarity 5-FU requires challenging sample preparation and therefore we thoroughly investigated different solid phase extraction mechanisms (ion pair, ion exchange, reversed phase), sorbents and derivatisation agents to enable trace-level analysis of 5-FU based on GC-MS/MS in natural and wastewaters. Ion pair and ion exchange retention mechanisms enable the extraction of 5-FU from deionised water, but were inappropriate for complex environmental matrices, where the reversed phase sorbent Isolute ENV+ gave the best extraction efficiencies (53% and 93% for wastewaters and surface waters, respectively). Further, alkylation was rejected in favour of silylation with MTBSTFA. The achieved limits of quantification (LOQ) for waste and surface waters were 1.6 ng/L and 0.54 ng/L, respectively. The method was used to analyse samples of hospital, wastewater treatment plant influent and effluent and surface waters. 5-FU was quantified in four out of the twelve samples of oncological ward wastewaters and municipal wastewater treatment plant influents in concentrations from 4.7 ng/L to 92 ng/L. This work is also the first to study the environmental transformation of 5-FU and its prodrug capecitabine (CAP). Their removal and transformation was simulated using a series of biodegradation and photodegradation experiments, where 5-FU proved more degradable in comparison to CAP. Transformation of 5-FU and CAP was studied by using ultra-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry (UPLC-QqTOF). Overall, six transformation products for 5-FU and ten for CAP are proposed; 13 of these are to our knowledge published for the first time.
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Kopp B, Crauste-Manciet S, Guibert A, Mourier W, Guerrault-Moro MN, Ferrari S, Jomier JY, Brossard D, Schierl R. Environmental and biological monitoring of platinum-containing drugs in two hospital pharmacies using positive air pressure isolators. ACTA ACUST UNITED AC 2012; 57:374-83. [PMID: 23091112 DOI: 10.1093/annhyg/mes073] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Environmental and biological monitoring of platinum containing drugs was implemented in two French hospital pharmacies using positive air pressure isolators and having similar working procedures when preparing antineoplastic drugs. Wipe sampling of surfaces, gloves, and vials was performed in the preparation room and in storage areas. All employees involved in the preparation of antineoplastic drugs were tested for urinary platinum on Monday before work and Friday after shift. Only traces of platinum were detected on surfaces in the preparation room outside the isolators (less than 1.61 pg cm(-2)). However, in one center, significant contamination was found in the storage area of the drug vials, which can most likely be linked to the rupture of a platinum vial and due to inefficient cleaning procedures. Surfaces inside the isolators were found to be contaminated (maximum: 198.4 pg cm(-2)). A higher level of contamination was detected in one pharmacy and could be explained by the lack of overgloving with regular changes during the preparation process. Nitrile gloves used during drug handling outside the isolator showed the highest platinum concentration (maximum: 5.86 ng per pair). With regards to platinum urine concentration, no significant difference was found between exposed and unexposed pharmacy personnel. Isolator technology combined with individual protective measures seems to be efficient to protect workers from occupational exposure to antineoplastic drugs, whereas specific individual protective procedures implemented were focussing on the risk of handling vials outside the isolator (e.g. high frequency of glove changing). Moreover, overgloving inside the isolator would contribute to substantially decrease inner surface contamination and should be recommended in order to limit the transfer of chemical contamination to the end products.
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Affiliation(s)
- Bettina Kopp
- Institute und Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), 80336 Munich, Germany
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Toyo’oka T. LC–MS determination of bioactive molecules based upon stable isotope-coded derivatization method. J Pharm Biomed Anal 2012; 69:174-84. [DOI: 10.1016/j.jpba.2012.04.018] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Revised: 04/17/2012] [Accepted: 04/18/2012] [Indexed: 10/28/2022]
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Yoshida J, Koda S, Nishida S, Nakano H, Tei G, Kumagai S. Association between occupational exposure and control measures for antineoplastic drugs in a pharmacy of a hospital. ACTA ACUST UNITED AC 2012; 57:251-60. [PMID: 23002276 DOI: 10.1093/annhyg/mes061] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To investigate the association between occupational contamination and exposure levels to antineoplastic drugs and the application of control measures in a hospital work environment. METHODS Wipe samples of equipments were collected at a hospital in Osaka Prefecture, Japan, from 2007 to 2011. These samples were subjected to measurements of cyclophosphamide (CP), gemcitabine (GEM), platinum-containing drugs (Pt), and fluorouracil (5FU). Additionally, 24-h urine samples were collected from pharmacists who handled antineoplastic drugs, which were analyzed for CP and alpha-fluoro-beta-alanine (AFBA). The application of control measures was scored according to a checklist, which consisted of the following five items: safety equipment and maintenance, training and documentation, devices for safe handling, personal protective equipment, and emergency care. The aim was to obtain a score of 80%. RESULTS The median CP, GEM, and 5FU concentrations of all wipe samples were significantly lower during the period when the mean score was >80% (attainment period) versus when the mean score was ≤80% (nonattainment period; all P < 0.001, Mann-Whitney's U-test). Additionally, the median urinary CP and AFBA concentrations of pharmacists during the attainment period tended to be lower than that of those during the nonattainment period (P = 0.061 and 0.061, respectively, using Mann-Whitney's U-test). CONCLUSIONS Contamination and levels of exposure to antineoplastic drugs decreased with a score higher than 80%. The scores of the items on the checklist appeared to adequately reflect the condition of the control measures, as increases in all five items were associated with reductions in the contamination by and levels of exposure to all drugs.
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Affiliation(s)
- Jin Yoshida
- Department of Environmental Health, Osaka Prefectural Institute of Public Health, 1-3-69, Nakamichi, Higashinari-ku, Osaka-shi, Osaka-fu, 537-0025, Japan.
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Tsutsui H, Fujii S, Sakamoto T, Min JZ, Todoroki K, Toyo'oka T. Chiral amines as reagents for HPLC-MS enantioseparation of chiral carboxylic acids. J Sep Sci 2012; 35:1551-9. [DOI: 10.1002/jssc.201200091] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | | | | | | | | | - Toshimasa Toyo'oka
- Laboratory of Analytical and Bio-Analytical Chemistry; Graduate School of Pharmaceutical Sciences; University of Shizuoka; Suruga-ku Shizuoka Japan
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Abstract
AbstractHydrophilic interaction chromatography (HILIC) is an increasingly popular alternative to conventional HPLC for drug analysis. It offers increased selectivity and sensitivity, and improved efficiency when quantifying drugs and related compounds in complex matrices such as biological and environmental samples, pharmaceutical formulations, food, and animal feed. In this review we summarize HILIC methods recently developed for drug analysis (2006–2011). In addition, a list of important applications is provided, including experimental conditions and a brief summary of results. The references provide a comprehensive overview of current HILIC applications in drug analysis.
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Armenta S, Blanco M. Ion Mobility Spectrometry: A Comprehensive and Versatile Tool for Occupational Pharmaceutical Exposure Assessment. Anal Chem 2012; 84:4560-8. [DOI: 10.1021/ac300655t] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S. Armenta
- Department of Chemistry, Faculty of Sciences, Universitat Autònoma de Barcelona, E-08193 Bellaterra,
Barcelona, Spain
| | - M. Blanco
- Department of Chemistry, Faculty of Sciences, Universitat Autònoma de Barcelona, E-08193 Bellaterra,
Barcelona, Spain
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Abstract
LC with atmospheric pressure ionization MS is essential to a large number of quantitative bioanalyses for a variety of compounds, especially nonvolatile or highly polar compounds. However, in many instances, weak ionization, poor LC retention and instability of certain analytes hinder the development of the LC–MS/MS method. Chemical derivatization has been used for different classes of analytes to improve their ionization efficiency, chromatographic separation and chemical stability. This work presents an overview of chemical derivatization methods that have been applied to the quantitative LC–MS/MS analyses of nine classes of molecules, including aldehydes, amino acids, bisphosphonate drugs, carbohydrates, carboxylic acids, nucleosides and their associated analogs, steroids, thiol-containing compounds and vitamin D metabolites, in biological matrices.
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Suspiro A, Prista J. Biomarkers of occupational exposure do anticancer agents: a minireview. Toxicol Lett 2011; 207:42-52. [PMID: 21911042 DOI: 10.1016/j.toxlet.2011.08.022] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2011] [Revised: 08/27/2011] [Accepted: 08/29/2011] [Indexed: 11/29/2022]
Abstract
The majority of anticancer agents has in common DNA-damaging properties and affects not only target-cells but also non-tumour cells. Its genotoxicity has been demonstrated in experimental models and in cancer patients treated with chemotherapy. Health care personnel involved in the preparation and administration of chemotherapy is therefore at risk for adverse health effects, since most environmental sampling studies demonstrated that there is widespread contamination of work surfaces and equipments with anticancer drugs. Adherence to safety guidelines and proper use of personal protective equipment are insufficient to prevent significant absorption, as evidenced by the presence of detectable amounts of drugs in urine samples and increased frequency of genotoxicity biomarkers. In this minireview, a critical appraisal of the most important biomarkers used for the evaluation of occupational exposure to anticancer agents as well as a summary of the key findings from several studies published in this field is performed.
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Affiliation(s)
- A Suspiro
- ENSP-UNL, Escola Nacional de Saúde Pública Universidade Nova de Lisboa, UNL, Avenida Padre Cruz, 1600-560 Lisboa, Portugal.
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Iwasaki Y, Nakano Y, Mochizuki K, Nomoto M, Takahashi Y, Ito R, Saito K, Nakazawa H. A new strategy for ionization enhancement by derivatization for mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2011; 879:1159-65. [PMID: 21382752 DOI: 10.1016/j.jchromb.2011.02.008] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 01/07/2011] [Accepted: 02/07/2011] [Indexed: 11/29/2022]
Abstract
Liquid chromatography-mass spectrometry (LC-MS) using atmospheric pressure ionization is drastically different from hitherto available analytical methods used to detect polar analytes. The electrospray ionization (ESI) and atmospheric pressure chemical ionization (APCI) sources of MS have contributed to the advancement of LC-MS and LC-MS/MS techniques for the analysis of biological samples. However, one major obstacle is the weak ionization of some analytes in the ESI and APCI techniques. In this review, we introduce high-sensitivity methods using several derivatization reagents for ionization enhancement. We also present an overview of chemical derivatization methods that have been applied to small molecules, such as amino acids and steroids, in biological samples.
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Affiliation(s)
- Yusuke Iwasaki
- Department of Analytical Chemistry, Faculty of Pharmaceutical Sciences, Hoshi University, 2-4-41 Ebara, Shinagawa-ku, Tokyo 142-8501, Japan
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