DNA and chromosomal damage in medical workers exposed to anaesthetic gases assessed by the lymphocyte cytokinesis-block micronucleus (CBMN) assay. A critical review
Abstract
The lymphocyte cytokinesis-block micronucleus (CBMN) assay has been applied in hundreds of in vivo biomonitoring studies of humans exposed either environmentally or occupationally to genotoxic chemicals. However, there is an emerging need to re-evaluate the use of MN and other biomarkers within the lymphocyte CBMN cytome assay as quantitative indicators of exposure to main classes of chemical genotoxins.
The main aim of the present report is to systematically review published studies investigating the use of the lymphocyte CBMN assay to determine DNA damage in subjects exposed to anaesthetic gases. We also compared performance of the CBMN assay against other DNA damage assays employed and identified strengths and weaknesses of the published studies.
We have retrieved 11 studies, published between 1996 and 2013, reporting MN associated with occupational exposures (operating room personnel). The individual job categories were often described (anaesthesiologists, technicians, radiologists) among cases, as well as duration of exposure.
All studies reported the compounds present at the workplace and, in some instances, the exposure levels were measured. Controls were recruited either among personnel of the hospital not exposed to anaesthetics or other healthy unexposed subjects.
The number of investigated subjects was relatively smaller due to the character of the occupation. Overall, the majority of the studies were age- and gender- matched (or investigated only males or females) while less attention was given to lifestyle confounders.
Appropriate measurement of exposure, available in approx. half of the studies only, was compromised by the lack of the personal dosimetry-based determinations.