[Genotoxic risk in nurses handling antiblastic drugs: systematic review of literature and meta-analysis]

Abstract

There is growing concern about possible genotoxic hazards for healthcare personnel handling cytotoxic chemotherapy drugs (CCD) due to increased use in the treatment of not only neoplastic diseases. It is therefore necessary to monitor health care workers and prevent exposure. We performed a structured computer search on Pubmed/Medline for molecular epidemiological studies reporting results referring to chromosome aberration (CA) in nurses exposed to CCD. Selected studies reported average group data relative to frequency of structural/numerical CA and the corresponding measures of dispersion. We calculated the ratio of mean as a measure of effect. We conducted a meta-analytic review of 26 studies. In most of the cases, studies showed a high frequency of CA in the exposed personnel compared to non-exposed subjects. Our study shows a statistically significant increase of CA in exposed personnel RoM=2,01 (IC95%=1,68-2,42). According to the prognostic value of CA, the studied population appears to be much more at risk to develop cancer than unexposed nurses. This finding clearly indicates the necessity to improve some steps in the administration process and nurses' awareness of genotoxic risk.