Antineoplastic drugs (AD) are a group of chemicals known to be mutagenic/carcinogenic. Concern has raised about possible genotoxic hazards for healthcare personnel handling these drugs, as occupational exposure to AD is still frequent in hospital settings despite significant safety policy improvements. Biomonitoring of genotoxic hazards has been reported in several studies, mainly by the use of cytogenetic assays, such as analysis of chromosome aberrations (CA) or micronuclei (MN) in peripheral blood lymphocytes. We have performed a systematic review of molecular epidemiology studies of occupational exposure to AD in the attempt to discover whether a general trend could be evinced on this topic. A structured computer search on PubMed was performed for molecular epidemiological studies reporting results of primary researches with cross-sectional evaluation of MN in personnel occupationally exposed to AD. Selected studies had to report average (± SD or SEM) group data for frequency of structural/numerical chromosome aberrations and/or micronuclei. The systematic review identified 28 studies. As a measure of effect we calculated the ratio of means (RoM), defined as the mean value in the exposed group divided by the mean value in the control group, useful to compare studies with outcomes expressed in different units (e.g., %, etc.). To perform the meta-analysis we used the software Review Manager (RevMan 5.1) by The Cochrane Collaboration. The majority of the studies had shown a high level of MN in healthcare personnel exposed to AD, compared to unexposed subjects, RoM = 5,02 [4,99-5,04]. The asymmetry in the lower part of the Funnel plot is due to small sample size of the studies in literature. In according to the prognostic value of MN, the studied population appears to be much more at risk to develop cancer than unexposed nurses. This finding clearly indicates the necessity to improve some steps in the administration process of AD to appropriately cope with genotoxic risk. Key messages Healthcare personnel handling AD is exposed to a high genotoxic risk Guidelines for handling AD, as well as safety recommendation, should be issued
Genotoxic effects in nurses occupationally exposed to antineoplastic drugs: meta-analysis of data.
GIANFREDI, VINCENZA;LEVORATO, SARA;VILLARINI, Milena;MORETTI, Massimo
2015
Abstract
Antineoplastic drugs (AD) are a group of chemicals known to be mutagenic/carcinogenic. Concern has raised about possible genotoxic hazards for healthcare personnel handling these drugs, as occupational exposure to AD is still frequent in hospital settings despite significant safety policy improvements. Biomonitoring of genotoxic hazards has been reported in several studies, mainly by the use of cytogenetic assays, such as analysis of chromosome aberrations (CA) or micronuclei (MN) in peripheral blood lymphocytes. We have performed a systematic review of molecular epidemiology studies of occupational exposure to AD in the attempt to discover whether a general trend could be evinced on this topic. A structured computer search on PubMed was performed for molecular epidemiological studies reporting results of primary researches with cross-sectional evaluation of MN in personnel occupationally exposed to AD. Selected studies had to report average (± SD or SEM) group data for frequency of structural/numerical chromosome aberrations and/or micronuclei. The systematic review identified 28 studies. As a measure of effect we calculated the ratio of means (RoM), defined as the mean value in the exposed group divided by the mean value in the control group, useful to compare studies with outcomes expressed in different units (e.g., %, etc.). To perform the meta-analysis we used the software Review Manager (RevMan 5.1) by The Cochrane Collaboration. The majority of the studies had shown a high level of MN in healthcare personnel exposed to AD, compared to unexposed subjects, RoM = 5,02 [4,99-5,04]. The asymmetry in the lower part of the Funnel plot is due to small sample size of the studies in literature. In according to the prognostic value of MN, the studied population appears to be much more at risk to develop cancer than unexposed nurses. This finding clearly indicates the necessity to improve some steps in the administration process of AD to appropriately cope with genotoxic risk. Key messages Healthcare personnel handling AD is exposed to a high genotoxic risk Guidelines for handling AD, as well as safety recommendation, should be issuedI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
