Indoor contamination levels and health risks of antineoplastic drugs for hospital
and pharmacy personnel in the Czech Republic
(Hladiny v prostředí a zdravotní rizika cytostatik pro pracovníky nemocnic a lékáren v
ČR)
Pavel Odraska1,2
, Lenka Dolezalova1
, Jan Kuta 2
, Michal Oravec 2
, Pavel Piler2
and Ludek
Blaha1,2
1
Masaryk Memorial Cancer Institute, Zluty kopec 7, Brno, Czech Republic, CZ65653. Email:
odraska@mou.cz
2
Research Centre for Toxic Compounds in the Environment (RECETOX), Faculty of
Science, Masaryk University, Kamenice 3, Brno, Czech Republic, CZ62500.
Abstract:
Antineoplastic drugs are chemically diverse group of chemicals, which are used in
medicine to treat cancer diseases. Cytostatic/cytotoxic effects of these drugs are mostly
based on direct DNA damage. Due to their non-specific mode of action, which does not
distinguish between tumor and health cells, cytotoxic drugs have many serious side
effects such as genotoxicity, carcinogenicity, reproductive and developmental toxicity.
With respect to their toxic properties, exposure of healthcare personnel handling these
drugs is undesirable. This presentation summarises results of our studies focused on
monitoring of occupational exposure to these drugs in the Czech Republic.
The monitoring of occupational exposure was based on analytical determination
of two chosen drug markers (cyclophosphamide and platinum) in all relevant matrices
(air, surfaces, hand washes and urine). Our studies showed that under the common
working conditions, inhalation of drug containing aerosols and vapours is rather of minor
importance. In contrast, contamination of hands and working surfaces was determined
very frequently. Furthermore, biomonitoring of the markers in the workers´ urine
revealed that the workers´ exposures range up to several micrograms of individual drugs
per day. This exposure can be associated with low but not negligible risk of cancer. For
example, cancer risk associated with the exposure to cyclophosphamide reached up to 8
extra cases per million exposed person per year for individual worker.
To support the occupational safety of the hospital workers, several additional
safety measures targeted for reduction of indoor contamination were suggested and
implemented into the Masaryk Memorial Cancer Institute, which was used as a model
oncology hospital. Subsequent monitoring showed that some of them were significantly
effective and therefore they can be recommended also to other hospitals.
In conclusions, our studies brings new insights into the levels and fate of widely
used antineoplastic drugs in the working environment. The results may further serve for
both exposure modelling and critical risk management of these hazardous drugs.
Acknowledgement:
Research was supported by Ministry of Education, Czech Republic (NPVII no.
2B06171), and by the INCHEMBIOL project MSM0021622412.