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"Sister Chromatid Exchanges and Micronuclei in Lymphocyte of Nurses Handling Antineoplastic Drugs"
M Ansari-Lari,M Saadat,M Shahryari,DD Farhud
Iranian Journal of Public Health , 2001,
Abstract: Individuals handling antineoplastic drugs or their wastes may absorb these potent genotoxic agents. The effects of handling antineoplastic drugs were examined in a group of 24 nurses working in the hematology and oncology departments of two different university hospitals in Shiraz (Iran) and in a group of 18 unexposed nurses as control group. The cytogenetic repercussions of exposure were assessed by examining sister chromatid exchanges (SCEs) and micronuclei (Mn) in circulating lymphocytes. A significant increased frequencies of SCE and Mn is observed in circulating lymphocytes. A significant increased frequencies of SCE and Mn is observed in nurses in daily contact with antineoplastic drugs as compared to control group.
Cancer incidence and adverse pregnancy outcome in registered nurses potentially exposed to antineoplastic drugs
Pamela A Ratner, John J Spinelli, Kris Beking, Maria Lorenzi, Yat Chow, Kay Teschke, Nhu D Le, Richard P Gallagher, Helen Dimich-Ward
BMC Nursing , 2010, DOI: 10.1186/1472-6955-9-15
Abstract: Female RNs registered with a professional regulatory body for at least one year between 1974 and 2000 formed the cohort (n = 56,213). The identifier file was linked to Canadian cancer registries. An RN offspring cohort from 1986 was created by linkages with the BC Birth and Health Status Registries. Exposure was assessed by work history in oncology or cancer agencies (method 1) and by estimating weighted duration of exposure developed from a survey of pharmacists and nursing unit administrators of all provincial hospitals and treatment centers and the work history of the nurses (method 2). Relative risks (RR) were calculated using Poisson regression for cancer incidence and odds ratios (OR) were calculated for congenital anomaly, stillbirth, low birth weight, and prematurity incidence, with 95% confidence intervals.In comparison with other female RNs, method 1 revealed that RNs who ever worked in a cancer center or in an oncology nursing unit had an increased risk of breast cancer (RR = 1.83; 95% CI = 1.03 - 3.23, 12 cases) and their offspring were at risk for congenital anomalies of the eye (OR = 3.46, 95% CI = 1.08 - 11.14, 3 cases). Method 2 revealed that RNs classified as having the highest weighted durations of exposure to antineoplastic drugs had an excess risk of cancer of the rectum (RR = 1.87, 95% CI = 1.07 - 3.29, 14 cases). No statistically significant increased risks of leukemia, other cancers, stillbirth, low birth weight, prematurity, or other congenital anomalies in the RNs' offspring were noted.Female RNs having had potential exposure to antineoplastic drugs were not found to have an excess risk of leukemia, stillbirth, or congenital anomalies in their offspring, with the exception of congenital anomalies of the eye, based on only three cases; however, elevated risks of breast and rectal cancer were observed.The nursing profession is known to involve occupational exposures that may have adverse health effects. Lie and Kj?heim's [1] review of 19 publi
A study protocol for the evaluation of occupational mutagenic/carcinogenic risks in subjects exposed to antineoplastic drugs: a multicentric project
Massimo Moretti, Roberta Bonfiglioli, Donatella Feretti, Sofia Pavanello, Francesca Mussi, Maria G Grollino, Milena Villarini, Anna Barbieri, Elisabetta Ceretti, Mariella Carrieri, Annamaria Buschini, Massimo Appolloni, Luca Dominici, Laura Sabatini, Umberto Gelatti, Giovanni B Bartolucci, Paola Poli, Laura Stronati, Giuseppe Mastrangelo, Silvano Monarca
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-195
Abstract: About 80 healthy non-smoking female nurses, who job it is to prepare or handle antineoplastic drugs, and a reference group of about 80 healthy non-smoking female nurses not occupationally exposed to chemicals will be examined simultaneously in a cross-sectional study. All the workers will be recruited from five hospitals in northern and central Italy after their informed consent has been obtained.Evaluation of surface contamination and dermal exposure to antineoplastic drugs will be assessed by determining cyclophosphamide on selected surfaces (wipes) and on the exposed nurses' clothes (pads). The concentration of unmetabolized cyclophosphamide as a biomarker of internal dose will be measured in end-shift urine samples from exposed nurses.Biomarkers of effect and susceptibility will be assessed in exposed and unexposed nurses: urinary concentration of 8-hydroxy-2-deoxyguanosine; DNA damage detected using the single-cell microgel electrophoresis (comet) assay in peripheral white blood cells; micronuclei and chromosome aberrations in peripheral blood lymphocytes. Genetic polymorphisms for enzymes involved in metabolic detoxification (i.e. glutathione S-transferases) will also be analysed.Using standardized questionnaires, occupational exposure will be determined in exposed nurses only, whereas potential confounders (medicine consumption, lifestyle habits, diet and other non-occupational exposures) will be assessed in both groups of hospital workers.Statistical analysis will be performed to ascertain the association between occupational exposure to antineoplastic drugs and biomarkers of DNA and chromosome damage, after taking into account the effects of individual genetic susceptibility, and the presence of confounding exposures.The findings of the study will be useful in updating prevention procedures for handling antineoplastic drugs.The occupational risk of environmental contamination during the storage, reconstitution, administration of antineoplastic drugs and the
Chemotherapy-Knowledge and Handling Practice of Nurses Working in a Medical University of Nepal  [PDF]
Ramanand Chaudhary, Basant Kumar Karn
Journal of Cancer Therapy (JCT) , 2012, DOI: 10.4236/jct.2012.31014
Abstract: Background: Many antineoplastic agents are known to be teratogenic and mutagenic to humans. Nurses are the main groups that are exposed to these drugs in hospital setting. Generally, the occupational activities that pose to greatest risk of exposure are the preparation and administration of antineoplastic agents, cleaning of chemotherapy spills, and handling of patient excreta. Objective: The objectives of this study were to evaluate the knowledge of nurse regarding the way of exposure of Cytotoxic Drugs (CDs) and to determine the current patterns of use of personal protective equipments while handling antineoplastic chemotherapeutic agents. Methods: An analytic cross sectional study was carried out at BPKIHS Dharan. The study was carried out on 125 nurses. The random sampling technique was used to select the study subjects using structured and semi-structured questionnaire. Collected data were analyzed using descriptive and inferential statistics. Result: More than 92% of participants reported usually wearing gloves during chemotherapy handling; 6% reported using laboratory coats as protective garments. Usual use of face and respiratory protection was less than 5%. Chemotherapy was reported to be prepared in nursing station where there are no laminar airflow hoods in 100% of work settings. None of the subjects have reportedly provided any type of medical monitoring. Conclusion: Use and availability of gloves have increased but personal protective equipment like protective garments, face and respiratory protective, when handling chemotherapy have decreased and medical monitoring of exposed employees still is neither widely practiced nor consistent with Occupational Safety and Health Administration (OSHA) guidelines.
Nursing diagnoses for patients with hematological toxicity after antineoplastic chemotherapy based on the icnp
Marisaulina Wanderley Abrantes de Carvalho, Angela Amorim de Araújo, Maria Miriam Lima da Nóbrega
Revista de Enfermagem UFPE On Line , 2009,
Abstract: Objective: to compose affirmative the nursing diagnosis, based on ICNP Version 1.0, for patients with hematological toxicity after antineoplastic chemotherapy. Methodology: a descriptive exploratory study developed from identification of priorities in terms of ICNP , for the construction of affirmative the nursing diagnosis for patients with haematological toxicity after antineoplastic chemotherapy, using the construction of affirmative criterion provided by International Council of Nurses and in accordance with ISO 18.104. Results: since the terms were constructed eleven affirmative the nursing diagnosis: Immunologic impairment process; Fever; Dyspnea; Impaired skin integrity; Fading; Inability to perform self-care in hospitalization or in domicile; Risk for infection; Risk for septic shock; Risk for hemorrhaging process; Risk for trauma; Risk for non adherence to treatment. Conclusion: conclude that the results of the study demonstrated the service to the proposed objective and it is expected that these diagnoses nursing care applied in patients with haematological toxicity after antineoplastic chemotherapy is possible to achieve an effective assistance to this clientele.
Safe Handling of Hazardous Drugs
Polovich, M
Online Journal of Issues in Nursing , 2004,
Abstract: Recommendations for the safe handling of hazardous drugs have been available for more than twenty years. Evidence for continued risk of occupational exposure is abundant; however, nurses' use of the recommended precautions is not universal. This may be related to a lack of information or to a lack of serious concern for the potential hazards. This article includes a discussion of current issues related to handling hazardous drugs in the workplace and a review of the history of safe handling guidelines, current recommendations, and barriers to implementing guidelines in health care settings.
Procedure of safe handling with cytostatic drugs
Kod?o Dragan
Archive of Oncology , 2003, DOI: 10.2298/aoo0303223k
Abstract: Working group for safe handling with cytostatic drugs has been formed by the Ministry of Health, and it consists of professionals from IORS, Federal Bureau of Weights and Measures, Industrial Medicine, Institute of Hematology, Military Medical Academy, and Crown Agents. The aim of this working group is to prepare procedures for safe handling with cytostatic drugs, as well as program for educational seminar for nurses, medical technicians, and pharmaceutical technicians. The procedures will serve as a guide of good practice of oncology health care, and will refer to all actions that health care professionals carry out from the moment of drugs arrival to the pharmacy to the moment of their application. In the first segment of this procedure, general rules are given for working with cytotoxic agents, control for risky exposures, safe system of work, control of working environment, monitoring of the employees' health condition adequate protection in the working environment, protective equipment of the employees (gloves, mask, cap, eyeglasses, shoe covers, coats and chambers for vertical laminary air stream). Storing of cytostatics, procedure in case of accident, and waste handling and removal are also described in this segment. Fifty-three standard operational procedures are described in detail in the second segment. Training scheme for preparation of chemotherapy is given in the third segment - education related to various fields and practical part, which would be carried out through workshops, and at the end of the course participants would pass a test and obtain certificate. After the procedures for safe handling with cytostatics are legally regulated employer will have to provide minimum of protective equipment, special rooms for the drugs dissolving, chambers with laminar airflow, 6 hours working time, rotation of the staff working with drugs dissolving in intervals of every five years, higher efficiency, better health control. In conclusion this specific field of work requires great psychological and physical efforts, and know-how. When taking care of ourselves, we are taking care of the others, as well.
Antineoplastic Drugs : Treatment Principles and Toxicity
Bibu John Kariyil
Veterinary World , 2011,
Abstract: The therapy of cancer has improved dramatically during the past half century. This improvement can be traced to a number of factors: a better understanding of cancer's cause and natural history, better technologies for early detection and diagnosis, improved control of primary tumors through surgery and radiation therapy and more effective drugs. The evolution of drug therapy for cancer has progressed rapidly from alkylating agents and antimetabolites to natural products, and most recently, molecular targeted drugs such as imatinib and gefitinib. As our understanding of the biology of cancer improves, new targets for therapy are being identified daily. [Vet. World 2011; 4(8.000): 380-382]
Tumor targeting using liposomal antineoplastic drugs  [cached]
Jörg Huwyler,Jürgen Drewe,Stephan Krähenbühl
International Journal of Nanomedicine , 2008,
Abstract: J rg Huwyler1, Jürgen Drewe2, Stephan Kr henbühl21University of Applied Sciences Northwestern Switzerland, Institute of Pharma Technology, Muttenz, Switzerland; 2Department of Research and Division of Clinical Pharmacology, University Hospital Basel, Basel, SwitzerlandAbstract: During the last years, liposomes (microparticulate phospholipid vesicles) have beenused with growing success as pharmaceutical carriers for antineoplastic drugs. Fields of application include lipid-based formulations to enhance the solubility of poorly soluble antitumordrugs, the use of pegylated liposomes for passive targeting of solid tumors as well as vector-conjugated liposomal carriers for active targeting of tumor tissue. Such formulation and drug targeting strategies enhance the effectiveness of anticancer chemotherapy and reduce at the same time the risk of toxic side-effects. The present article reviews the principles of different liposomal technologies and discusses current trends in this field of research.Keywords: tumor targeting, antineoplastic drugs, liposomes, pegylation, steric stabilization, immunoliposomes
Downregulation of Scar Fibroblasts by Antineoplastic Drugs: A Potential Treatment for Fibroproliferative Disorders  [PDF]
M. Georgina Uberti, Yvonne N. Pierpont, Rajat Bhalla, Karan Desai, Martin C. Robson, Wyatt G. Payne
Surgical Science (SS) , 2016, DOI: 10.4236/ss.2016.76037
Abstract: The various fibroproliferative disorders affecting humans have in common excess fibroblast activity and persistent overexpression or dysregulated activity of transforming growth factor beta (TGF-β). Cancer has many similar characteristics. Antineoplastic drugs can downregulate fibroblast activity and cytokine growth factors. This study evaluates the effect of six antineoplastic drugs on keloid and Dupuytren’s disease fibroblasts. Keloid, normal scar, Dupuytren’s affected palmar fascia, and normal palmar fascia fibroblasts were grown and seeded into Fibroblast Populated Collagen Lattices (FPCLs). The FPCLs were treated with one of six antineoplastic drugs or left untreated as controls. At 7 days, supernatants were extracted from all FPCLs and assayed for expression of Transforming Growth Factor beta (TGF)-β1 and TGF-β2. All six antineoplastic drugs significantly inhibited FPCL contraction in both fibroproliferative conditions compared with the untreated controls (p < 0.05). Similarly, TGF-β1 and TGF-β2 expression was downregulated in the supernatants of all FPCLs by the drug exposure. Cytotoxicity did not occur in these studies and was not the reason for the results. Although antineoplastic drugs can have significant side effects when given systemically, these results may be minimized when given to small areas involved in fibroproliferative scarring or when given topically or intralesionally. These in vitro results suggest that antineoplastic drugs may have a utility for treating various fibroproliferative disorders and warrant further investigation.
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