Biomarker end-points in occupational exposure to antineoplastic drugs

P104-037 BIOMARKER END-POINTS IN OCCUPATIONAL EXPOSURE TO ANTINEOPLASTIC DRUGS A. Colacci (1), S. Perdichizzi (1), P. Silingardi (1), M. C. Nucci (2), M. Vaccari (1), A. Barbieri (3), C. Bolognesi (4), M. G. Mascolo (1), F. S. Violante (3), S. Grilli (5), E. Morandi (1). (1) Environmental Protection and Health Prevention Agency, Emilia-Romagna, Italy, Bologna, Italy (2) Occupational Health Unit, Sant’Orsola-Malpighi Hospital, Bologna, Italy, (3) Occupational Medicine Unit, University of Bologna, Sant’Orsola-Malpighi Hospital, Bologna, Italy, (4) Environmental Carcinogenesis Unit National Institute for Cancer Research (IST) – Genoa, Italy, (5) Dept. Experimental Pathology, Cancer Research Section, Bologna University Medical School, Antineoplastic drugs (AD) have been in clinical use for five decades. A number of studies indicate that antineoplastic drugs may cause increased genotoxic effects in pharmacists and nurses exposed in the workplace. Studies of toxicities, however, are complicated by a number of factors including the general lack of sensitive and specific measures of biological absorption as well as the "mixture" of exposures to various ADs in combination with workplace and lifestyle exposures. The present study aims at identifying markers of early exposure to AD in occupational groups, that could be applied in the evaluation and monitoring of primary prevention measures. For this purpose, the study recruited a sample of nurses exposed to AD and a control group including not exposed nurses working in the same health care facility. Several approaches were adopted to investigate the early response to the exposure, including the environmental monitoring of working surfaces, the concentration of drugs in urine, the identification of micronuclei in peripheral lymphocytes and in buccal mucosa cells as well as the assessment of the expression of heat shock proteins (HSP). Despite the usage of personal protective equipment, 19 out of the 50 exposed workers were found positive for at least one of the checked drugs. The micronuclei induction was not increased in the exposed workers in both tests on peripheral blood lymphocytes and on exfoliated buccal cells. No difference was observed in the expression of HSPs 27, 70, 90, 110, chosen as early markers of exposure, between the exposed and not exposed groups. However, HSP 27 is significantly higher in the subgroup that was exposed to more than one drug and the expression varied according to the number of used drugs. This result is suggestive of a possibile use of HSP 27 as an early biomarker of exposure to multiple ADs.