Use of cytogenetic methods to determine mutagenic changes in the blood of pharmacy personnel and nurses who handle cytotoxic agents.

Lymphocytes of subjects from throughout the United Kingdom were studied over a two-year period beginning in January 1985 to determine the level of chromosomal damage produced by environmental exposure to cytotoxic agents. A small pilot study was conducted to determine the expected background level of chromosomal aberrations. Four groups of subjects were then recruited: pharmacy personnel who reconstituted the drugs under recommended conditions, nurses who did not reconstitute the drugs but worked on units where patients received cytotoxic chemotherapy, unexposed office workers from the same geographic location as the pharmacy personnel and nurses (negative control), and patients receiving cytotoxic drugs (positive control). Subjects completed questionnaires about smoking, viral illnesses, radiation exposure, and medication use in the past 12 months; pharmacy personnel were asked the numbers of times (1) they had handled specific drugs and (2) spills had occurred with these drugs. Lymphocytes from subjects were incubated for 48 hours, and first-division metaphases were examined for chromosome and chromatid aberrations; damage was measured as the number of aberrations per 100 cells. For a blood sample to be included in the analysis, at least 100 metaphase divisions had to be examined. Data were analyzed for 50 pharmacy staff members, 11 nurses, 12 controls, and 6 patients. Metaphase divisions in cells of the pharmacy personnel and nurses indicated no significant difference in chromosomal damage compared with the unexposed office workers. When the pharmacy, nurse, and control groups were pooled into a nonpatient group and compared with the patient group, significantly greater damage was observed in the patient group.(ABSTRACT TRUNCATED AT 250 WORDS)