[Potential hazards to medical personnel resulting from exposure to paclitaxel].

Abstract

This article, aimed at assessing potential health risks to medical personnel, presents a literature review on paclitaxel (PTX), a natural taxane alkaloid widely used in cancer chemotherapy. The review analyzes the toxic properties of PTX, occupational exposure routes and sources, as well as findings from environmental and biological monitoring studies and potential health effects. The methodology included a review of literature from reputable databases, institutional reports on hazardous medicinal products, and data from national registries. The results confirm that, despite its effectiveness in cancer treatment, PTX is a highly toxic substance associated with significant occupational risk. Due to its high molecular weight and relatively high vapor pressure, exposure may occur via inhalation and dermal contact during various stages of drug handling - from preparation to contact with patients' excreta. Biological monitoring has detected PTX in the urine and plasma of healthcare workers, while environmental monitoring has confirmed widespread surface contamination in medical facilities. The potential health effects of PTX primarily include mutagenic and genotoxic actions (aneugenicity, clastogenicity, DNA damage, chromosomal aberrations, and micronuclei formation), as well as neurotoxicity, myelosuppression, hepatotoxicity, and adverse effects on reproduction (embryotoxicity, fetotoxicity, and impaired fertility). To identify irregularities early and effectively reduce health risks associated with PTX exposure, a comprehensive occupational exposure assessment should become standard practice. This assessment should incorporate 3 complementary components: biological monitoring of workers, air concentration measurements, and surface contamination testing using wipe sampling. The inclusion of surface contamination measurements as a routine exposure surveillance method should be recognized as a best practice in healthcare settings where cytotoxic substances are used. A reference value of 0.1 ng/cm² for surface contamination is recommended. The implementation of effective preventive measures, appropriate personal protective equipment, regular decontamination, and staff training is essential for protecting the health of medical personnel. Med Pr Work Health Saf. 2025;76(6):469-486.