Systematic review of genotoxicity induced by occupational exposure to antineoplastic drugs

With increasing numbers of cancer cases, the use of antineoplastic agents is expected to rise. This will be accompanied by an increase in occupational exposure, which can cause unwanted health effects in workers. Our aim was to give an overview of genotoxic and epigenetic effects after occupational exposure to antineoplastic agents and to assess the concentration-effect relation. Four databases were searched for papers investigating genotoxic and/or epigenetic effects of occupational exposure to antineoplastic agents. Out of the 245 retrieved papers, 62 were included in this review. In this systematic literature review, we confirmed that exposure of healthcare workers to antineoplastic agents can lead to genotoxic damage. However, we observed a lack of data on exposure as well as genotoxic and epigenetic effects in workers other than healthcare workers. Furthermore, gaps in the current knowledge regarding the potential epigenetic effects caused by antineoplastic drug exposure and regarding the link between internal antineoplastic drug concentration and genotoxic and epigenetic effects after occupational exposure to antineoplastic agents were identified, offering a first step for future research.

Automated summary

With increasing cancer cases, the use of antineoplastic agents is expected to rise, leading to an increase in occupational exposure and potential health effects for workers. A systematic literature review confirmed genotoxic damage in healthcare workers exposed to antineoplastic agents, but highlighted a lack of data and knowledge on exposure, as well as genotoxic and epigenetic effects in other worker groups. Gaps in understanding the potential epigenetic effects and concentration-effect relation offer opportunities for future research.