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

Objectives People who handle antineoplastic drugs,
many of which classified as human carcinogens by
International Agency for Research on Cancer, are
exposed to low doses in comparison with patients;
however, the long duration of exposure could lead to
health effects. The aim of this work was to evaluate
DNA damage in white blood cells from 63 nurses who
handle antineoplastic drugs in five Italian hospitals and
74 control participants, using different versions of the
Comet assay.
Methods Primary DNA damage was assessed by using
the alkaline version of the assay on leucocytes, whereas
to detect DNA oxidative damage and cryptic lesions
specifically, the Comet/ENDO III assay and the Comet/
araC assay were performed on leucocytes and
lymphocytes, respectively.
Results In the present study, no significant DNA
damage was correlated with the work shift. The exposed
population did not differ significantly from the reference
group with respect to DNA primary and oxidative
damage in leucocytes. Strikingly, in isolated lymphocytes
treated with araC, lower data dispersion as well as a
significantly lower mean value for the percentage of
DNA in the comet tail was observed in exposed
participants as compared with the control group
( p<0.05), suggesting a potential chronic exposure to
crosslinking antineoplastic drugs.
Conclusions Although stringent rules were adopted at
national and international levels to prevent occupational
exposure to antineoplastic drugs, data reported in this
study support the idea that a more efficient survey on
long-lasting exposures at very low concentrations is
needed.