Monitoring surface contamination for thirty antineoplastic drugs: a new proposal for surface exposure levels (SELs)
Background Chemotherapy drugs are widely used to treat cancer, but their active compounds represent a danger for workers who could be exposed to them. However, they aren’t yet included in directive CE No. 1272/2008 and the European Biosafety Network has only recommended a limit value of 100 pg/cm 2...
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Format: | Article |
Language: | English |
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Nofer Institute of Occupational Medicine
2022-11-01
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Series: | Medycyna Pracy |
Subjects: | |
Online Access: | http://medpr.imp.lodz.pl/Monitoring-surface-contamination-for-thirty-antineoplastic-drugs-a-new-proposal-for,154743,0,2.html |
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author | Stefano Dugheri Nicola Mucci Elisabetta Bucaletti Donato Squillaci Giovanni Cappelli Lucia Trevisani Alessandro Bonari Michele Cecchi Enrico Mini Andrea Ghiori Daniela Tognoni Nicola Berti Francesca Alderighi Nicola Li Vigni Irene Orlandi Giulio Arcangeli |
author_facet | Stefano Dugheri Nicola Mucci Elisabetta Bucaletti Donato Squillaci Giovanni Cappelli Lucia Trevisani Alessandro Bonari Michele Cecchi Enrico Mini Andrea Ghiori Daniela Tognoni Nicola Berti Francesca Alderighi Nicola Li Vigni Irene Orlandi Giulio Arcangeli |
author_sort | Stefano Dugheri |
collection | DOAJ |
description | Background
Chemotherapy drugs are widely used to treat cancer, but their active compounds represent a danger for workers who could be exposed to them. However, they aren’t yet included in directive CE No. 1272/2008 and the European Biosafety Network has only recommended a limit value of 100 pg/cm 2 for surface contamination. Thus, it is crucial to assess surface contaminations in healthcare environments. Currently, the technique of choice is surface wipe test combined with liquid chromatography tandem mass spectrometry to achieve high sensibility.
Material and Methods
A campaign involving Careggi University Hospital (Florence, Italy) was performed from January 2020 to December 2021, collecting 1449 wipe samples between administration units, preparation unit, and personnel gloves. From the obtained data, the 90th percentile was calculated for 30 antiblastic drugs and proposed as surface exposure levels (SELs); while from data concerning personnel glove contamination, weekly contamination was estimated.
Results
In the 2-year period only 417 wipe samples were found positive (28.8%), the majority of which regard samples coming from administration unit bathrooms. The proposed SELs are almost all <100 pg/cm 2 , except for few drugs which produce higher contamination on bathroom surfaces. Also, the estimation of pharmacy personnel’s glove contamination highlighted very low results (ng/week).
Conclusions
Deeply established protocols and procedures for safe handling of ADs allow for obtaining excellent cleaning results and thus a safer work environment, however, the risk of cytostatic contaminations cannot be avoided in healthcare workplaces, and thus a harmonization of classification and labeling of chemotherapy drugs throughout the European Union should be done. Med Pr. 2022;73(5):383–96 |
first_indexed | 2024-04-13T06:39:12Z |
format | Article |
id | doaj.art-2ab3fd90e5664af7aed5a27076cafe95 |
institution | Directory Open Access Journal |
issn | 0465-5893 2353-1339 |
language | English |
last_indexed | 2024-04-13T06:39:12Z |
publishDate | 2022-11-01 |
publisher | Nofer Institute of Occupational Medicine |
record_format | Article |
series | Medycyna Pracy |
spelling | doaj.art-2ab3fd90e5664af7aed5a27076cafe952022-12-22T02:57:47ZengNofer Institute of Occupational MedicineMedycyna Pracy0465-58932353-13392022-11-0173538339610.13075/mp.5893.01288154743Monitoring surface contamination for thirty antineoplastic drugs: a new proposal for surface exposure levels (SELs)Stefano Dugheri0Nicola Mucci1Elisabetta Bucaletti2Donato Squillaci3Giovanni Cappelli4Lucia Trevisani5Alessandro Bonari6Michele Cecchi7Enrico Mini8Andrea Ghiori9Daniela Tognoni10Nicola Berti11Francesca Alderighi12Nicola Li Vigni13Irene Orlandi14Giulio Arcangeli15Careggi University Hospital, Florence, Italy (Industrial Hygiene and Toxicology Laboratory, Occupational Medicine Unit)University of Florence, Florence, Italy (Department of Experimental and Clinical Medicine)University of Florence, Florence, Italy (Department of Experimental and Clinical Medicine)University of Florence, Florence, Italy (Department of Experimental and Clinical Medicine)University of Florence, Florence, Italy (Department of Experimental and Clinical Medicine)University of Florence, Florence, Italy (Department of Experimental and Clinical Medicine)Careggi University Hospital, Florence, Italy (General Laboratory)Careggi University Hospital, Florence, Italy (Pharmacy AD Preparation Unit)University of Florence, Florence, Italy (Department of Health Sciences)Careggi University Hospital, Florence, Italy (Pharmacy AD Preparation Unit)Careggi University Hospital, Florence, Italy (Pharmacy AD Preparation Unit)Careggi University Hospital, Florence, Italy (Health and Safety Service)Careggi University Hospital, Florence, Italy (Health and Safety Service)Careggi University Hospital, Florence, Italy (Health and Safety Service)Careggi University Hospital, Florence, Italy (Health and Safety Service)University of Florence, Florence, Italy (Department of Experimental and Clinical Medicine)Background Chemotherapy drugs are widely used to treat cancer, but their active compounds represent a danger for workers who could be exposed to them. However, they aren’t yet included in directive CE No. 1272/2008 and the European Biosafety Network has only recommended a limit value of 100 pg/cm 2 for surface contamination. Thus, it is crucial to assess surface contaminations in healthcare environments. Currently, the technique of choice is surface wipe test combined with liquid chromatography tandem mass spectrometry to achieve high sensibility. Material and Methods A campaign involving Careggi University Hospital (Florence, Italy) was performed from January 2020 to December 2021, collecting 1449 wipe samples between administration units, preparation unit, and personnel gloves. From the obtained data, the 90th percentile was calculated for 30 antiblastic drugs and proposed as surface exposure levels (SELs); while from data concerning personnel glove contamination, weekly contamination was estimated. Results In the 2-year period only 417 wipe samples were found positive (28.8%), the majority of which regard samples coming from administration unit bathrooms. The proposed SELs are almost all <100 pg/cm 2 , except for few drugs which produce higher contamination on bathroom surfaces. Also, the estimation of pharmacy personnel’s glove contamination highlighted very low results (ng/week). Conclusions Deeply established protocols and procedures for safe handling of ADs allow for obtaining excellent cleaning results and thus a safer work environment, however, the risk of cytostatic contaminations cannot be avoided in healthcare workplaces, and thus a harmonization of classification and labeling of chemotherapy drugs throughout the European Union should be done. Med Pr. 2022;73(5):383–96http://medpr.imp.lodz.pl/Monitoring-surface-contamination-for-thirty-antineoplastic-drugs-a-new-proposal-for,154743,0,2.htmlhealth risk assessmentantineoplastic drugswipe testultra-high performance liquid chromatographysurface exposure leveltandem mass spectrometry |
spellingShingle | Stefano Dugheri Nicola Mucci Elisabetta Bucaletti Donato Squillaci Giovanni Cappelli Lucia Trevisani Alessandro Bonari Michele Cecchi Enrico Mini Andrea Ghiori Daniela Tognoni Nicola Berti Francesca Alderighi Nicola Li Vigni Irene Orlandi Giulio Arcangeli Monitoring surface contamination for thirty antineoplastic drugs: a new proposal for surface exposure levels (SELs) Medycyna Pracy health risk assessment antineoplastic drugs wipe test ultra-high performance liquid chromatography surface exposure level tandem mass spectrometry |
title | Monitoring surface contamination for thirty antineoplastic drugs: a new proposal for surface exposure levels (SELs) |
title_full | Monitoring surface contamination for thirty antineoplastic drugs: a new proposal for surface exposure levels (SELs) |
title_fullStr | Monitoring surface contamination for thirty antineoplastic drugs: a new proposal for surface exposure levels (SELs) |
title_full_unstemmed | Monitoring surface contamination for thirty antineoplastic drugs: a new proposal for surface exposure levels (SELs) |
title_short | Monitoring surface contamination for thirty antineoplastic drugs: a new proposal for surface exposure levels (SELs) |
title_sort | monitoring surface contamination for thirty antineoplastic drugs a new proposal for surface exposure levels sels |
topic | health risk assessment antineoplastic drugs wipe test ultra-high performance liquid chromatography surface exposure level tandem mass spectrometry |
url | http://medpr.imp.lodz.pl/Monitoring-surface-contamination-for-thirty-antineoplastic-drugs-a-new-proposal-for,154743,0,2.html |
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