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Multicentre study for the evaluation of mutagenic/carcinogenic risk in nurses exposed to antineoplastic drugs: assessment of DNA damage
  1. Annamaria Buschini1,
  2. Milena Villarini2,
  3. Donatella Feretti3,
  4. Francesca Mussi1,
  5. Luca Dominici2,
  6. Ilaria Zerbini3,
  7. Massimo Moretti2,
  8. Elisabetta Ceretti3,
  9. Roberta Bonfiglioli4,
  10. Mariella Carrieri5,
  11. Umberto Gelatti3,
  12. Carlo Rossi1,
  13. Silvano Monarca2,
  14. Paola Poli1
  1. 1Department of Life Sciences, University of Parma, Parma, Italy
  2. 2Department of Medical-Surgical Specialities and Public Health, University of Perugia, Perugia, Italy
  3. 3Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
  4. 4Section of Occupational Medicine, Department of Internal Medicine, Geriatrics and Nephrology, University of Bologna, Bologna, Italy
  5. 5Department of Molecular Medicine, University of Padova, Padova, Italy
  1. Correspondence to Professor Annamaria Buschini, Department of Life Sciences, University of Parma, Parco Area delle Scienze 11/A, Parma 43124, Italy; annamaria.buschini{at}


Objectives People who handle antineoplastic drugs, many of which classified as human carcinogens by International Agency for Research on Cancer, are exposed to low doses in comparison with patients; however, the long duration of exposure could lead to health effects. The aim of this work was to evaluate DNA damage in white blood cells from 63 nurses who handle antineoplastic drugs in five Italian hospitals and 74 control participants, using different versions of the Comet assay.

Methods Primary DNA damage was assessed by using the alkaline version of the assay on leucocytes, whereas to detect DNA oxidative damage and cryptic lesions specifically, the Comet/ENDO III assay and the Comet/araC assay were performed on leucocytes and lymphocytes, respectively.

Results In the present study, no significant DNA damage was correlated with the work shift. The exposed population did not differ significantly from the reference group with respect to DNA primary and oxidative damage in leucocytes. Strikingly, in isolated lymphocytes treated with araC, lower data dispersion as well as a significantly lower mean value for the percentage of DNA in the comet tail was observed in exposed participants as compared with the control group (p<0.05), suggesting a potential chronic exposure to crosslinking antineoplastic drugs.

Conclusions Although stringent rules were adopted at national and international levels to prevent occupational exposure to antineoplastic drugs, data reported in this study support the idea that a more efficient survey on long-lasting exposures at very low concentrations is needed.

  • Occupational exposure
  • Comet assay
  • Antineoplastic drugs

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