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The meta-analysis of cytogenetic biomarkers as an assessment of occupational risk for healthcare workers exposed to antineoplastic drugs

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Abstract

Objective

Antineoplastic drugs (ADs) are widely used in clinical practice and have been demonstrated to be effective in treating malignant tumors. However, they carry a risk of cytogenotoxicity for healthcare workers. Studies have reported that genotoxic biomarkers can be applied to assess the occupational health status of healthcare workers at an early stage, but results of different studies are variable. The objectives of the review were examine the association between long-term exposure to ADs and cytogenetic damage to healthcare workers.

Methods

We systematically reviewed studies between 2005 and 2021 using PubMed, Embase and Web of Science databases that used cytogenetic biomarkers to assess occupational exposure to ADs in healthcare workers. We used RevMan5.4 to analyze the tail length parameters of the DNA, frequency of the chromosomal aberrations, sister chromatid exchanges and micronuclei. A total of 16 studies were included in our study. The studies evaluate the quality of the literature through the Agency for Healthcare Research and Quality.

Results

The results revealed that under the random-effects model, the estimated standard deviation was 2.37 (95% confidence interval [CI] 0.92–3.81, P = 0.001) for the tail length parameters of the DNA, 1.48 (95% CI 0.71–2.25, P = 0.0002) for the frequency of chromosomal aberrations, 1.74 (95% CI 0.49–2.99, P = 0.006) for the frequency of sister chromatid exchanges and 1.64 (95% CI 0.83–2.45, P < 0.0001) for the frequency of micronuclei.

Conclusions

The results indicate that there is a significant association between occupational exposure to ADs and cytogenetic damage, to which healthcare workers should be alerted.

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Data availability

Data are available on reasonable request. Data cannot be made publicly available, because public availability would compromise participant privacy.

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Acknowledgements

We thank Drs.XiaoHong Huang and Yeqing Gu for providing a careful review of the manuscript and helpful comments.

Funding

This work was supported by the special fund for the association between exposure to antineoplastic agents and genotoxicity of female healthcare workers [LGWJ2021-14].

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Authors and Affiliations

  1. Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, No.6082 Longgang Avenue, Shenzhen, 518116, China

    Hong Huang & Shuhan Liu

  2. Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China

    Yeqing Gu

  3. Longgang District Central Hospital of Shenzhen, Shenzhen, 518116, Guangdong, China

    Song Hu, Xiao Zhong, Yanshan Huang & Ji Peng

  4. Shantou University Medical College, Shantou, 515041, Guangdong, China

    Yanshan Huang

  5. Department of Nursing, Longgang District Central Hospital of Shenzhen, Shenzhen, Guangdong, China

    Xiaohong Huang

  6. Shenzhen Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China

    Xiaohong Huang

  7. Longgang District Central Hospital of Shenzhen, No.6082 Longgang Avenue, Longgang District, Shenzhen, Guangdong, China

    Xiaohong Huang

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  1. Hong Huang
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  2. Yeqing Gu
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Contributions

HH, YG and XH contributed to the study conception and design; HH, YG, SL, SH, XZ, YH and JP contributed to data collection, assembly, analysis and interpretation of the data; HH, YG and XH contributed to the manuscript drafting and revising. All authors approved the final version of the manuscript. HH was responsible for the overall content as guarantor.

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Correspondence to Xiaohong Huang.

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Huang, H., Gu, Y., Liu, S. et al. The meta-analysis of cytogenetic biomarkers as an assessment of occupational risk for healthcare workers exposed to antineoplastic drugs. Int Arch Occup Environ Health 96, 785–796 (2023). https://doi.org/10.1007/s00420-023-01969-6

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  • DOI: https://doi.org/10.1007/s00420-023-01969-6

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