Long-term monitoring of sister chromatid exchanges and micronucleus frequencies in pharmacy personnel occupationally exposed to cytostatic drugs

Objectives: Many antineoplastic drugs were found to have carcinogenic, muta genic and teratogenic potential. The aim of this study was to carry out cyt ogenetic and internal dose monitoring of hospital pharmacy personnel regula rly involved in the preparation of cytostatic agents, in order to test poss ible cytostatics-induced genotoxic effects due to occupational exposure und er routine working conditions, and in cases of accidental contamination. Methods: Platinum in whole blood and anthracyclines in plasma were measured to assess internal exposure to cytostatics. The level of cytogenetic damag e was determined in peripheral blood lymphocytes with the micronucleus test and the sister chromatid exchange assay. Five series of monitoring were pe rformed over a period of 2 years. Results: No significant differences in the mean frequencies of sister chrom atid exchanges (SCE) and micronuclei (MN) were found between occupationally exposed probands and controls (9.9 +/- 1.4 vs 10.1 +/- 1.2 SCEs/cell and 2 1.2 +/- 7.2 vs 23.3 +/- 7.5 MN/2000 binucleated (BN) cells, n = 16). Signif icant elevations of SCE or MN were detected in seven out of 13 cases of acc idental contamination at the workplace, whereas no increase in platinum in blood and anthracyclines in plasma was observed in these probands. Two case s of non-reported contamination were identified by measurement of epirubici n in plasma. Smoking was found to increase the SCE significantly. No correl ation between individual SCE scores and MN scores was observed. Conclusions: Our findings support a transient increase in SCE or MN after r elevant exposure to cytostatic drugs in cases of accidental contamination. The lack of significant differences in SCE and MN between hospital pharmacy personnel and unexposed controls, points to high standards of safety at th e corresponding workplaces.