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Extent of Primary DNA Damage Measured by the Comet Assay in Health Professionals Exposed to Antineoplastic Drugs: A Systematic Review and Meta-Analysis

1
Department of Pharmaceutical Sciences (Unit of Public Health), University of Perugia, Via del Giochetto, 06122 Perugia, Italy
2
Post Graduate School of Hygiene and Preventive Medicine, Department of Experimental Medicine, University of Perugia, Piazzale Gambuli, 06122 Perugia, Italy
3
Digestive Endoscopy Unit, IRCCS Istituto Oncologico Veneto, Via Gattamelata 64, 35128 Padova, Italy
*
Authors to whom correspondence should be addressed.
Shared first authorship. These two Authors equally contribute to the manuscript.
Int. J. Environ. Res. Public Health 2020, 17(2), 523; https://doi.org/10.3390/ijerph17020523
Received: 12 December 2019 / Revised: 9 January 2020 / Accepted: 11 January 2020 / Published: 14 January 2020
(This article belongs to the Section Occupational Safety and Health)
Background: Antineoplastic drugs (ANDs) are a broad group of chemicals showing, at the same time, carcinogenic effects. The potential, albeit true, risk of side effects cannot be accepted, especially if resulting from occupational exposure. The aim of this study was to evaluate the association between occupational exposure to ANDs and the extent of primary DNA damage in health professionals. Methods: A systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed/Medline, Web of Science, and Scopus were used to perform the literature search. The databases were examined in July 2019. Sub-group, moderator, and cumulative analyses were conducted. The trim and fill method was used in the case of potential publication bias. Results: Twenty studies were included in the qualitative analysis, and 19 in quantitative evaluation. The pooled effect size was 1.27 [(95% confidence interval (CI) = 0.66–1.88), p = 0.000] based on 1569 subjects. The moderator analysis by duration of exposure showed a positive association between duration of exposure and primary DNA damage. Conclusions: This systematic review clearly shows a significant association between occupational exposure to ANDs and the extent of primary DNA damage in health professionals. Considering these results, health professionals should be warned against this potential occupational risk.
Keywords: comet assay; single-cell gel-electrophoresis; antineoplastic drugs; occupational exposure; health personnel comet assay; single-cell gel-electrophoresis; antineoplastic drugs; occupational exposure; health personnel
MDPI and ACS Style

Gianfredi, V.; Nucci, D.; Fatigoni, C.; Salvatori, T.; Villarini, M.; Moretti, M. Extent of Primary DNA Damage Measured by the Comet Assay in Health Professionals Exposed to Antineoplastic Drugs: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2020, 17, 523.

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