Abstract
Background: Antineoplastic drugs (ANDs) are a broad group of chemicals showing, at the same time, carcinogenic effects. The potential, albeit true, risk of side effects cannot be accepted, especially if resulting from occupational exposure. The aim of this study was to evaluate the association between occupational exposure to ANDs and the extent of primary DNA damage in health professionals. Methods: A systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed/Medline, Web of Science, and Scopus were used to perform the literature search. The databases were examined in July 2019. Sub-group, moderator, and cumulative analyses were conducted. The trim and fill method was used in the case of potential publication bias. Results: Twenty studies were included in the qualitative analysis, and 19 in quantitative evaluation. The pooled effect size was 1.27 [(95% confidence interval (CI) = 0.66–1.88), p = 0.000] based on 1569 subjects. The moderator analysis by duration of exposure showed a positive association between duration of exposure and primary DNA damage. Conclusions: This systematic review clearly shows a significant association between occupational exposure to ANDs and the extent of primary DNA damage in health professionals. Considering these results, health professionals should be warned against this potential occupational risk.
Highlights
Antineoplastic drugs (ANDs) are a broad group of chemicals, mainly used in chemotherapy; their anti-proliferative effect was accidentally discovered during the First and Second World Wars, when bone marrow and lymph nodes depletion was registered in soldiers exposed to sulfur mustard [1,2].the anticancer applicability of sulfur mustard was discovered in the late 1940s, and it was first used to treat non-Hodgkin’s lymphoma and leukaemia [3,4]
Considering the comet assay performed on peripheral blood lymphocytes, a total of 19 studies were included in the quantitative evaluation
One study reported the data separately for pharmacists, nurses working in day hospital, and nurses working in the ward, so they were considered as three independent studies and, for this reason, the meta-analysis included 21 datasets
Summary
Antineoplastic drugs (ANDs) are a broad group of chemicals, mainly used in chemotherapy; their anti-proliferative effect was accidentally discovered during the First and Second World Wars, when bone marrow and lymph nodes depletion was registered in soldiers exposed to sulfur mustard [1,2].the anticancer applicability of sulfur mustard was discovered in the late 1940s, and it was first used to treat non-Hodgkin’s lymphoma and leukaemia [3,4]. Antineoplastic drugs (ANDs) are a broad group of chemicals, mainly used in chemotherapy; their anti-proliferative effect was accidentally discovered during the First and Second World Wars, when bone marrow and lymph nodes depletion was registered in soldiers exposed to sulfur mustard [1,2]. Antineoplastic drugs (ANDs) are a broad group of chemicals showing, at the same time, carcinogenic effects. The potential, albeit true, risk of side effects cannot be accepted, especially if resulting from occupational exposure. The aim of this study was to evaluate the association between occupational exposure to ANDs and the extent of primary DNA damage in health professionals. The moderator analysis by duration of exposure showed a positive association between duration of exposure and primary DNA damage
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