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Occupational exposure of platinum-based anti-cancer drugs: five-year monitoring of hair and environmental samples in a single hospital

ABSTRACT: Background Occupational exposure to chemotherapeutic agents in hospitals is a critical issue. Here, we focused on occupational exposure to platinum-based anti-cancer drugs (PDs) by evaluating platinum concentrations in hair and environmental workplace samples to monitor the risk among workers. Methods Hospital workers who dealt with or without PDs, patients treated with PDs, and non-medical office workers outside the hospital donated hair samples and completed a questionnaire regarding their history of handling PDs, including any incidents. Hair samples were collected and surface wipe sampling was performed in July 2010 and April 2015, before and after moving to a new building and introducing a revised safety program in August 2010. Samples were analyzed by inductively coupled plasma-mass spectrometry. Results Platinum concentrations in hair from PDs-handling workers was significantly higher than in non-PDs-handling workers (P?=?0.045), although 50 times lower than that from PDs-treated patients. Platinum concentrations in the hospital environment had decreased at the second survey 5?years later but had not changed significantly in the hair samples from hospital workers. Conclusion Platinum concentrations in hair are likely dependent on the frequency of handling PDs. Reduced environmental contamination from PDs did not influence platinum levels in hospital workers’ hair. Continuous monitoring by measuring platinum concentrations in the environment and in hair would provide information regarding these issues.

SUBMITTER: Hori A

PROVIDER: S-EPMC7523399 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Project description:BackgroundCalcineurin inhibitors, including tacrolimus, remain a cornerstone of immunosuppressive therapy after kidney transplantation. However, the therapeutic window is narrow, and nephrotoxic side effects occur with overdose, while the risk of alloimmunization and graft rejection increases with underdose. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) allows quantification of tacrolimus in biological samples from patients. This study investigates the feasibility of quantifying tacrolimus in scalp hair from kidney transplant (KT) recipients and correlates hair tacrolimus concentrations with tacrolimus dosage and blood trough levels. The aim was to provide proof-of-principle for hair tacrolimus drug monitoring in KT recipients.MethodSingle-center prospective study between September 9, 2021 and December 4, 2021, including KT recipients under tacrolimus. Minors, patients with active skin or hair diseases, and patients with scalp hair shorter than 4 cm were excluded from participation. Scalp hair was collected from the posterior vertex of patients, cut into segments, and analyzed for tacrolimus by LC-MS/MS. Patients filled out a questionnaire on hair treatments and washing habits. In parallel, tacrolimus trough levels were measured in whole blood and correlated with hair tacrolimus concentrations.ResultsIn total, 39 consenting KT recipients were included, and hair samples were collected at 53 visits. Tacrolimus was detected in 98% of hair samples from patients exposed to the drug. Tacrolimus hair levels and whole blood trough levels were correlated with a beta coefficient of 0.42 (95% CI: -0.22-1.1, p = n.s.). Age and dark hair affected hair tacrolimus measurements, while different tacrolimus formulations (immediate release vs. extended release), hair washes, and permanent coloring did not. Longitudinal measurements in a subgroup of patients indicate that long-term measurement of hair tacrolimus levels is feasible.ConclusionMeasuring tacrolimus in hair is a potentially reliable method to monitor drug exposure in KT patients. Rapid wash-in effects and consistent concentrations over time indicate that tacrolimus is incorporated into the hair matrix, allowing temporal resolution in the analysis of recent exposure and exposure history. This method provides a simple and low-risk alternative to regular blood sampling, sparing patients from frequent hospital visits through the self-collection of hair samples.

Project description:Deserts are characterized by unpredictable precipitation and extreme temperatures. Their fauna and flora are sensitive to anthropogenic environmental changes, and often recover slowly from environmental disasters. The effects of oil spills on the biota of desert regions, however, have scarcely been studied. We predicted that terrestrial invertebrates suffer long-term negative effects from an oil spill, due to their close association with the substrate. Thus, we investigated the effects of two oil spills that occurred in 1975 and 2014 in the hyper-arid 'Arava desert (Israel), on a spider that constructs silk-lined nests in burrows in compact, sandy soil in this extreme desert habitat. The spider, Sahastata aravaensis sp. nov. (Filistatidae), is described herein. We assessed spider burrow abundance in plots located in oil-contaminated and nearby uncontaminated clean soil (control) areas over five consecutive years and measured habitat characteristics in these plots. In the laboratory, we determined the preference of individuals for clean vs. oil-contaminated soil as a resting substrate. Finally, as this species was previously undescribed, we added a new species description. The abundance of Sahastata was significantly lower in oil-contaminated plots, and this was the case in the 40-year-old oil spill (1975) as well as in the recent one (2014). In laboratory tests, spiders showed a significant preference for the clean soil substrate over the oil-contaminated substrate. In the field, soil crust hardness and vegetation density did not differ significantly between oil-contaminated and control plots, but these measures were highly variable. The burrows were significantly clustered, suggesting that the young disperse only short distances. In the laboratory adult spiders did not dig burrows, perhaps indicating that adults remain permanently in their natal burrows and that in the field they may use vacant burrows. We conclude that Sahastata populations were affected negatively by the oil spills and these effects were long-lasting. We propose that by monitoring their spatial distribution, burrow-dwelling spiders such as Sahastata can be used as effective bioindicators of soil pollution in desert habitats.

Project description:RationaleSurvivors of critical illness experience significant morbidity, but the impact of surviving the intensive care unit (ICU) has not been quantified comprehensively at a population level.ObjectivesTo identify factors associated with increased hospital resource use and to ascertain whether ICU admission was associated with increased mortality and resource use.MethodsMatched cohort study and pre/post-analysis using national linked data registries with complete population coverage. The population consisted of patients admitted to all adult general ICUs during 2005 and surviving to hospital discharge, identified from the Scottish Intensive Care Society Audit Group registry, matched (1:1) with similar hospital control subjects. Five-year outcomes included mortality and hospital resource use. Confounder adjustment was based on multivariable regression and pre/post within-individual analyses.Measurements and main resultsOf 7,656 ICU patients, 5,259 survived to hospital discharge (5,215 [99.2%] matched to hospital control subjects). Factors present before ICU admission (comorbidities/pre-ICU hospitalizations) were stronger predictors of hospital resource use than acute illness factors. In the 5 years after the initial hospital discharge, compared with hospital control subjects, the ICU cohort had higher mortality (32.3% vs. 22.7%; hazard ratio, 1.33; 95% confidence interval, 1.22-1.46; P < 0.001), used more hospital resources (mean hospital admission rate, 4.8 vs. 3.3/person/5 yr), and had 51% higher mean 5-year hospital costs ($25,608 vs. $16,913/patient). Increased resource use persisted after confounder adjustment (P < 0.001) and using pre/post-analyses (P < 0.001). Excess resource use and mortality were greatest for younger patients without significant comorbidity.ConclusionsThis complete, national study demonstrates that ICU survivorship is associated with higher 5-year mortality and hospital resource use than hospital control subjects, representing a substantial burden on individuals, caregivers, and society.

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Occupational exposure of platinum-based anti-cancer drugs: five-year monitoring of hair and environmental samples in a single hospital

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