Antineoplastic drugs (ADs) will continue to represent a potential risk for personnel involved in the handling of these compounds and great concerns have been raised by the presence of ADs in many surveyed workplaces. Eight hospitals were investigated by means of wipe sampling for surface residue determination. Each wipe sample was tested for five ADs considered suitable exposure markers. Cyclophosphamide (CP), gemcitabine (GEM), 5-fluorouracil (5-FU), platinum-containing drugs (Pt), and epi-doxorubicin (EPI) contamination levels were measured in 85 per cent of the studied pharmacies and 93 per cent of outpatient care units (OpCUs). This study showed that 83 out of 349 samples were positive in Pharmacies, this proportion being statistically significant (χ2 = 42.9, p < 0.001). The positive samples provided evidence of at least one substance with levels greater than the limit of detection (LOD). The two most frequently detected substances were Pt (42%) and CP (30%). These accounted for 72 per cent of the whole dataset, followed by 5-FU and GEM. Based on the 90th percentile of wipe sampling data distribution, we suggest hygienic guidance values (HGVs) of 3.6, 1.0, 0.9, and 0.5 ng cm-2 for CP, 5-FU, GEM and Pt, respectively, as the best target levels of the surface contamination load in Italian pharmacies. The approach of proposing guidance values at the 90th percentile of results obtained from workplaces with good hygiene practice was found to be a simple and practical way of controlling occupational exposure. HGVs were challenged in this study as technical threshold limits to benchmark AD residual surface contamination at workplaces.
Pesticides used to protect agricultural crops may contaminate groundwater. This work aimed to identify the pesticides used in Lombardy, Italy, in 2016, their concentration in the groundwater and the risk for health associated with the intake of drinkable water in the adult population. The risk was evaluated for the presence of single and multiple active substances in the groundwater, calculating the hazard quotient (HQ) and the hazard index (HI), respectively. Lombardy utilises an agricultural area of 980,112 h, which is mainly cultivated with cereals (74%). Approximately 2354 pesticides (about 1.3 × 107 kg), containing 410 active substances (about 4.5 × 106 kg) were sold. There were groundwater contamination measurements in 158 monitoring points, which were investigated twice a year for 31 active substances, and a total of 9152 determinations. Only 17 currently used active substance were measured in the groundwater, among which three belonged to the 10 best-sold pesticides. The exceedance of the environmental quality standard was observed for about 1.5% determinations. The intake of contaminated water in the adult population resulted in a HQ typically ranging between 10−3 and 10−4 and a HI of about 10−3. Although the number of pesticides sold in 2016 in Lombardy was big, only a small fraction of active substances was monitored in the groundwater. Considering these monitored substances, the intake of contaminated groundwater in the adult general population posed an irrelevant risk for health.
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