Biological Monitoring of the Oncology Healthcare Staff Exposed to Cyclophosphamide in Two Hospitals in Tehran

Background: Antineoplastic drugs as chemotherapy agents are used for various therapeutic purposes. Occupational exposure to antineoplastic drugs is possible through inhalation, skin contact, skin absorption, and digestive or injection. Assessment of occupational exposure of staff working with anti-neoplastic drugs has been a major concern among practitioners and occupational health and safety managers. Objectives: Considering the importance of safeguarding oncology personnel against antineoplastic drugs, the aim of this study was to validate a method for analysing cyclophosphamide (CPA) in urine samples as the biomarker of the exposure of oncology personnel of two hospitals in Tehran. Methods: Standard urine samples were obtained from a healthy man without having any exposure to CPA drug. The standards urine samples of CPA within the concentration range of 0.02 to 50 microgram per liter (µg/L) were prepared by diluting the urine stock solution. Ifosfamide (IFO) was added as an internal standard at a concentration of 20 µg/L. CPA and IFO analysis by gas chromatography-electron capture detector (GC-ECD) in this study was confirmed by gas chromatography-mass spectrometry (GC-MS) for verification of their peak retention times and MS signature at 95% confidence. Results: Urinary CPA concentrations as the biomarker of the exposure of the oncology personnel were detected within the range of 0.52 to 21.4 µg/L. The drug presence in the urine of 31% (10 of 32) of two hospital staff indicate the biological monitoring potential to recognition of worker’s exposure. Conclusions: In general, biological monitoring of oncology personnel could be a useful tool for assessing occupational exposure through all routes and efficacy of the current safety measures. Owing to higher values of urinary CPA in this study compared to the studies of their colleagues abroad stringent control measures were deemed necessary.