Title : Hungarian Nurse Study: Long term monitoring and follow-up among hospital nurses, handling cytostatic drugs
We have carried out a multiple end-point approach genotoxicology monitoring of nurses exposed to cytostatics since 1992, in order to follow-up the improvement in work-related conditions. In 2000 the Public Act No. XXV on Chemical Safety (11th April 2000, conforming to the directives of European Union 67/548/EEC) and the 26/2000 order of the Ministry of Health (30.Sept.2000) on the Protection against occupational carcinogenic substances and prevention of health damages caused by carcinogenic substances were elaborated. In 2004 the methodological guidelines of the National Institute of Pharmacy, Hungary on manufacturing and use of mixed cytostatic infusions was issued.
The guidelines in these regulations on the protection against exposure to carcinogenic agents and for the performance of environmental and biological monitoring at workplaces with higher cancer risk were largely based on the results of the follow-up genotoxicological and immunotoxicological monitoring of nurses exposed to cytostatics made by the our cytogenetic laboratory at the National Institute of Chemical Safety. Chromosomal studies are based on peripheral blood lymphocyte (PBL) cultures, which may present mutations as a cytogenetic change on chromosome structures.
Our genotoxicological and immunotoxicological biomarkers are suitable to indicate the need for intervention in high cancer risk groups. In those cases, where removal of environmental hazards are not efficient enough in preventive measures since they’ve already suffered irreversible genetic damages, it may be possible to introduce chemoprevention, which includes changes in lifestyle, smoking and drinking habits as well as prescription of vitamins, antioxidants, minerals etc.