Mohammad Javad Zare Sakhvidi1, Mohammad Hajaghazadeh2, Mehrdad Mostaghaci3, Amir Houshang Mehrparvar3, Fariba Zare Sakhvidi4, Elham Naghshineh5. 1. a Faculty of Health, Department of Occupational Health , Shahid Sadoughi University of Medical Sciences , Yazd , Iran. 2. b Faculty of Health, Department of Occupational Health , Urmia University of Medical Sciences , Urmia , Iran. 3. c Faculty of Medicine, Department of Occupational Medicine , Shahid Sadoughi University of Medical Sciences , Yazd , Iran. 4. d Faculty of Health, Department of Occupational Health , Shahid Sadoughi University of Medical Sciences , Yazd , Iran. 5. e Faculty of Medicine, Department of Obstetrics/Gynecology, Isfahan University of Medical Sciences , Isfahan , Iran.
Abstract
BACKGROUND: Unintended occupational exposure to antineoplastic drugs (ANDs) may occur in medical personnel. Some ANDs are known human carcinogens and exposure can be monitored by genotoxic biomarkers. OBJECTIVE: To evaluate the obstacles to obtaining conclusive results from a comet assay test to determine DNA damage among AND exposed healthcare workers. METHODS: We systematically reviewed studies that used alkaline comet assay to determine the magnitude and significance of DNA damage among health care workers with potential AND exposure. Fifteen studies were eligible for review and 14 studies were used in the meta-analysis. RESULTS: Under random effect assumption, the estimated standardized mean difference (SMD) in the DNA damage of health care workers was 1.93 (95% CI: 1.15-2.71, p < 0.0001). The resulting SMD was reduced to 1.756 (95% CI: 0.992-2.52, p < 0.0001) when the analysis only included nurses. In subgroup analyses based on gender and smoking, heterogeneity was observed. Only for studies reporting comet moment, I2 test results, as a measure of heterogeneity, dropped to zero. Heterogeneity analysis showed that date of study publication was a possible source of heterogeneity (B = -0.14; p < 0.0001). CONCLUSIONS: A mixture of personal parameters, comet assay methodological variables, and exposure characteristics may be responsible for heterogenic data from comet assay studies and interfere with obtaining conclusive results. Lack of quantitative environmental exposure measures and variation in comet assay protocols across studies are important obstacles in generalization of results.
BACKGROUND: Unintended occupational exposure to antineoplastic drugs (ANDs) may occur in medical personnel. Some ANDs are known humancarcinogens and exposure can be monitored by genotoxic biomarkers. OBJECTIVE: To evaluate the obstacles to obtaining conclusive results from a comet assay test to determine DNA damage among AND exposed healthcare workers. METHODS: We systematically reviewed studies that used alkaline comet assay to determine the magnitude and significance of DNA damage among health care workers with potential AND exposure. Fifteen studies were eligible for review and 14 studies were used in the meta-analysis. RESULTS: Under random effect assumption, the estimated standardized mean difference (SMD) in the DNA damage of health care workers was 1.93 (95% CI: 1.15-2.71, p < 0.0001). The resulting SMD was reduced to 1.756 (95% CI: 0.992-2.52, p < 0.0001) when the analysis only included nurses. In subgroup analyses based on gender and smoking, heterogeneity was observed. Only for studies reporting comet moment, I2 test results, as a measure of heterogeneity, dropped to zero. Heterogeneity analysis showed that date of study publication was a possible source of heterogeneity (B = -0.14; p < 0.0001). CONCLUSIONS: A mixture of personal parameters, comet assay methodological variables, and exposure characteristics may be responsible for heterogenic data from comet assay studies and interfere with obtaining conclusive results. Lack of quantitative environmental exposure measures and variation in comet assay protocols across studies are important obstacles in generalization of results.
Entities:
Keywords:
Antineoplastic drugs; Comet assay; DNA damage; Genotoxicity; Health care workers; Occupational exposure
Authors: Clara Ersson; Peter Møller; Lykke Forchhammer; Steffen Loft; Amaya Azqueta; Roger W L Godschalk; Frederik-Jan van Schooten; George D D Jones; Jennifer A Higgins; Marcus S Cooke; Vilas Mistry; Mahsa Karbaschi; David H Phillips; Osman Sozeri; Michael N Routledge; Kirsty Nelson-Smith; Patrizia Riso; Marisa Porrini; Giuseppe Matullo; Alessandra Allione; Maciej Stepnik; Magdalena Ferlińska; João Paulo Teixeira; Solange Costa; Laura-Ana Corcuera; Adela López de Cerain; Blanca Laffon; Vanessa Valdiglesias; Andrew R Collins; Lennart Möller Journal: Mutagenesis Date: 2013-02-27 Impact factor: 3.000