URINARY CYCLOPHOSPHAMIDE EXCRETION AND CHROMOSOMAL-ABERRATIONS IN PERIPHERAL-BLOOD LYMPHOCYTES AFTER OCCUPATIONAL EXPOSURE TO ANTINEOPLASTIC AGENTS

In this study we have compared the results of a method for the detecti on of cyclophosphamide in urine and the results of analysis of chromos omal aberrations in peripheral blood lymphocytes of four groups of sub jects with various exposure statuses. These groups are 17 Dutch and 11 Czech exposed workers (mainly hospital nurses and pharmacy technician s) handling antineoplastic agents and 35 Dutch and 23 Czech controls ( nurses, medical doctors, pharmacy and lab technicians) not handling th ese drugs. The groups were subdivided into smokers and non-smokers bec ause of a confounding effect of smoking. Within the Dutch groups, the percentage of aberrant cells and the number of breaks per cell were in creased for smokers compared to non-smokers. The percentage of aberran t cells was increased in Dutch exposed workers in comparison with Dutc h control workers. Within the Czech groups the percentage of aberrant cells and the number of breaks per cell were increased in exposed work ers in comparison with control workers. However, both Dutch and Czech smokers mainly contributed to the increase. The results suggest an add itive effect of exposure and smoking in the Dutch subjects and a more than additive effect in the Czech subjects. In urine samples of three out of 11 Dutch exposed workers cyclophosphamide was found in a range of 0.1-0.5 mu g/24 h. Higher levels were detected in the urine of eigh t out of 11 Czech exposed workers, a range of 0.1-2.9 mu g/24 h. No co rrelation was observed between the amounts of cyclophosphamide excrete d in urine on the one hand and the percentage of aberrant cells and th e number of breaks per cell on the other hand. The present study is th e first study showing that hospital workers having an increase in chro mosome aberrations related to their work are exposed to at least one a ntineoplastic agent.