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Ladeira C, Møller P, Giovannelli L, Gajski G, Haveric A, Bankoglu EE, Azqueta A, Gerić M, Stopper H, Cabêda J, Tonin FS, Collins A. The Comet Assay as a Tool in Human Biomonitoring Studies of Environmental and Occupational Exposure to Chemicals-A Systematic Scoping Review. TOXICS 2024; 12:270. [PMID: 38668493 PMCID: PMC11054096 DOI: 10.3390/toxics12040270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/29/2024]
Abstract
Biomonitoring of human populations exposed to chemical substances that can act as potential mutagens or carcinogens, may enable the detection of damage and early disease prevention. In recent years, the comet assay has become an important tool for assessing DNA damage, both in environmental and occupational exposure contexts. To evidence the role of the comet assay in human biomonitoring, we have analysed original research studies of environmental or occupational exposure that used the comet assay in their assessments, following the PRISMA-ScR method (preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews). Groups of chemicals were designated according to a broad classification, and the results obtained from over 300 original studies (n = 123 on air pollutants, n = 14 on anaesthetics, n = 18 on antineoplastic drugs, n = 57 on heavy metals, n = 59 on pesticides, and n = 49 on solvents) showed overall higher values of DNA strand breaks in the exposed subjects in comparison with the unexposed. In summary, our systematic scoping review strengthens the relevance of the use of the comet assay in assessing DNA damage in human biomonitoring studies.
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Affiliation(s)
- Carina Ladeira
- H&TRC-Health & Technology Research Center, ESTeSL-Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, 1990-096 Lisbon, Portugal
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal
| | - Peter Møller
- Department of Public Health, Section of Environmental Health, University of Copenhagen, 1172 Copenhagen, Denmark;
| | - Lisa Giovannelli
- Department NEUROFARBA, Section Pharmacology and Toxicology, University of Florence, 50121 Florence, Italy;
| | - Goran Gajski
- Division of Toxicology, Institute for Medical Research and Occupational Health, 10000 Zagreb, Croatia; (G.G.); (M.G.)
| | - Anja Haveric
- Institute for Genetic Engineering and Biotechnology, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina;
| | - Ezgi Eyluel Bankoglu
- Institute of Pharmacology and Toxicology, University of Würzburg, 97078 Würzburg, Germany; (E.E.B.); (H.S.)
| | - Amaya Azqueta
- Department of Pharmaceutical Sciences, School of Pharmacy and Nutrition, University of Navarra, 31009 Pamplona, Spain;
| | - Marko Gerić
- Division of Toxicology, Institute for Medical Research and Occupational Health, 10000 Zagreb, Croatia; (G.G.); (M.G.)
| | - Helga Stopper
- Institute of Pharmacology and Toxicology, University of Würzburg, 97078 Würzburg, Germany; (E.E.B.); (H.S.)
| | - José Cabêda
- Guarda Nacional Republicana, Destacamento Territorial de Vila Franca de Xira, Núcleo de Proteção Ambiental, 1500-124 Lisbon, Portugal;
| | - Fernanda S. Tonin
- Pharmaceutical Care Research Group, Universidad de Granada, 18012 Granada, Spain;
| | - Andrew Collins
- Department of Nutrition, University of Oslo, 0316 Oslo, Norway;
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Pajic J, Milovanovic APS. Biological response to the continuous occupational exposure to antineoplastic drugs and radionuclides. Int J Radiat Biol 2023; 99:1934-1947. [PMID: 37498230 DOI: 10.1080/09553002.2023.2241901] [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: 01/05/2023] [Revised: 07/02/2023] [Accepted: 07/11/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE Antineoplastic drugs and radioiodine are recognized occupational risk factors affecting the genetic material of exposed persons. To assess cytogenetic damage and evaluate the presence of chromosomal instability during occupational exposure, a biomonitoring study was performed using a chromosomal aberration assay and a cytokinesis-block micronucleus (CBMN) test. MATERIALS AND METHODS Blood samples from 314 healthy donors divided into 3 groups (control, exposed to antineoplastic drugs and exposed to radioiodine) were collected and cytogenetically analyzed. RESULTS There was an increase in almost all analyzed parameters registered in the exposed persons. Chromatid breaks were higher in the subjects exposed to antineoplastic drugs, while dicentrics and premature centromere division (PCD) parameters were higher in nuclear medicine workers. The total number of micronuclei was higher in both groups of the exposed. The correlation analysis indicated the association of dicentrics, acentrics, chromosome and chromatid break with PCDs in both groups of the exposed, and micronuclei and nucleoplasmic bridges with PCDs in the subjects exposed to radioiodine. The discriminant analysis marked off PCD1-5 as the best predictor of exposure. Age, sex, sampling season and duration of exposure significantly influenced the analyzed parameters, while smoking habits did not show any influence. CONCLUSION Based on the observed results, premature centromere division can be considered a valuable parameter of genotoxic risk for individuals occupationally exposed to low doses of ionizing radiation.
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Affiliation(s)
- Jelena Pajic
- Serbian Institute of Occupational Health "Dr Dragomir Karajovic", Belgrade, Serbia
| | - Aleksandar P S Milovanovic
- Occupational Health Department, Faculty of Medicine, University of Belgrade, Dr Subotica 8, Belgrade, Serbia; Serbian Institute of Occupational Health "Dr Dragomir Karajovic", Belgrade, Serbia
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Vanneste D, Verscheure E, Srinivasan AN, Godderis L, Ghosh M. Systematic review of genotoxicity induced by occupational exposure to antineoplastic drugs. Arch Toxicol 2023; 97:1453-1517. [PMID: 37099053 DOI: 10.1007/s00204-023-03481-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/02/2023] [Indexed: 04/27/2023]
Abstract
With increasing numbers of cancer cases, the use of antineoplastic agents is expected to rise. This will be accompanied by an increase in occupational exposure, which can cause unwanted health effects in workers. Our aim was to give an overview of genotoxic and epigenetic effects after occupational exposure to antineoplastic agents and to assess the concentration-effect relation. Four databases were searched for papers investigating genotoxic and/or epigenetic effects of occupational exposure to antineoplastic agents. Out of the 245 retrieved papers, 62 were included in this review. In this systematic literature review, we confirmed that exposure of healthcare workers to antineoplastic agents can lead to genotoxic damage. However, we observed a lack of data on exposure as well as genotoxic and epigenetic effects in workers other than healthcare workers. Furthermore, gaps in the current knowledge regarding the potential epigenetic effects caused by antineoplastic drug exposure and regarding the link between internal antineoplastic drug concentration and genotoxic and epigenetic effects after occupational exposure to antineoplastic agents were identified, offering a first step for future research.
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Affiliation(s)
- Dorian Vanneste
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, ON5 Herestraat 49, Box 952, 3000, Leuven, Belgium
| | - Eline Verscheure
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, ON5 Herestraat 49, Box 952, 3000, Leuven, Belgium
| | - Adhithya Narayanan Srinivasan
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, ON5 Herestraat 49, Box 952, 3000, Leuven, Belgium
| | - Lode Godderis
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, ON5 Herestraat 49, Box 952, 3000, Leuven, Belgium
| | - Manosij Ghosh
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, ON5 Herestraat 49, Box 952, 3000, Leuven, Belgium.
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Huang H, Gu Y, Liu S, Hu S, Zhong X, Huang Y, Peng J, Huang X. The meta-analysis of cytogenetic biomarkers as an assessment of occupational risk for healthcare workers exposed to antineoplastic drugs. Int Arch Occup Environ Health 2023:10.1007/s00420-023-01969-6. [PMID: 37079056 DOI: 10.1007/s00420-023-01969-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 03/07/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE Antineoplastic drugs (ADs) are widely used in clinical practice and have been demonstrated to be effective in treating malignant tumors. However, they carry a risk of cytogenotoxicity for healthcare workers. Studies have reported that genotoxic biomarkers can be applied to assess the occupational health status of healthcare workers at an early stage, but results of different studies are variable. The objectives of the review were examine the association between long-term exposure to ADs and cytogenetic damage to healthcare workers. METHODS We systematically reviewed studies between 2005 and 2021 using PubMed, Embase and Web of Science databases that used cytogenetic biomarkers to assess occupational exposure to ADs in healthcare workers. We used RevMan5.4 to analyze the tail length parameters of the DNA, frequency of the chromosomal aberrations, sister chromatid exchanges and micronuclei. A total of 16 studies were included in our study. The studies evaluate the quality of the literature through the Agency for Healthcare Research and Quality. RESULTS The results revealed that under the random-effects model, the estimated standard deviation was 2.37 (95% confidence interval [CI] 0.92-3.81, P = 0.001) for the tail length parameters of the DNA, 1.48 (95% CI 0.71-2.25, P = 0.0002) for the frequency of chromosomal aberrations, 1.74 (95% CI 0.49-2.99, P = 0.006) for the frequency of sister chromatid exchanges and 1.64 (95% CI 0.83-2.45, P < 0.0001) for the frequency of micronuclei. CONCLUSIONS The results indicate that there is a significant association between occupational exposure to ADs and cytogenetic damage, to which healthcare workers should be alerted.
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Affiliation(s)
- Hong Huang
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, No.6082 Longgang Avenue, Shenzhen, 518116, China
| | - Yeqing Gu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Shuhan Liu
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, No.6082 Longgang Avenue, Shenzhen, 518116, China
| | - Song Hu
- Longgang District Central Hospital of Shenzhen, Shenzhen, 518116, Guangdong, China
| | - Xiao Zhong
- Longgang District Central Hospital of Shenzhen, Shenzhen, 518116, Guangdong, China
| | - Yanshan Huang
- Longgang District Central Hospital of Shenzhen, Shenzhen, 518116, Guangdong, China
- Shantou University Medical College, Shantou, 515041, Guangdong, China
| | - Ji Peng
- Longgang District Central Hospital of Shenzhen, Shenzhen, 518116, Guangdong, China
| | - Xiaohong Huang
- Department of Nursing, Longgang District Central Hospital of Shenzhen, Shenzhen, Guangdong, China.
- Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China.
- Longgang District Central Hospital of Shenzhen, No.6082 Longgang Avenue, Longgang District, Shenzhen, Guangdong, China.
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Fleury-Souverain S, Maurin J, Guillarme D, Rudaz S, Bonnabry P. Development and application of a liquid chromatography coupled to mass spectrometry method for the simultaneous determination of 23 antineoplastic drugs at trace levels. J Pharm Biomed Anal 2022; 221:115034. [PMID: 36095884 DOI: 10.1016/j.jpba.2022.115034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 01/06/2023]
Abstract
The goal of this study was to develop a method for the simultaneous quantification of 23 commonly used antineoplastic drugs in a hospital pharmacy, using ultra-high pressure liquid chromatography separation coupled to tandem mass spectrometry detection (UHPLC-MS/MS). The following drugs were investigated: 5-fluorouracil, cytarabine, ganciclovir, gemcitabine, dacarbazine, methotrexate, pemetrexed, busulfan, topotecan, rentitrexed, ifosfamide, cyclophosphamide, etoposide, irinotecan, doxorubicin/epirubicin, vincristine, docetaxel, paclitaxel, daunorubicin, idarubicin, vinblastine, oxaliplatin and carboplatin. The chromatographic separation was performed on a phenyl-hexyl column (2.1 ×100 mm, 1.7 µm) with a gradient elution of methanol and water containing 10 mM ammonium formate adjusted to pH 4.9. All compounds were analyzed in less than 13 min and detected with a triple quadrupole mass spectrometer operating in MRM mode. Limits of detection (LODs) and limits of quantification (LOQs) were comprised between 0.01 and 5 ng.mL-1, and between 0.5 and 5 ng.mL-1, respectively. Accuracies ranged between 117% and 83% at the LOQ, intermediate and upper LOQ concentrations, with relative standard deviations (RSD) inferior to 8%, for all the antineoplastic drugs. Finally, the UHPLC-MS/MS method was successfully applied to the analysis of surface samples to evaluate the chemical contamination by these highly toxic compounds in a chemotherapy preparation unit in a hospital pharmacy with the purpose of monitoring the exposure of health care professionals.
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Affiliation(s)
- S Fleury-Souverain
- Institute of Pharmaceutical Sciences of Western Switzerland (ISPSO), School of Pharmaceutical Sciences, University of Geneva, CMU - Rue Michel Servet 1, 1211 Geneva 4, Switzerland; Pharmacy, Geneva University Hospitals (HUG), Geneva, Switzerland.
| | - J Maurin
- Institute of Pharmaceutical Sciences of Western Switzerland (ISPSO), School of Pharmaceutical Sciences, University of Geneva, CMU - Rue Michel Servet 1, 1211 Geneva 4, Switzerland; Pharmacy, Geneva University Hospitals (HUG), Geneva, Switzerland
| | - D Guillarme
- Institute of Pharmaceutical Sciences of Western Switzerland (ISPSO), School of Pharmaceutical Sciences, University of Geneva, CMU - Rue Michel Servet 1, 1211 Geneva 4, Switzerland
| | - S Rudaz
- Institute of Pharmaceutical Sciences of Western Switzerland (ISPSO), School of Pharmaceutical Sciences, University of Geneva, CMU - Rue Michel Servet 1, 1211 Geneva 4, Switzerland
| | - P Bonnabry
- Institute of Pharmaceutical Sciences of Western Switzerland (ISPSO), School of Pharmaceutical Sciences, University of Geneva, CMU - Rue Michel Servet 1, 1211 Geneva 4, Switzerland; Pharmacy, Geneva University Hospitals (HUG), Geneva, Switzerland
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Pajic J, Rovcanin B, Rakic B. Evaluation of Genetic Damage in Persons Occupationally Exposed to Antineoplastic Drugs in Serbian Hospitals. Ann Work Expo Health 2021; 65:307-318. [PMID: 33886965 DOI: 10.1093/annweh/wxaa100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/17/2020] [Accepted: 09/29/2020] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Although useful in the treatment of malignant cells, antineoplastic drugs (ANPDs) as chemical genotoxic agents, can interfere with normal cell physiology causing genetic damage and unfavourable health effects, especially in occupationally exposed persons. The Cytokinesis-block Micronucleus (CBMN) Cytome assay has been widely used in human biomonitoring studies as a reliable biomarker of chemical genotoxic exposure. OBJECTIVES Our comprehensive research was conducted in order to evaluate micronuclei as a marker for preventive medical screening purposes for persons occupationally exposed to ANPDs. METHODS Using the CBMN Cytome test, peripheral blood lymphocytes of 201 control and 222 exposed subjects were screened for genetic damage. RESULTS Age and gender influenced micronucleus (MN) frequency, but smoking habit did not. The mean micronuclei frequencies and other parameters of the CBMN Cytome test [numbers of binuclear lymphocytes with one (MN1) or two (MN2) micronuclei] were significantly higher in the group of exposed persons. Positive correlation between duration of occupational exposure and MN frequency was revealed. CONCLUSIONS The results of our study performed on a large sample confirmed the capacity of the CBMN Cytome assay to serve as a reliable biomarker of long-term ANPD exposure.
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Affiliation(s)
- Jelena Pajic
- Serbian Institute of Occupational Health "Dr Dragomir Karajovic", Radiation protection department, Deligradska 29,Belgrade, Serbia
| | - Branislav Rovcanin
- Center for Endocrine Surgery, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Koste Todorovica 8, Belgrade, Serbia
| | - Boban Rakic
- Serbian Institute of Occupational Health "Dr Dragomir Karajovic", Radiation protection department, Deligradska 29,Belgrade, Serbia
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Ness SLR, Mascarenhas MÁ, Arbo MD, Tonietto BD, Cestonaro LV, Dos Santos NG, Garcia SC, Ferreira CF, Capp E. Occupational exposure assessment in professionals who manipulate and administer antineoplastic drugs in a university hospital in Southern Brazil. J Oncol Pharm Pract 2021; 27:1205-1213. [PMID: 33736555 DOI: 10.1177/10781552211003638] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Our goal was to demonstrate the effects of occupational exposure to antineoplastic drugs on oxidative stress parameters and DNA damage in health professionals who manipulate and administer antineoplastic drugs in a University Hospital in Southern Brazil. METHODS The case-control study with a longitudinal design, involved 64 individuals, 29 of them pharmacists, pharmacy technicians and nurses who were occupationally exposed to antineoplastic drugs and 35 professionals who were not exposed. Gene mutations were determined by micronucleus from salivary fluid; DNA damage by comet assay and oxidative stress parameters in whole blood were also evaluated. RESULTS All workers exposed to antineoplastic drugs used personal protective equipment (PPE). It was demonstrated that the total nonprotein thiol and thiobarbituric acid reactive substances levels showed interaction between group and time, with higher levels one week after handling/administration of antineoplastic drugs in the exposed group (GEE, p ≤ 0.0001 and p = 0,013, respectively). Additionally, there was a group effect on the activities of the catalase and glutathione peroxidase antioxidant enzymes (GEE, p = 0.027 and p ≤ 0.0001, respectively), and workers occupationally exposed to antineoplastic drugs had higher enzyme activities compared to those not exposed. No genotoxic damage was demonstrated through the evaluated parameters. CONCLUSIONS Despite the correct use of PPE, professionals occupationally exposed to antineoplastic drugs were more susceptible to oxidative stress than those not exposed. The evaluation of the studied parameters is especially important for the definition of conducts and practices in the area, always in search of guaranteeing the establishment of a rational policy to protect workers' health.
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Affiliation(s)
- Sandro Luis R Ness
- Graduação na Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Central de Misturas Intravenosas, Serviço de Farmácia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Marcello Á Mascarenhas
- Programa de Pós-Graduação Strict Sensu em Biociências e Reabilitação, Curso de Farmácia do Centro Universitário Metodista-IPA, Porto Alegre, Brazil
| | - Marcelo D Arbo
- Graduação na Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Laboratório de Toxicologia, Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Brazil
| | - Bruna D Tonietto
- Graduação na Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Laboratório de Toxicologia, Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Brazil
| | - Larissa V Cestonaro
- Graduação na Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Laboratório de Toxicologia, Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Brazil
| | - Nícolas G Dos Santos
- Graduação na Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Laboratório de Toxicologia, Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Brazil
| | - Solange Cristina Garcia
- Graduação na Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Laboratório de Toxicologia, Departamento de Análises, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Brazil
| | - Charles F Ferreira
- Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia (PPGGO), Hospital de Clínicas de Porto Alegre (HCPA), Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Grupo de Pesquisa: Climatério, e Menopausa. Hospital de Clínicas de Porto Alegre (HCPA), Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Edison Capp
- Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia (PPGGO), Hospital de Clínicas de Porto Alegre (HCPA), Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Graduação na Faculdade de Medicina (FAMED), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Mateo González-Román M, Hidalgo García PP, Peña Otero D. Cytostatic drugs and risk of genotoxicity in health workers. A literature review. ACTA ACUST UNITED AC 2019; 31:247-253. [PMID: 34243912 DOI: 10.1016/j.enfcle.2019.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 07/21/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To analyse the genotoxic risk of cytostatic drugs in health professionals after occupational exposure. METHOD Literature was searched for the databases PubMed, Lilacs, The Cochrane Library and Scopus with free and controlled language (MeSH terms) using boolean operators AND and OR. The research was limited to articles published between 2005-2016. RESULTS 11 articles were selected depending on their relevancy to this review's aim. Nine of the 11 articles proved the existence of damage to genetic material (DNA) of health workers, who were exposed to cytostatics. Furthermore, current security practices do not eliminate the chance of exposure completely. Therefore, the creation of new clinical trials is required. CONCLUSIONS Handling cytostatic drugs can cause a genotoxic risk to health workers who are exposed to these substances. This exposure may cause damage on the workers' DNA. There are not enough data to prove a cause-effect relationship between the genotoxic risk and adverse reactions on individuals. Health education will be the main way to raise the awareness and prevention this problem.
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Affiliation(s)
| | | | - David Peña Otero
- Hospital Sierrallana, Instituto de Investigación Sanitaria Valdecilla, Grupo de Enfermería (IDIVAL), Torrelavega, Cantabria, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Grupo de Enfermería (IiSGM), Madrid, Spain.
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Aristizabal-Pachon AF, Castillo WO. Genotoxic evaluation of occupational exposure to antineoplastic drugs. Toxicol Res 2019; 36:29-36. [PMID: 31998624 DOI: 10.1007/s43188-019-00003-7] [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] [Received: 10/02/2018] [Revised: 01/18/2019] [Accepted: 01/29/2019] [Indexed: 12/19/2022] Open
Abstract
During the last years, several reports have provided evidence about adverse health effects on personal involved in Antineoplastic Drugs (ANPD) handling. ANPD has the ability to bind DNA, thus produce genotoxic damage. In this way, XRCC1 and XRCC3 proteins are necessary for efficient DNA repair and polymorphisms in this genes can be associated with an individual response to ANPD exposure. Therefore, the aim of this study was to evaluate genetic damage of occupational exposure to antineoplastic drugs and the possible effect of XRCC1 and XRCC3 polymorphisms in oncology employees from Bogotá, Colombia. Peripheral blood samples were obtained from 80 individuals, among exposed workers and healthy controls. The comet assay and Cytokinesis-block micronucleus cytome assay was performed to determinate genetic damage. From every sample DNA was isolated and genotyping for XRCC1 (Arg194Trp, Arg280His and Arg399Gln) and XRCC3 (Thr241Met) SNPs by PCR-RFLP. The exposed group showed a significant increase of comet assay results and micronucleus frequency, compared with unexposed group. It was observed a gender, exposure time and workplace effect on comet assay results. Our results showed no significant associations of comet assay results and micronucleus frequency with either genotype, allele, nor haplotype of XRCC1 and XRCC3 SNPs. The results suggest that occupational exposure to ANPD may lead to genotoxic damage and even be a risk to human health. To our knowledge, this is the first study to assess the genotoxic damage of occupational exposure to APND in South America.
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Affiliation(s)
- Andres Felipe Aristizabal-Pachon
- 1Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Carrera 7 # 43-82, Bogota, D.C. Colombia
| | - Willian Orlando Castillo
- 2Department of Biology, Faculty of Natural Sciences, Exact and Education, University of Cauca, Popayán, Colombia
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Mateo González-Román M, Hidalgo García PP, Peña Otero D. Cystostatic drugs and risk of genotoxicity in health workers. A literature review. ENFERMERIA CLINICA 2019; 31:S1130-8621(19)30287-6. [PMID: 31506228 DOI: 10.1016/j.enfcli.2019.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 04/03/2019] [Accepted: 07/21/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To analyse the genotoxic risk of cytostatic drugs in health professionals after occupational exposure. METHOD The literature was searched using the databases PubMed, Lilacs, The Cochrane Library and Scopus with free and controlled language (MeSH terms) using Boolean operators AND and OR. The research was limited to articles published between 2005-2016. RESULTS 11 articles were selected depending on their relevancy to this review's aim. Nine of the 11 articles proved the existence of damage to genetic material (DNA) of health workers, who were exposed to cytostatics. Furthermore, current security practices do not fully eliminate the chance of exposure. Therefore, new clinical trials are required. CONCLUSIONS Handling cytostatic drugs can cause a genotoxic risk to health workers who are exposed to these substances. This exposure may cause damage to the workers' DNA. There are not enough data to prove a cause-effect relationship between the genotoxic risk and adverse reactions in individuals. Health education will be the main way to raise awareness of and prevent this problem.
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Affiliation(s)
| | | | - David Peña Otero
- Hospital Sierrallana, Instituto de Investigación Sanitaria Valdecilla, Grupo de Enfermería (IDIVAL), Torrelavega, Cantabria, España; Instituto de Investigación Sanitaria Gregorio Marañón, Grupo de Enfermería (IiSGM), Madrid, España.
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The comet assay for human biomonitoring: Effect of cryopreservation on DNA damage in different blood cell preparations. MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2019; 843:11-17. [PMID: 31421731 DOI: 10.1016/j.mrgentox.2019.02.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 02/12/2019] [Accepted: 02/13/2019] [Indexed: 11/24/2022]
Abstract
This study was designed within the frame of the COST Action hCOMET 15132 (Working Group 6), with the aim of comparing different peripheral blood cell preparations for their feasibility in human biomonitoring studies, using the comet assay for the evaluation of DNA damage. Basal levels of strand breaks/ALS and formamidopyrimidine DNA glycosylase (Fpg) - sites, and H2O2 (500 μM)-induced strand breaks, were measured in whole blood, peripheral blood mononuclear cells - lymphocytes and monocytes - and buffy coat; in fresh and 1, 4 and 12 weeks-frozen samples. The comparison among the fresh preparations showed that the basal levels of DNA damage were all very low and similar in the three samples. Frozen whole blood samples stored in cryostraws without cryoprotection showed similar basal levels of DNA damage as fresh samples, indicating that this preparation, often chosen for biobanks, resists efficiently freezing/thawing artifacts. However, long-term storage of frozen buffy coat samples in cryostraws and with no cryopreservative did not appear feasible. Storage up to 3 months of frozen cryoprotected peripheral blood mononuclear cells induced small increases in basal strand breaks and no other statistically significant modification. Altogether, this study suggests that whole blood could be the most suitable sample to be used to perform comet assay in human epidemiological biomonitoring for genotoxicity assessment in frozen samples, such as those stored in biobanks.
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Safe Handling of Anti-Neoplastic Drugs in the University Hospitals: A Descriptive Survey Study Among Oncology Nurses. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2018. [DOI: 10.5812/ijcm.6482] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Gajski G, Ladeira C, Gerić M, Garaj-Vrhovac V, Viegas S. Genotoxicity assessment of a selected cytostatic drug mixture in human lymphocytes: A study based on concentrations relevant for occupational exposure. ENVIRONMENTAL RESEARCH 2018; 161:26-34. [PMID: 29100207 DOI: 10.1016/j.envres.2017.10.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 10/23/2017] [Accepted: 10/25/2017] [Indexed: 06/07/2023]
Abstract
Cytostatic drugs are highly cytotoxic agents used in cancer treatment and although their benefit is unquestionable, they have been recognized as hazardous to healthcare professionals in occupational settings. In a working environment, simultaneous exposure to cytostatics may occur creating a higher risk than that of a single substance. Hence, the present study evaluated the combined cyto/genotoxicity of a mixture of selected cytostatics with different mechanisms of action (MoA; 5-fluorouracil, cyclophosphamide and paclitaxel) towards human lymphocytes in vitro at a concentration range relevant for occupational as well as environmental exposure. The results suggest that the selected cytostatic drug mixture is potentially cyto/genotoxic and that it can induce cell and genome damage even at low concentrations. This indicates not only that such mixture may pose a risk to cell and genome integrity, but also that single compound toxicity data are not sufficient for the prediction of toxicity in a complex working environment. The presence of drugs in different amounts and with different MoA suggests the need to study the relationship between the presence of genotoxic components in the mixture and the resulting effects, taking into account the MoA of each component by itself. Therefore, this study provides new data sets necessary for scientifically-based risk assessments of cytostatic drug mixtures in occupational as well as environmental settings.
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Affiliation(s)
- Goran Gajski
- Mutagenesis Unit, Institute for Medical Research and Occupational Health, Zagreb, Croatia.
| | - Carina Ladeira
- Grupo de Investigação em Ambiente e Saúde, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisbon, Portugal; Grupo de Investigação em Genética e Metabolismo, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisbon, Portugal.
| | - Marko Gerić
- Mutagenesis Unit, Institute for Medical Research and Occupational Health, Zagreb, Croatia.
| | - Vera Garaj-Vrhovac
- Mutagenesis Unit, Institute for Medical Research and Occupational Health, Zagreb, Croatia.
| | - Susana Viegas
- Grupo de Investigação em Ambiente e Saúde, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Lisbon, Portugal; Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal.
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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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Roussel C, Witt KL, Shaw PB, Connor TH. Meta-analysis of chromosomal aberrations as a biomarker of exposure in healthcare workers occupationally exposed to antineoplastic drugs. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2017; 781:207-217. [PMID: 31416576 DOI: 10.1016/j.mrrev.2017.08.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/14/2017] [Accepted: 08/18/2017] [Indexed: 12/15/2022]
Abstract
Many antineoplastic drugs used to treat cancer, particularly alkylating agents and topoisomerase inhibitors, are known to induce genetic damage in patients. Elevated levels of chromosomal aberrations, micronuclei, and DNA damage have been documented in cancer patients. Elevations in these same biomarkers of genetic damage have been reported in numerous studies of healthcare workers, such as nurses and pharmacists, who routinely handle these drugs, but results vary across studies. To obtain an overall assessment of the exposure effect, we performed a meta-analysis on data obtained from peer-reviewed publications reporting chromosomal aberration levels in healthcare workers exposed to antineoplastic drugs. A literature search identified 39 studies reporting on occupational exposure to antineoplastic drugs and measurement of chromosomal aberrations in healthcare workers. After applying strict inclusion criteria for data quality and presentation, data from 17 studies included in 16 publications underwent meta-analysis using Hedges' bias-corrected g and a random-effects model. Results showed the level of chromosomal aberrations in healthcare workers exposed to antineoplastic drugs was significantly higher than in controls. The standardized mean differences (difference of means divided by within sd) from all studies were pooled, yielding a value 1.006 (unitless) with p<0.001. Thus, in addition to the documented genotoxic effects of antineoplastic drugs in cancer patients, this meta-analysis confirmed a significant association between occupational exposure to antineoplastics during the course of a normal work day and increases in chromosomal aberrations in healthcare workers. Based on the studies reviewed, we were unable to accurately assess whether appropriate use of protective measures might reduce the incidence of genetic damage in healthcare workers. However, given the potential for increased cancer risk linked to increases in chromosomal aberrations, the results of this study support the need to limit occupational exposure of healthcare workers to antineoplastic drugs as much as possible.
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Affiliation(s)
- Christine Roussel
- Doylestown Hospital, 595 West State Street, Doylestown, PA, 18901, United States.
| | - Kristine L Witt
- Biomolecular Screening Branch, National Institute of Environmental Health Sciences/Division of the National Toxicology Program, Research Triangle Park, NC, 27709, United States.
| | - Peter B Shaw
- Division of Applied Research and Technology, National Institute for Occupational Safety and Health, 1090 Tusculum Avenue, Cincinnati, OH, 45226, United States.
| | - Thomas H Connor
- Division of Applied Research and Technology, National Institute for Occupational Safety and Health, 1090 Tusculum Avenue, Cincinnati, OH, 45226, United States.
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Occupational exposure to cytostatic/antineoplastic drugs and cytogenetic damage measured using the lymphocyte cytokinesis-block micronucleus assay: A systematic review of the literature and meta-analysis. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2016; 770:35-45. [DOI: 10.1016/j.mrrev.2016.05.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 05/06/2016] [Accepted: 05/07/2016] [Indexed: 12/23/2022]
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17
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Moretti M, Grollino MG, Pavanello S, Bonfiglioli R, Villarini M, Appolloni M, Carrieri M, Sabatini L, Dominici L, Stronati L, Mastrangelo G, Barbieri A, Fatigoni C, Bartolucci GB, Ceretti E, Mussi F, Monarca S. Micronuclei and chromosome aberrations in subjects occupationally exposed to antineoplastic drugs: a multicentric approach. Int Arch Occup Environ Health 2014; 88:683-95. [DOI: 10.1007/s00420-014-0993-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 10/20/2014] [Indexed: 11/24/2022]
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18
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Ladeira C, Viegas S, Pádua M, Gomes M, Carolino E, Gomes MC, Brito M. Assessment of genotoxic effects in nurses handling cytostatic drugs. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2014; 77:879-87. [PMID: 25072720 DOI: 10.1080/15287394.2014.910158] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Several antineoplastic drugs have been classified as carcinogens by the International Agency for Research on Cancer (IARC) on the basis of epidemiological findings, animal carcinogenicity data, and outcomes of in vitro genotoxicity studies. 5-Fluorouracil (5-FU), which is easily absorbed through the skin, is the most frequently used antineoplastic agent in Portuguese hospitals and therefore may be used as an indicator of surface contamination. The aims of the present investigation were to (1) examine surface contamination by 5-FU and (2) assess the genotoxic risk using cytokinesis-block micronucleus assay in nurses from two Portuguese hospitals. The study consisted of 2 groups: 27 nurses occupationally exposed to cytostatic agents (cases) and 111 unexposed individuals (controls). Peripheral blood lymphocytes (PBL) were collected in order to measure micronuclei (MN) in both groups. Hospital B showed a higher numerical level of contamination but not significantly different from Hospital A. However; Hospital A presented the highest value of contamination and also a higher proportion of contaminated samples. The mean frequency of MN was significantly higher in exposed workers compared with controls. No significant differences were found among MN levels between the two hospitals. The analysis of confounding factors showed that age is a significant variable in MN frequency occurrence. Data suggest that there is a potential genotoxic damage related to occupational exposure to cytostatic drugs in oncology nurses.
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Affiliation(s)
- C Ladeira
- a Escola Superior de Tecnologia da Saúde de Lisboa , Instituto Politécnico de Lisboa , Lisbon , Portugal
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