Environmental Contaminations and Occupational Exposures Involved in Preparation of Chemotherapeutic Drugs

Many healthcare workers are concerned about the risk of occupational exposures to hazardous drugs. Since Falck [Falck et al.,1979] reported that mutagens were detected in the urine samples of nurses involved in chemotherapy, many reports have been published about the presence of urinary mutagen [Roth et al.,1994; Burgaz et al.,1999; Kasuba et al.,1999; Lanza et al.,1999; Jakab et al.,2001; Kopjar & Garaj-Vrhovac,2001], and about the detection of unchanged hazardous drugs in the urine samples of healthcare workers [Hirst et al.,1984; Sessink et al.,1992, 1994, 1995; Ensslin et al.,1994; Minoia et al.,1998; Burgaz et al.,1999; Pethran et al.,2003]. Tomioka [Tomioka & Kumagai,2005] monitored occupational exposures to hazardous drugs by routes of exposures and the levels at which the drugs exert their effects; i.e. (i) external exposures, exposure to airborne drugs and drugs deposited on the working table; (ii) internal exposures, presence of drugs or their metabolites in blood and urine; (iii) cellular level effects, presence of mutagens in urine and frequency of sister chromatid exchanges; and (iv) effects on individual level, susceptibility to cancer and effects on reproduction. Recent improvements of analytical instruments have permitted direct monitoring of external exposures and internal exposures.