Environmental and biological monitoring of antineoplastic drugs in four workplaces in a Swedish hospital

Abstract

The variability in surface contamination of CP and IF was rather low especially on floors. Higher concentrations of CP and IF were found on the floors compared with the work areas. The highest surface loads were found on floors (in patient lavatories and utility rooms) that were related to patient activities such as handling of patients' urine. Although high contaminations were found, the biological monitoring showed no uptake. Wipe sampling is a good method to improve the work practices.

Antineoplastic drugs contamination of workplace surfaces in two Portuguese hospitals

“…These results probably are resulting from defective cleaning procedures that can be related with the detergents used and/or the frequency of the cleaning procedures and, also, the surfaces that are object of the cleaning actions. Similar results led other authors to the same type of conclusions (Hedmer et al 2008;Touzin et al 2010;Turci et al 2011;Hon et al 2013). Moreover, our results showed different results in the number of surfaces with contamination between the drugs considered.…”

“…Those drugs are among the most frequently employed, and in high amounts, every day in both hospitals. Most of the studies published concerning this issue used the same approach (Larson et al 2003;Mason et al 2005;Castiglia et al 2008;Hedmer et al 2005Hedmer et al , 2008Touzin et al 2009;Kopp et al 2013). Additionally, these drugs are also recommended as markers for chemical contamination monitoring by ISOPP (2007).…”

“…However, since the observations were performed on different days and the drug flow was well described, we believe that it was possible to identify the potentially contaminated surfaces and the ones that represent higher risk for workers due to the fact that they are frequently handled. Furthermore, we studied only surfaces that may be touched/handled by the workers and avoided surfaces such as floors of the preparation and administration units, accordingly to other studies (Schmaus et al 2002;Hedmer et al 2008;Castiglia et al 2008;Kopp et al 2013;Hon et al 2013). This type of information is very useful because it allows the identification of the "weak points" in the working and cleaning procedures and where preventive actions can have the best result regarding minimizing workplace contamination.…”

“…Over the last 30 years, particularly in Europe and North America, as awareness increased, numerous safety guidelines have been developed and published, aiming the protection of workers health, specifically diseases associated with these occupational settings. However, and despite the investment made in personal protective equipment, biological safety cabinets and workers training, occupational exposure of health care workers is still being reported (Fransman et al 2007;Hedmer et al 2008;. It may be impossible to eliminate all risk; however, it is imperious to reduce risk to the lowest level (Davis et al 2011).…”

Environmental Contaminations and Occupational Exposures Involved in Preparation of Chemotherapeutic Drugs

“…Previously, in studies of external exposures [Sessink et al,1992;Minoia et al,1998;Sabatini et al,2005;Hedmer et al,2008] and studies in internal exposures [Hirst et al,1984;Sessink et al,1992Sessink et al, , 1994Sessink et al, , 1995Ensslin et al,1994;Burgaz et al,1999;Pethran et al,2003], cyclophosphamide was frequently used as a marker of occupational exposures because of its slight volatility and human genotoxicity [Connor et al,2000], reproductive toxicity [Anderson et al,1995], carcinogenicity [IARC,1981], and ease of detection [Turci et al,2002;Barbieri et al,2006].…”