Abstract
The bacterial fluctuation test and measurement of the frequency of sister chromatid exchanges were used for evaluation of the exposure of different groups of hospital personnel to cytostatic drugs.
Increased mutagenic activity in the urine was detected only in personnel working with inadequate safety precautions, e.g., lack of a ventilated safety cabin for preparation of parenteral solutions. Although such a safety cabin was used within the hospital pharmacy, increased mutagenic activity was detected in the urine of prescriptionists preparing parenteral cytostatic drugs. After a change of glove material and improvement of ventilation in the safety cabin, no work-related increase in urinary mutagenic activity was seen. None of the different groups tested, showed any increase in the frequency of sister chromatid exchanges.
It is therefore concluded that handling of cytostatic drugs according to the issued safety recommendations including working in a well ventilated safety cabin, will not result in any enhancement of mutagenic activity in the urine related to work.
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References
Ames BN, McCann J, Yamaski E (1975) Methods for detecting carcinogens and mutagens with the Salmonella/mammalian microsome mutagenicity test. Mutat Res 31: 347–364
Andersson RW, Puckett WH, Dana WJ, Nguyen TV, Theiss JC, Matney TS (1982) Risk of handling injectable antineoplastic agents. Am J Hosp Pharm 39: 1881–1887
Benedict WF, Baker MS, Haroun L, Choi E, Ames BN (1977) Mutagenicity of cancer chemotherapeutic agents in the Salmonella/microsome test. Cancer Res 37: 2203–2213
Clark LC, Thompson HL (1949) Determination of creatine an creatinine in urine. Anal Chem 21: 1218–1225
Bos RP, Leenaars AO, Theuws JLG, Henderson PTH (1982) Mutagenicity of urine from nurses handling cytostatic drugs. Influence of smoking. Int Arch Occup Environ Health (in press)
Falck K (1982a) Application of the bacterial urinary mutagenicity assay in detection of exposure to genotoxic chemicals. Academic dissertation, University of Helsinki/Institute of Occupational Health, pp 55
Falck K (1982b) Urinary mutagenicity caused by smoking. In: Sorsa M, Vainio H (eds) Mutagens in our environment. Alan R. Liss Publ. Co., New York, pp 387–400
Falck K, Gröhn P, Sorsa M, Vainio H, Heinonen E, Holsti LR (1979) Mutagenicity in urine of nurses handling cytostatic drugs. Lancet 1: 1250–1251
Falck K, Sorsa M, Vainio H, Kilpikari K (1980) Mutagenicity in urine of workers in rubber industry. Mutat Res 79: 45–52
Green MHL, Bridges BA, Rogers AM, Horspool G, Murel KJ, Bridges JW, Fry JR (1977) Mutagenicity screening by a simplified bacterial fluctuation test: use of microsomal preparations and whole liver cells for metabolic activation. Mutat Res 48: 287–294
Gundersen S (1976) Forsiktighetsregler ved preparering og infusjon av cytostatika. Tidsskr Nor Lægefören 96: 1388
Haglund U, Zech L (1979) Simultaneaous staining of sister chromatid exchanges and Q-bands in human chromosomes. After treatment with methyl methane sulphonate, quinarcrine mustard and quinarcrine. Hum Genet 49: 307–317
Harris CC (1976) The carcinogenicity of anticancer drugs: a hazard in man. Cancer 37: 1014–1023
IARC (International Agency for Research on Cancer) (1981) Monographs on the evaluation of the carcinogenic risk of chemicals to humans. Some antineoplastic and immunosuppressive agents, vol 26. IARC, Lyon France, pp 441
Kleinberg ML, Quinn MJ (1981) Airborne drug levels in a laminar flow hood. Am J Hosp Pharm 38: 1301–1303
Knowles RS, Virden JE (1980) Handling of injectable antineoplastic agents. Br Med J 281: 589
Löfroth G (1980) Mutagenic activity in photocopies. Science 209: 1037–1039
Norppa H, Sorsa M, Vainio H, Gröhn P, Heinonen E, Holsti L, Nordman E (1980) Increased sister chromatid exchange frequencies in lymphocytes of nurses, handling cytostatic drugs. Scand J Work Environ Health 6: 299–303
Siebert D, Simon U (1973) Cyclophosphamide: Pilot study of genetically active metabolites in urine of a treated human patient. Mutat Res 19: 65–72
Sorsa M, Hemminki K, Vainio H (1982a) Biologic monitoring of exposure to chemical mutagens in the occupational environment. Teratogenesis Carcinogenesis Mutagenesis 2: 137–150
Sorsa M, Norppa H, Vainio H (1982b) Induction of sister chromatid exchanges (SCEs) among nurses handling cytostatic drugs. Banbury Proceedings, vol 14. Cold Spring Harb Lab, New York (in press)
Staiano N, Gallelli JF, Adamson RH, Thorgeirsson SS (1981) Lack of mutagenic activity in urine from hospital pharmacists admixing antitumor drugs. Lancet 1: 615–616
Tortorici M (1980) Precautions followed by personnel involved with the preparation of parenteral antineoplastic medications. Hosp Pharm 15: 293–301
Vainio H, Falck K, Sorsa M (1982) Mutagenicity in urine of workers occupationally exposed to mutagens and carcinogens. In: Aitio A, Riihimäki V, Vainio H (eds) Biological monitoring and health surveillance of workers exposed to chemicals. Hemisphere Publ Co, Washington DC 324–330
Waksvik H, Klepp P, Brøgger A (1981) Chromosome analyses of nurses handling cytostatic drugs. Cancer Treat Rep 65: 607–611
Yamasaki E, Ames BN (1977) Concentration of mutagens from urine by adsorption with the nonpolar resin XAD-2: Cigarette smokers have mutagenic urine. Proc Natl Acad Sci (USA) 74: 3555–3559
Zimmerman PF, Laben RK, Barkley EW, Gallelli JF (1981) Recommendations for the safe handling of injectable antineoplastic drug products. Am J Hosp Pharm 38: 1693–1695
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Kolmodin-Hedman, B., Hartvig, P., Sorsa, M. et al. Occupational handling of cytostatic drugs. Arch Toxicol 54, 25–33 (1983). https://doi.org/10.1007/BF00277812
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DOI: https://doi.org/10.1007/BF00277812