Biological monitoring of occupational exposure to cytostatic drugs with platinum.

Frèdéric Deschamps, Véronique Marinutti-Liberge, Denis Lamiable

Department of Occupational Health, Faculté de Médecine, 51 rue Cognacq-Jay, 51100 REIMS, FRANCE. Tel: +33 3 26 78 44 48, Fax: +33 3 26 91 82 94, E-mail:

Backgrouund : the past 20 years has been an explosion in the introduction of effective cytostatic agents for treating malignant disease. Several cytostatic drugs have been shown to be mutagenic, teratogenic and carcinogenic in experimental systems. Medical staff is potentially exposed to a wide spectrum of antineoplastic drugs in combinations not used in therapy although in significantly lower concentration. The aim of the study was to investigate whether oncology workers are occupationally exposed to antineoplastic drug by measuring platinum urinary concentration used as marker. Patients and methods : the exposed group consisted of nurses, pharmacy technicians and pharmacists, handling antineoplastic drugs for at least one month. The control group consisted of medical workers who had never been occupationally exposed to known carcinogenic substances. Each person was interviewed. The questions covered a detail occupational, medical and family history, and adverse effects outbreaks. Frequency of handling cytostatic drugs was evaluated. Last information include the type of protective measures used. Results : platinum was included in two of the four most frequently used drugs. An elevated level of urinary platinum (0.63 µg/g creat.) was found in one exposed worker, and none in the control group. No relationships were observed between the excretion rate and the kind of activity, the frequency or the duration of handling cytostatic drugs, or the excretion rates and the use of gloves or masks. Conclusion : occupational surveillance of health care workers is often inconsistent. The biomonitoring using platinum or other methods is simple, fast and selective. Since even very low exposure levels may result in a health hazard, high sensitivity by metal dosage is required.

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Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Paris, France; February 9 - 12, 2002; in the section on Environment and Occupation.