AimThe aim was to identify similarities and differences between private practice and NHS in practitioners' experiences of delivering acupuncture to treat pain. We wished to identify differences which could affect patients' experiences and inform our understanding of how trials conducted in private clinics relate to NHS clinical practice Background
The mutagenic and carcinogenic properties of cyto toxic drugs have led to concern over potential haz ards to pharmacy personnel who are required to prepare cytotoxic drugs. The platinum compounds cisplatin and carboplatin are frequently used antican cer agents and are unique by virtue of their suitability for quantification by highly sensitive physical meth ods such as inductively coupled plasma mass spec troscopy (ICPMS). We have performed a pilot study of ICPMS determination of platinum levels in biological samples from pharmacists preparing chemotherapy, including platinum-based antineoplastic drugs. In pa tients treated with platinum compounds, elemental platinum was readily detected in plasma and whole leukocytes and bound to leukocyte DNA for at least 4 weeks after treatment. However, in 28 pharmacists from our institution (18 involved in preparation of platinum-based compounds, 10 controls), tissue plat inum levels were below the limit of detection (0.05 nmol/L) by ICPMS. ICPMS measurement of platinum levels has the potential to be used to monitor health care workers for exposure to platinum-based cytotox ics. Exposure may result from accidental exposure to a platinum-based compound or may be due to poor technique by personnel preparing chemotherapy doses. We are intending to institute a prospective monitoring policy to gather further data.
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