The risks of handling cytotoxic drugs. I. Methods of testing exposure

Results of various biological and physical/chemical tests of the urines or blood of health-care personnel working with cytotoxic drugs are discussed. The outcomes of these tests are conflicting and inconclusive. The physical/chemical tests seem to be an alternative method. However, until now it has not been possible to establish the threshold concentration in urine or blood beneath which no effect has to be expected. Therefore, the interpretation of the concentration of cytotoxic drugs and/or the metabolites in the urine or blood is difficult. As long as one will not be able to provide conclusive data on the health hazards when working with cytotoxic drugs, protective measures have to be taken in order to lower the risk as much as possible.