Cost and pollution by the use of xylene in cervical cytology in four Peruvian hospitals

Abstract

Background: Cytological samples are cleared with xylene in two or three baths during a Pap test, however, this solvent has a high degree of toxicity, and being a controlled reagent infers high costs for its purchase and implications for environmental pollution. We estimated the impact of xylene during the Pap test in terms of the number of liters and cost of two baths of xylene, and also estimated the impact with three baths Methods: This cross-sectional study was carried out in four hospitals of EsSalud in Peru in two stages. First, the analysis of the impact due to the use of two baths of xylene was conducted during the period 2015–2019, and second, the estimates were calculated based on the assumption of three baths of xylene for the years 2020–2025. The assumption was based on the recommendations of the 2018 EsSalud cytology guideline. The monthly amount of xylene was ~10 liters per bath/month and the cost per liter was estimated at 8.13 USD (27 soles). Results: For the staining of 594,898 cytology tests, 7,848 liters of xylene were necessary, resulting in a cost of 60,861 USD (202,068 soles) during the period 2015–2019. The estimates showed a maximum assumption of 9,483 liters and 77,110 USD (256,040 soles) for the use of three baths of xylene in the four EsSalud hospitals (p = 0.0025) during the period 2020–2025. Conclusions: We determined that there was a high economic impact of using xylene with two baths from 2015 to 2019 and a dramatic increase in costs with the possible use of three baths of xylene in the Pap test for the following five years.

Label-free virtual peritoneal lavage cytology via deep-learning-assisted single-color stimulated Raman scattering microscopy

“…On the other hand, it is expensive to construct and maintain a certificated cytology laboratory with precision facilities and trained personnel 11 . Along with a number of cytology tests per year, the high consumption of hazardous reagents, such as xylene, also poses high economic costs in storage and disposal, as well as chemical hazards to pathologists 12,13 .…”

Label‐Free Virtual Peritoneal Lavage Cytology via Deep‐Learning‐Assisted Single‐Color Stimulated Raman Scattering Microscopy

“…[11] Along with plentiful cytology tests per year, the high consumption of hazardous reagents poses high storage and disposal costs and health risks to pathologists. [12,13] Several techniques of virtual pathology have been developed to address similar limitations of histology, including nonstandardized image quality and complex infrastructure. They are based on label-free microscopy that provides contrasts among sample components, including autofluorescence imaging (AFI), [14][15][16] photoacoustic microscopy (PAM), [17] quantitative phase (QP) microscopy, [18] deep-UV microscopy, [19] and stimulated Raman scattering (SRS) microscopy.…”