Human effect monitoring in cases of occupational exposure to antineoplastic drugs: a method comparison.

OBJECTIVES: To investigate whether DNA damage increased in subjects possibly exposed to high amounts of antineoplastic agents.
METHODS: The level of genetic damage was determined in peripheral mononuclear blood cells with the sister chromatid exchange test, the alkaline elution technique, and the cytokinesis block micronucleus test.
RESULTS: The supposed increased exposure of the study subjects was caused by a malfunction of a safety hood resulting in leakage of air during preparation of an infusion of an antineoplastic drug. Two months after a new safety hood was installed, the frequencies of micronuclei and sister chromatid exchanges of exposed nurses (n = 10) were still significantly increased when compared with a matched control group (p < 0.01 and p < 0.05, one sided Wilcoxon test, respectively). In a second examination seven months later, the frequency of micronuclei had significantly decreased to control values (p < 0.05, one sided Wilcoxon test, n = 6). Moreover, the study subjects who smoked (n = 8) had significantly increased frequencies of micronuclei and sister chromatid exchanges (p < 0.01 and p < 0.05, one sided U test, respectively). No differences in the rate of DNA damage could be detected with the alkaline elution technique.
CONCLUSIONS: Control measures on the level of biological effect should be performed regularly to ensure maximum safety precautions for workers potentially exposed to genotoxic agents.