Using a closed-system protective device to reduce personnel exposure to antineoplastic agents

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

“…However, workplaces other than university hospital need to be investigated to gain more conWdent assessment of the levels of surface contamination in Sweden. In comparison with previous investigators, our contamination levels of CP and IF on Xoor areas seem to be lower than the levels found by Minoia et al (1998) and within the same ranges as those found by Connor 1999b, Schmaus et al (2002, Wick et al (2003), Mason et al (2003Mason et al ( , 2005 and Fransman et al (2007b).…”

“…By performing wipe sampling it is possible to estimate the transferable surface load of antineoplastic drugs to the skin and thereby it is possible to evaluate the potential dermal exposure. Previous studies investigated surface contamination of antineoplastic drugs at one time only (Sessink et al 1992a, b;McDevitt et al 1993;Minoia et al 1998;Connor et al 1999a;Floridia et al 1999;Rubino et al 1999;KiVmeyer et al 2002;Schmaus et al 2002;Ziegler et al 2002;Wick et al 2003;Turci et al 2003;CrausteManciet et al 2005;Fransman et al 2005;Schulz et al 2005). However, no information on how the contamination levels on the sampled surfaces varied over time was obtained with the study design used in those studies.…”

“…Also more recent studies indicate occupational exposure despite the use of PPE such as protective clothing and special gloves, and other safety precautions e.g. biological safety cabinets (BSC) class II (Turci et al 2002;Pethran et al 2003;Wick et al 2003).…”

Validation of urinary excretion of cyclophosphamide as a biomarker of exposure by studying its renal clearance at high and low plasma concentrations in cancer patients

“…Health care workers handling this drug can be occupationally exposed and CP has been detected as a surface contaminant in workplaces where antineoplastic drugs are used (Sessink et al 1992a;McDevitt et al 1993;Minoia et al 1998;Connor et al 1999;Schmaus et al 2002;Wick et al 2003;Hedmer et al 2005). Amounts of CP have been detected in urine (Hirst et al 1984;Evelo et al 1986;Sessink et al 1992bSessink et al , 1994Ensslin et al 1994;Minoia et al 1998;Turci et al 2002;Pethran et al 2003;Wick et al 2003), indicating that these workers are occupationally exposed to CP. Absorption of CP occurs mainly through skin or through inhalation of a gas phase or particulates.…”

Evaluation of early DNA damage in healthcare workers handling antineoplastic drugs

“…Although several guidelines on safe handling practices have been promulgated, it is still necessary to evaluate the eVects of occupational exposure to mixtures of the chemotherapic agents used for the treatment of various types of cancer (Gazzetta UYciale Repubblica Italiana 1999;NIOSH 2004;OSHA 1986OSHA , 1995. Even if workers who handle antineoplastic drugs are knowledgeable about the risks of exposure to these drugs and they observe the protective measures recommended by guidelines, detectable levels of antineoplastic drugs still have been detected in their urine and in the facilities where drugs are prepared and administered (Connor et al 1999;Ensslin et al 1997;Pethran et al 2003;Sessink et al 1994Sessink et al , 1997Wick et al 2003). In particular, the administration process exposes nurses to a number of possible routes (e.g., spillage of drugs, patient's body Xuids) (Ziegler et al 2002).…”