Penetration and splash protection of six disposable gown materials against fifteen antineoplastic drugs

Abstract

Introduction. Six commercially available, disposable protective gown materials were tested for splash protection and penetration against 15 antineoplastic drugs and five control solutions. Materials. The commercially available drugs in standard concentrations included etoposide, teniposide, docetaxel, paclitaxel, carmustine, topotecan, irinotecan, doxorubicin, liposomal doxorubicin, vinorelbine, cisplatin, carboplatin, mitoxantrone, cyclophosphamide, and fluorouracil. Control solutions included water, saline, 10% ethanol, fluorescein aqueous, and fluorescein in 25% ethanol. Methods. A6 3 6 cm gown sample was placed on an absorptive pad on the work surface of a biological safety cabinet. A single drop of each solution was dropped onto the gown from a height of 20 cm to simulate a simple splash. Each dispensed drop was observed for 1 minute. Two endpoints were used: (a) absorption into the gown material versus beading on the gown surface and (b) visible detection of the drug on the opposite side of the gown. Results. Two gowns failed; one (ChemoPlust) allowed penetration of 10 solutions and the other (ChemoBloct Wraparound), four solutions. Three gowns allowed non-water soluble drugs to soak into the material but did not allow penetration: Tyvekt (five drugs), ChemoBloct Maximum (two drugs), and CYTA (one drug). Only one gown (Saranext) provided complete splash protection, with beading on the gown surface observed for all agents. Conclusions. Gowns with polyethylene or vinyl coating provided adequate splash protection and prevented penetration of the challenge chemicals during the 1-minute observation period. Polypropylene-based gowns did not provide adequate splash protection and should not be used to prepare chemotherapy.

Safe Handling of Hazardous Drugs in Home Infusion

“…Gowns must be disposable, fully closed in front (eg, without snaps), closable in the rear, have long sleeves with elastic or knit cuffs to facilitate a snug fit around the wrist, and be made of a material designed to resist HDs, such as polyethylene or vinyl. 39 This is different from the reusable washable gowns used in other nursing areas (eg, infection prevention). For health care workers, IV tubing, bags, syringes, and PPE must be properly disposed of in a container designated for hazardous drugs.…”

“…While the glove standard has been in place for a considerable length of time, ASTM has been working on a new standard for chemotherapy gowns, but the release date is still unknown. Gowns must be disposable, fully closed in front (eg, without snaps), closable in the rear, have long sleeves with elastic or knit cuffs to facilitate a snug fit around the wrist, and be made of a material designed to resist HDs, such as polyethylene or vinyl 39. This is different from the reusable washable gowns used in other nursing areas (eg, infection prevention).…”

Hazardous Agents in the Home

“…Studies have associated workplace exposures to hazardous drugs with health effects such as skin rashes, adverse reproductive effects, infertility, spontaneous abortions, congenital malformations, and/or other cancers (Bos & Sessink, 1997;Connor et al, 2002;Harrison & Kloos, 1999;Stucker et al, 1990;Valanis et al, 1997). Therefore, guidelines have been established for handling hazardous medication by industries and regulatory experts such as the Occupational Safety and Health Administration (OSHA, 1999); the Oncology Nursing Society (ONS, 2006); the American Society of Health Systems Pharmacists (ASHP, 2006); and the National Institute for Occupational Safety and Health (NIOSH, 2004).…”