Biomarkers of occupational exposure do anticancer agents: A minireview

The majority of anticancer agents has in common DNA-damaging properties and affects not only target-cells but also non-tumour cells. Its genotoxicity has been demonstrated in experimental models and in cancer patients treated with chemotherapy. Health care personnel involved in the preparation and administration of chemotherapy is therefore at risk for adverse health effects, since most environmental sampling studies demonstrated that there is widespread contamination of work surfaces and equipments with anticancer drugs. Adherence to safety guidelines and proper use of personal protective equipment are insufficient to prevent significant absorption, as evidenced by the presence of detectable amounts of drugs in urine samples and increased frequency of genotoxicity biomarkers. In this minireview, a critical appraisal of the most important biomarkers used for the evaluation of occupational exposure to anticancer agents as well as a summary of the key findings from several studies published in this field is performed.

► We review publications on biomarkers in healthcare personnel exposed to cytostatics.
► Exposure biomarkers are positive in nearly all studies.
► Most studies using effect (genotoxicity) biomarkers are also positive.
► So far only chromosomal aberrations and micronuclei correlate with future cancer risk.
► Present data on susceptibility biomarkers needs further larger scale investigation.