Micronuclei and chromosome aberrations in subjects occupationally exposed to antineoplastic drugs: a multicentric approach

Massimo Moretti, Maria Giuseppa Grollino, Sofia Pavanello, Roberta Bonfiglioli, Milena Villarini, Massimo Appolloni, Mariella Carrieri, Laura Sabatini, Luca Dominici, Laura Stronati, Giuseppe Mastrangelo, Anna Barbieri, Cristina Fatigoni, Giovanni Battista Bartolucci, Elisabetta Ceretti, Francesca Mussi, Silvano Monarca

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20 Citations (Scopus)


Objectives: Recently published works showed that occupational exposure to antineoplastic drugs (ANPD) is still frequent in hospital settings, despite significant safety policy improvements. The aim of this study was to assess the current level of occupational exposure to ANPD and any potentially associated cytogenetic damages in hospital nurses routinely handling ANPD. Methods: Occupationally ANPD-exposed (n = 71) and ANPD-unexposed (n = 77; control) nurses were recruited on a voluntary basis from five hospitals in Northern and Central Italy. Evaluation of surface contamination and dermal exposure to ANPD was assessed by determining cyclophosphamide (CP) on selected surfaces (wipes) and on exposed nurses’ clothes (pads). The concentration of unmetabolized CP—as a biomarker of internal dose—was measured in end-shift urine samples. Biomonitoring of genotoxic effects (i.e., biological effect monitoring) was conducted by analyzing micronuclei (MN) and chromosome aberrations (CA) in peripheral blood lymphocytes. Genetic polymorphisms for enzymes involved in metabolic detoxification (i.e., glutathione S-transferases) were analyzed as well. Results: We observed a significant increase in MN frequency (5.30 ± 2.99 and 3.29 ± 1.97; mean values ± standard deviation; p < 0.0001) in exposed nurses versus controls, as well as in CA detection (3.30 ± 2.05 and 1.84 ± 1.67; p < 0.0001), exposed subjects versus controls. Our results provide evidence that, despite safety controlled conditions, ANPD handling still represents a considerable genotoxic risk for occupationally exposed personnel. Conclusions: Because both MN and CA have been described as being predictive of group-increased cancer risk, our findings point to a need for improving specific safety procedures in handling and administering ANPD.
Original languageEnglish
Pages (from-to)683 - 695
Number of pages13
JournalInternational Archives of Occupational and Environmental Health
Issue number6
Publication statusPublished - 2 Nov 2015
Externally publishedYes


All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health

Cite this

Moretti, M., Grollino, M. G., Pavanello, S., Bonfiglioli, R., Villarini, M., Appolloni, M., Carrieri, M., Sabatini, L., Dominici, L., Stronati, L., Mastrangelo, G., Barbieri, A., Fatigoni, C., Bartolucci, G. B., Ceretti, E., Mussi, F., & Monarca, S. (2015). Micronuclei and chromosome aberrations in subjects occupationally exposed to antineoplastic drugs: a multicentric approach. International Archives of Occupational and Environmental Health, 88(6), 683 - 695. https://doi.org/10.1007/s00420-014-0993-y