Evaluation of the Surface Contamination by Cytotoxic Agents of a Chemotherapy Reconstitution Unit: From Analysing Work Practices to Preventive and Corrective Actions

Abstract

<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction:</jats:title><jats:p>The staff handling the cytotoxics are exposed to contamination as an occupational hazard. The unit of the Centre Hospitalier Universitaire (C.H.U) of Saint Pierre is ISO9001 certified. In a constant effort to improve the quality of our work, samples of the work surface were collected and allowed us, in a first step, to evaluate the contamination in a CRU in Reunion Island. As a result, corrective and preventive actions were implemented in the work routines.</jats:p></jats:sec><jats:sec><jats:title>Material and method:</jats:title><jats:p>53 samples of the work surface, collected in December 2015 and in March and April 2016 in seven different spots, were treated in this observational study. The 5-FU was chosen as example and analysed and quantified by using liquid chromatography associated with a mass spectrometer with a detection limit of 2 ng/pf.</jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p>We observed a great difference in contamination; 29 samples were positive, the isolator container was the location with the highest level of contamination, including manipulator gloves under the isolator, work surface and the inside of the isolator bin. The contamination was reduced after a first clean-up with water only.</jats:p><jats:p>The overwrapping bags and the manipulator gloves are only a little or not at all contaminated.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>In order to reduce the exposure to cytotoxic residuals, corrective actions have been implemented: more frequent changes of manipulator gloves, the use of closed systems, and cleaning of the isolator with water. The efficiency of these modifications of work practices will be evaluated again in a few months.</jats:p></jats:sec>