# Cross-Sectional Multicenter Biomonitoring Study on Genotoxicity and Oxidative DNA Damage in Oncology Healthcare Workers from Seven Italian Hospitals

## TL;DR

This study assesses DNA damage in healthcare workers handling cancer drugs, finding evidence of genotoxic and oxidative effects, and highlights the need for biomarkers in health surveillance.

## Contribution

The study demonstrates oxidative DNA damage in workers performing HIPEC and PIPAC for the first time and evaluates both direct and oxidative DNA damage in a large sample.

## Key findings

- Fpg-comet parameters were higher in exposed workers, indicating DNA damage.
- A weak correlation was found between fpg-comet and BMCyt assay results.
- Oxidative DNA damage was observed in workers handling HIPEC and PIPAC.

## Abstract

Cancer cases have been estimated that will increase in the next years with consequent increase of antineoplastic (AD) drug treatments and workers handling these hazardous chemicals. We aimed to evaluate genotoxic/oxidative effects of AD exposure by fpg-comet assay on a large size sample of workers (214 exposed and 164 controls) involved in preparation; administration, including Hyperthermic intraperitoneal chemotherapy (HIPEC) and pressurized intraperitoneal aerosol chemotherapy (PIPAC); and disposal. With the final aim to identify suitable early biomarkers of genotoxic effect useful to health surveillance, we correlated fpg-comet assay (blood) and Buccal Micronucleus Cytome (BMCyt) assay data. Fpg-comet parameters resulted higher in the exposed group vs. controls, demonstrating direct and oxidative DNA damage in workers handling ADs. Fpg-comet direct DNA damage and genotoxic parameters of BMCyt assay demonstrated a weak statistically significant correlation. This cross-sectional study is one of the few available evaluating both direct and oxidative DNA damage due to ADs on a large sample size of workers and correlating fpg-comet and BMCyt assay results. It highlights the need to evaluate genotoxic effects by both the biomarkers and furnishes a contribution to their validation. Moreover, we demonstrate for the first time oxidative DNA damage on workers performing HIPEC and PIPAC administration.