The efficiency of antineoplastic drug contamination removal by widely used disinfectants–laboratory and hospital studies

Bláhová, Lucie; Kuta, Jan; Doležalová, Lenka; Kozáková, Šárka; Krovová, Tereza; Bláha, Luděk

doi:10.1007/s00420-021-01671-5

Cited by 11 publications

(25 citation statements)

References 44 publications

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“…This highlights that the patient sweat is an important source of secondary contamination and that the wax/varnish-treated surfaces that are often in direct contact with the patient may serve as long-term deposits of AD contamination. This observation is supported by our recent observations of CP mobilization from the wax-treated Marmoleum oors (Bláhová et al, 2021) as well as by other studies (ISOOP 2007). On the contrary, inert materials such as tiles used in bathrooms or toilets can easily be washed out keeping thus contamination under the control.…”

Section: Discussionsupporting

confidence: 91%

“…Besides CP, Pt contamination was observed in patient households (63% samples positive during the rst sampling) but with a low median of 0.2 pg/cm 2 comparable to the available German household study (Böhlandt et al, 2017). The observed concentrations are two orders of magnitude lower than Pt contamination in hospitals including the Czech Republic, where long-term monitoring data indicate a median of 200 pg/cm 2 (Bláhová et al, 2021). Here it should be critically noted that the analyses of total Pt, which is a common approach in the ADs monitoring studies (Böhlandt et al, 2017;Konate et al, 2011;Schierl et al, 2009;Yoshida et al, 2013) do not allow to discriminate other different sources of Pt such as occupation (e.g.…”

Section: Discussionsupporting

confidence: 55%

“…The oor contamination by ADs observed in the households has been much lower in comparison with available pharmacy and hospital studies where accidental values higher than 100 ng/cm 2 (for CP) or higher than 10 ng/cm 2 (Pt) were reported (Kopp et al, 2013;Schierl et al, 2009;Turci et al, 2003). Our recent study concerned 26 hospitals in the Czech Republic and showed median contamination of hospital toilet oors being 30, 200, 10 pg/cm 2 for CP (N = 25), Pt (N = 18) and PX (N = 25), respectively (Bláhová et al, 2021). Interestingly, the median values observed in the present study for CP (16.6 pg/cm 2 for oors) were closely comparable, and the immediate exposures thus are similar in both occupational and household settings.…”

Section: Discussionmentioning

confidence: 60%

“…Although we are aware of the limitations of our pilot study, there are several lines of evidence indicating that Pt may reside in the body of patients for a long time, and it may become released during later life stages posing thus hazards to family members or staff in retirement houses or hospices. Also, detection of IF on the oor of the retirement house two years after the latest potentially con rmed source might raise a concern of long-term accumulation (and release) of ADs from indoor materials (Bláhová et al, 2021). Further research studies in these directions might clarify the hypotheses.…”

Section: Discussionmentioning

confidence: 96%

“…The patients had a good prognosis and received intravenous chemotherapies containing CP, DOX, EPI, IRI, FU, PX or Pt-based ADs. We focused on CP and Pt treatments because of their high frequency and amounts used in the Czech Republic, and considering hazardous and pharmacokinetics properties when relatively high unmetabolized amounts are released in human excretion (Bláhová et al, 2021).…”

Section: Methodsmentioning

confidence: 99%

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Levels And Risks of Antineoplastic Drugs In Households of Oncology Patients, Hospices And Retirement Homes

Bláhová

Kuta

Doležalová

et al. 2021

Preprint

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BackgroundContamination of the indoor environment by the antineoplastic drugs (ADs) is known to pose health risks to the exposed staff in hospitals or pharmacies. ADs may also contaminate households of the patients receiving chemotherapy but the exposure levels and potential risks to family members have not been studied. The objective was to provide an in-depth research of surface contamination by ADs inside homes focusing on the households of oncology patients, hospices and retirement houses. ResultsThe main study included repeated samplings of surfaces (floors, desktops) in households of 17 ambulant oncology patients receiving different chemotherapies with cyclophosphamide (CP), platinum-based drugs (Pt), doxorubicin (DOX), 5-fluorouracil (FU) and others. Screening of AD contamination was further performed in 2 hospices and 2 retirement homes. The wipe samples were analyzed by HPLC-MS/MS and ICP-MS/MS for 11 organic ADs and total Pt as a marker of Pt-based ADs. Patients treated with chemotherapy were found to serve as a source of contamination for their households, representing thus a risk to sensitive family members such as children or elderly people. Carcinogenic CP was commonly found at relatively high concentrations, especially during the first 6 days after the chemotherapy (maximum 511 pg/cm2). Sweat seems to be a major medium for the spread of the contamination, and high and long-time persisting CP levels (traces still found after 6 months post-chemotherapy) were found on various desktops including kitchen dining tables. The pilot studies in hospices and retirement homes indicated rather lower exposure risks of the personnel but pointed to potential long-lasting contamination by Pt or some other persistent ADs such as ifosfamide, IF.ConclusionsThis is one of the first studies investigating the contamination by ADs in indoor environments outside of hospitals or pharmacies. Peak concentrations of the carcinogenic CP in households were comparable to those observed in hospitals. The information guidance flier with practical recommendations was prepared improving thus information as well as prevention of eventual risks for family members.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 96%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Levels And Risks of Antineoplastic Drugs In Households of Oncology Patients, Hospices And Retirement Homes

Bláhová

Kuta

Doležalová

et al. 2021

Preprint

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Evaluation of long-term data on surface contamination by antineoplastic drugs in pharmacies

Quartucci

Rooney

Nowak

et al. 2023

Int Arch Occup Environ Health

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Purpose The handling of antineoplastic drugs represents an occupational health risk for employees in pharmacies. To minimize exposure and to evaluate cleaning efficacy, wipe sampling was used to analyze antineoplastic drugs on surfaces. In 2009, guidance values were suggested to facilitate the interpretation of results, leading to a decrease in surface contamination. The goal of this follow-up was to evaluate the time trend of surface contamination, to identify critical antineoplastic drugs and sampling locations and to reassess guidance values. Methods Platinum, 5-fluorouracil, cyclophosphamide, ifosfamide, gemcitabine, methotrexate, docetaxel and paclitaxel were analyzed in more than 17,000 wipe samples from 2000 to 2021. Statistical analysis was performed to describe and interpret the data. Results Surface contaminations were generally relatively low. The median concentration for most antineoplastic drugs was below the limit of detection except for platinum (0.3 pg/cm2). Only platinum and 5-fluorouracil showed decreasing levels over time. Most exceedances of guidance values were observed for platinum (26.9%), cyclophosphamide (18.5%) and gemcitabine (16.6%). The most affected wipe sampling locations were isolators (24.4%), storage areas (17.6%) and laminar flow hoods (16.6%). However, areas with no direct contact to antineoplastic drugs were also frequently contaminated (8.9%). Conclusion Overall, the surface contaminations with antineoplastic drugs continue to decrease or were generally at a low level. Therefore, we adjusted guidance values according to the available data. The identification of critical sampling locations may help pharmacies to further improve cleaning procedure and reduce the risk of occupational exposure to antineoplastic drugs.

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Occupational risk assessment of glutaraldehyde through personal air monitoring in a hospital setting

Zambrano-Carrillo,

Hernandez-Jerez

2023

Annals of Work Exposures and Health

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Glutaraldehyde is a high-efficiency disinfectant that has been included in the protocols of some hospitals for controlling the spread of SARS-CoV-2, together with sodium hypochlorite and quaternary ammonium disinfectants. However, exposure has been poorly studied in workplace settings, despite the association between glutaraldehyde and respiratory diseases and skin conditions in exposed workers. This study evaluated the magnitude of exposure associated with the use of glutaraldehyde in healthcare workers across various work areas of a first level of Hospital-Based Care in Colombia. Workers were classified into similar exposure groups (SEGs) based on work areas and tasks performed, and airborne concentrations of glutaraldehyde were measured in different work areas of each SEG through direct monitoring. The 95th percentile of glutaraldehyde concentrations in all SEGs studied exceeded the TLV-C immediately after use. Cleaning workers and nurses had the highest exposures to glutaraldehyde. Results indicate that workers were overexposed and highlight the need to implement controls to reduce exposure. The high-exposure levels also raise the need to consider glutaraldehyde substitution and adequate use of personal protective equipment (PPE).

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The efficiency of antineoplastic drug contamination removal by widely used disinfectants–laboratory and hospital studies

Cited by 11 publications

References 44 publications

Levels And Risks of Antineoplastic Drugs In Households of Oncology Patients, Hospices And Retirement Homes

Levels And Risks of Antineoplastic Drugs In Households of Oncology Patients, Hospices And Retirement Homes

Evaluation of long-term data on surface contamination by antineoplastic drugs in pharmacies

Occupational risk assessment of glutaraldehyde through personal air monitoring in a hospital setting

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