Monitoring exposure of nursing and pharmacy personnel to cytotoxic drugs: urinary mutation assays and urinary platinum as markers of absorption.

In a study to determine whether hospital staff who handle cytotoxic drugs show signs of drug absorption, urinary mutagenicity assays gave positive results in a high proportion of non-exposed control subjects as well as in "exposed" hospital staff and were therefore considered unsuitable for routine monitoring. Determination of urinary platinum levels with atomic-absorption spectrophotometry of untreated urine may be a useful alternative. With this method platinum levels were below the reliable limits of detection in nurses and pharmacists who handled cytotoxic drugs (including platinum-containing drugs) and in controls. The urine of cisplatin-treated patients contained an average platinum level of 7 micrograms/ml, suggesting that contact with urine from patients undergoing intensive chemotherapy may be hazardous.