Abstract
Anticancer drugs themselves can cause adverse health effects when administered to human patients. In addition, it has become apparent that personnel in human medicine, occupationally exposed to these anticancer drugs, may also be at risk. The past decades, the use of chemotherapy in veterinary medicine has been gaining popularity. Consequently,
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an increasing number of people in veterinary medicine may be exposed to anticancer drugs. This raises the question whether veterinary personnel and owners of treated pets may be at risk as well. However, little is known about exposure in this setting. The aim of this thesis, therefore, is to assess exposure to anticancer drugs in veterinary oncology and to evaluate the efficacy of the current veterinary guidelines on safe handling of antineoplastic drugs, treated pets and wastes. Since pet-dogs are the main group of veterinary patients treated with anticancer drugs, we have focused on this group. Potential sources of exposure are excretion products of treated pets and contaminated surfaces. Antineoplastic drug residues were detected in urine, feces and saliva up to three weeks after administration of carboplatin, doxorubicin or epirubicin to pet-dogs. Moreover, residues were found in sebum and cerumen of pet-dogs treated with carboplatin, up to three weeks after dosing. When a slow release carboplatin drug delivery formulation was used, excretion occurred at higher levels, up to at least four weeks after administration. As a result, the periods of risk considered by the veterinary guidelines on safe handling of antineoplastic drugs, treated pets and wastes may not be adequate to keep exposure at low levels. Environmental contamination with antineoplastic drug residues was generally low in veterinary oncology centers and homes of treated pet-dogs. Furthermore, the presence of residues of carboplatin was monitored on surfaces in human oncology settings. Environmental contamination was higher in human oncology units and slightly lower in homes of treated human cancer patients. In all instances in veterinary and human oncology, surface contamination indicated that dispersion of antineoplastic drug residues by people occurred. Potential uptake of residues of carboplatin, doxorubicin and epirubicin was evaluated in people at risk of exposure. The veterinary guidelines were able to avert uptake of antineoplastic drug residues by veterinary personnel. On the other hand, uptake could not be prevented in some of the owners of pet-dogs treated with carboplatin, doxorubicin or epirubicin. Residues of doxorubicin and epirubicin have cytotoxic and cardiotoxic potency. In addition, some of the platinum species in urine samples from pet-dogs treated with carboplatin have DNA-binding capacity. However, the true health risks associated with the exposure as reported in this thesis are difficult to measure and still remain to be established.
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