Occupational exposure to antineoplastic drugs in hospital environments: potential risk associated with contact with cyclophosphamide- and ifosfamide-contaminated surfaces

• Published in: Medycyna pracy Vol. 71; no. 5; pp. 519 - 529
• Main Authors: Mucci, Nicola, Dugheri, Stefano, Farioli†, Andrea, Garzaro, Giacomo, Rapisarda, Venerando, Campagna, Marcello, Bonari, Alessandro, Arcangeli, Giulio
• Format: Journal Article
• Language: English
• Published: Lodz Nofer Institute of Occupational Medicine 24-09-2020
• Subjects: antineoplastic drugs; Automation; Chromatography; cyclophosphamide; Drugs; Environmental monitoring; ifosfamide; Medical personnel; occupational exposure; Pharmacy; surface contamination; wipe test; Italy
• ISSN: 0465-5893; 2353-1339
• DOI: 10.13075/mp.5893.00931

In Italy, the consumption of CP and IP exceeds 500 kg/year and is second to that of 5-fluorouracil [4]. Since 2004, the European community has promoted the implementation of administrative and engineering controls across member states, in order to provide healthcare workers with the highest protection, and to warrant the use of appropriate and validated procedures for handling hazardous drugs. Recently, the European Biosafety Network has published a brochure in 8 languages on the amendments where a value of 0.1 ng/cm2 of the surface threshold contamination is recommended for ADs [7]. [...]today, several manuscripts [8-10] have been published showing that ADs were detected in urine samples of healthcare workers employed in preparation and administration units. [...]independent guidelines based on the percentile values for several ADs were suggested by several authors [14-16] with the aim of monitoring compliance with procedures, cleaning effectiveness, and pollution's persistency over time. Wipes were sampled at the beginning (B) and at the end (E) of the work shift (WS) for 3 consecutive days in a week. [...]wipe tests were taken from the surface of 25 drug vials and on related primary packaging of CP (Endoxan powder form, 1 g, batch 8D158B, Baxter) and IP (Holoxan powder form, 1 g, batch 8E076A, Baxter).