Tompa Anna, Biró Anna, Jakab Mátyás
Semmelweis University, Institute Public Health, Budapest, Hungary.
Department of Geno- and Immune-toxicology, National Public Health Center, National Directorate of Chemical Safety, Budapest, Hungary.
Asia Pac J Oncol Nurs. 2016 Oct-Dec;3(4):365-369. doi: 10.4103/2347-5625.196484.
Several biomarkers may be used to detect harmful exposure and individual susceptibility to cancer. Monitoring of biomarkers related to exposure may have a significant effect on early detection of cell transformation, thereby aiding the primary prevention of various chronic and malignant diseases. Nurses who handle cytotoxic drugs are exposed to carcinogenic agents, which have the potential to interrupt the cell cycle and to induce chromosomal aberrations. The presence of high chromosomal aberrations indicates the need for intervention even when exposure to these carcinogens is low.
Nationally representative samples of 552 nurses were investigated by a follow-up monitoring system. The measured biomarkers were clinical laboratory routine tests, completed with genotoxicological (chromosome aberrations [CAs] and sister chromatid exchanges [SCEs]) and immunotoxicological monitoring (ratio of lymphocyte subpopulations and lymphocyte activation markers) measured on peripheral blood lymphocytes. Results were compared to the data of 140 healthy, age-matched controls.
In nurses exposed to cytostatics, we observed a significantly increased frequency of CAs and SCEs compared with those in the controls. Cytostatic drug exposure also manifested itself in an increased frequency of helper T lymphocytes. Genotoxicological and immunotoxicological changes, as well as negative health effects (i.e., iron deficiency, anemia, and thyroid diseases), increased among cytostatic exposed subjects.
These results raised concerns about the protection of nursing staff from chemical carcinogens in the working environment.
几种生物标志物可用于检测有害暴露以及个体对癌症的易感性。监测与暴露相关的生物标志物可能对细胞转化的早期检测产生重大影响，从而有助于各种慢性和恶性疾病的一级预防。处理细胞毒性药物的护士会接触致癌物质，这些物质有可能干扰细胞周期并诱导染色体畸变。即使接触这些致癌物的水平较低，但高染色体畸变的存在表明需要进行干预。
通过随访监测系统对552名具有全国代表性的护士样本进行了调查。所测量的生物标志物为临床实验室常规检测，并对外周血淋巴细胞进行了遗传毒理学（染色体畸变[CAs]和姐妹染色单体交换[SCEs]）及免疫毒理学监测（淋巴细胞亚群比例和淋巴细胞活化标志物）。将结果与140名年龄匹配的健康对照者的数据进行比较。
与对照组相比，我们观察到接触细胞抑制剂的护士中CAs和SCEs的频率显著增加。细胞抑制剂药物暴露还表现为辅助性T淋巴细胞频率增加。在接触细胞抑制剂的受试者中，遗传毒理学和免疫毒理学变化以及负面健康影响（即缺铁、贫血和甲状腺疾病）有所增加。
这些结果引发了对保护护理人员免受工作环境中化学致癌物影响的关注。
