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Occupational exposure to cyclophosphamide.

M Hirst, S Tse, D G Mills

    Lancet (London, England)
    |January 28, 1984
    PubMed
    Summary
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    Healthcare workers may be exposed to anticancer drugs like cyclophosphamide (CP) through skin contact or inhalation. Studies found CP in nurses' urine, suggesting occupational exposure risks during drug preparation.

    Area of Science:

    • Occupational Health
    • Pharmacology
    • Environmental Health

    Background:

    • Occupational exposure to anticancer drugs poses risks to healthcare personnel.
    • Previous research indicates potential health hazards for staff handling cytotoxic agents.

    Purpose of the Study:

    • To investigate the occupational exposure of healthcare personnel to cyclophosphamide (CP).
    • To determine the absorption routes and presence of CP in urine samples of nurses and volunteers.

    Main Methods:

    • Urine samples from two oncology nurses and five volunteers were analyzed for CP using gas chromatography.
    • Volunteers received topical application of CP to assess dermal absorption.
    • Gas-chromatography/mass-spectrometry confirmed the identity of CP.

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    Main Results:

    • Cyclophosphamide (CP) was detected in urine samples from volunteers after topical application, with variable absorption over 24 hours.
    • CP was found in urine samples from nurses, but levels did not correlate with drug quantities handled.
    • CP appeared more rapidly in nurses' urine than volunteers', suggesting potential inhalation exposure.

    Conclusions:

    • Occupational exposure to cyclophosphamide (CP) is confirmed in healthcare settings.
    • Both dermal absorption and possibly inhalation of aerosols during drug preparation contribute to CP exposure in nurses.
    • Findings suggest CP metabolites may contribute to increased mutagenicity observed in oncology nurses' urine.