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Monitoring occupational exposure to cancer chemotherapy drugsReports of the health effects of handling cytotoxic drugs and compliance with guidelines for handling these agents are briefly reviewed, and studies using analytical and biological methods of detecting exposure are evaluated. There is little conclusive evidence of detrimental health effects from occupational exposure to cytotoxic drugs. Work practices have improved since the issuance of guidelines for handling these drugs, but compliance with the recommended practices is still inadequate. Of 64 reports published since 1979 on studies of workers' exposure to these drugs, 53 involved studies of changes in cellular or molecular endpoints (biological markers) and 12 described chemical analyses of drugs or their metabolites in urine (2 involved both, and 2 reported the same study). The primary biological markers used were urine mutagenicity, sister chromatid exchange, and chromosomal aberrations; other studies involved formation of micronuclei and measurements of urinary thioethers. The studies had small sample sizes, and the methods were qualitative, nonspecific, subject to many confounders, and possibly not sensitive enough to detect most occupational exposures. Since none of the currently available biological and analytical methods is sufficiently reliable or reproducible for routine monitoring of exposure in the workplace, further studies using these methods are not recommended; efforts should focus instead on wide-spread implementation of improved practices for handling cytotoxic drugs.
Document ID
20040170285
Document Type
Reprint (Version printed in journal)
Authors
Baker, E. S. (NASA Headquarters Washington, DC United States)
Connor, T. H.
Date Acquired
August 22, 2013
Publication Date
November 15, 1996
Publication Information
Publication: American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
Volume: 53
Issue: 22
ISSN: 1079-2082
Subject Category
Life Sciences (General)
Distribution Limits
Public
Copyright
Other
Keywords
Review, Academic
Review