Exposure to Antineoplastic Drugs in Occupational Settings: A Systematic Review of Biological Monitoring Data

Veruscka Leso, Cristina Sottani, Carolina Santocono, Francesco Russo, Elena Grignani, Ivo Iavicoli

Research output: Contribution to journalReview articlepeer-review


The high toxicity of antineoplastic drugs (ADs) makes them dangerous not only for patients, but also for exposed workers. Therefore, the aim of this review was to provide an updated overview of the biological monitoring of occupational AD exposure in order to extrapolate information useful to improve risk assessment and management strategies in workplaces. Several studies demonstrated that remarkable portions of healthcare workers may have traces of these substances or their metabolites in biological fluids, although with some conflicting results. Nurses, directly engaged in AD handling, were the occupational category at higher risk of contamination, although, in some cases, personnel not involved in AD-related tasks also showed quantifiable internal doses. Overall, further research carried out on greater sample sizes appears necessary to gain deeper insight into the variability retrieved in the reported results. This may be important to understand the impact of the extent of ADs use, different handling, procedures, and cleaning practices, spill occurrence, training of the workforce, as well as the adoption of adequate collective and personal protective equipment in affecting the occupational exposure levels. This may support the achievement of the greatest clinical efficiency of such therapies while assuring the health and safety of involved workers.

Original languageEnglish
Pages (from-to)3737
JournalInternational Journal of Environmental Research and Public Health
Issue number6
Publication statusPublished - Mar 1 2022


  • Antiblastic drugs
  • Biomarkers
  • Cytotoxic drugs
  • Exposure evaluation
  • Healthcare workers
  • Human biomonitoring
  • Internal dose
  • Job exposure
  • Risk assessment
  • Risk management

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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