Veille documentaire MTPH

Médecine du travail du personnel hospitalier

Applicability of the comet assay in evaluation of DNA damage in healthcare providers’ working with antineoplastic drugs: a systematic review and meta-analysis

Auteur     Mohammad Javad Zare Sakhvidi
Auteur     Mohammad Hajaghazadeh
Auteur     Mehrdad Mostaghaci
Auteur     Amir Houshang Mehrparvar
Auteur     Fariba Zare Sakhvidi
Auteur     Elham Naghshineh
Volume     22
Numéro     1
Pages     52-67
Publication     International Journal of Occupational and Environmental Health
ISSN     2049-3967
Date     Jan 2016
Résumé     BACKGROUND: Unintended occupational exposure to antineoplastic drugs (ANDs) may occur in medical personnel. Some ANDs are known human carcinogens and exposure can be monitored by genotoxic biomarkers. OBJECTIVE: To evaluate the obstacles to obtaining conclusive results from a comet assay test to determine DNA damage among AND exposed healthcare workers. METHODS: We systematically reviewed studies that used alkaline comet assay to determine the magnitude and significance of DNA damage among health care workers with potential AND exposure. Fifteen studies were eligible for review and 14 studies were used in the meta-analysis. RESULTS: Under random effect assumption, the estimated standardized mean difference (SMD) in the DNA damage of health care workers was 1.93 (95% CI: 1.15-2.71, p < 0.0001). The resulting SMD was reduced to 1.756 (95% CI: 0.992-2.52, p < 0.0001) when the analysis only included nurses. In subgroup analyses based on gender and smoking, heterogeneity was observed. Only for studies reporting comet moment, I2 test results, as a measure of heterogeneity, dropped to zero. Heterogeneity analysis showed that date of study publication was a possible source of heterogeneity (B = -0.14; p < 0.0001). CONCLUSIONS: A mixture of personal parameters, comet assay methodological variables, and exposure characteristics may be responsible for heterogenic data from comet assay studies and interfere with obtaining conclusive results. Lack of quantitative environmental exposure measures and variation in comet assay protocols across studies are important obstacles in generalization of results.

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