Abstract

Health professionals who had been working in different health care units and who were chronically exposed to cytostatic drugs were examined during the last 25 years. In their working area of the oncology outpatient and hospital units cytostatic drug exposure regularly exceeded safety limits due to the lack of proper safety devices. Their health condition was annually investigated by clinics, and it was found that they developed more hematological, immunological and reproductive alterations. In the present study we assessed changes in immune phenotypes based on the CD4/CD8 T-cells ratio, B and NK cell percentages measured by FACS methodology. The investigations were carried out in 550 subjects exposed to different cytostatic agents in oncology departments. Data were compared to age matched 83 healthy and non-exposed female controls. Biomarkers were measured by routine clinical laboratory tests, completed with immune phenotyping and measured in peripheral blood lymphocytes (PBL). Health personnel exposed to different agents showed increased ratio of CD4/CD8 T-cell and a decrease in activated T-cells. Beside these parameters we found an elevation of B-cells and a decrease in NK-cells. Within the exposed groups smokers showed even stronger decreased NK-cell counts compared to non-smokers. These changes in immune-phenotypes may give us a new biomarker immune suppression of PBL-cells among nurses after toxic exposures in their working environment.

Keywords: Occupational Exposure of Cytostatic Drugs; Immune Depression; CD4/CD8 Ratio; NK-Cells; B-Cells

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