Association between occupational exposure levels of antineoplastic drugs and work environment in five hospitals in Japan

Abstract

The contamination level of antineoplastic drugs was suggested to be related with the amount of drugs handled, cleaning methods of the equipment, and the skill level of the technique of maintaining negative pressure inside a vial. In order to reduce the contamination and exposure to antineoplastic drugs in the hospital work environment very close to zero, comprehensive safety precautions, including adequate mixing and cleaning methods was required in addition to BSC and closed system device.

Benefits of Wipe Sampling: Evaluation of Long-Term 5-Fluorouracil and Platinum Monitoring Data

“…This has been supported by the results of many other studies [19,21,22,27,40,41], and is insofar critical as gloves are often not worn in areas where no contamination is expected [42]. Nevertheless, the present findings generally range in lower magnitudes than results from older studies [13,33,43,44] and also from more recent international studies [19,28,31,41,[45][46][47], indicating country-specific levels of contamination and pointing out the constant improvements in occupational hygiene practice in the participating pharmacies. The continuous improvement is likely to have benefitted from repeated and long-term monitoring.…”

Occupational Exposure to Chemotherapy of Pharmacy Personnel at a Single Centre

“…Several other studies have consistently shown contamination of such equipment. 30,34,43,44 This result is not surprising, given that this location is where all chemotherapy drugs, in their concentrated form, are reconstituted. The chemotherapy storage drawers in the oncology pharmacy were also contaminated.…”

“…Other studies have had similar results. 36,44 Although it would have been preferable to have all surface wipes analyzed by the same laboratory, there was good correlation between results from the 2 laboratories for surface wipes from the same areas at the same time point.…”

“…Alternatively, it is possible that controls were exposed through some other source. For example, Yoshida and others 44 analyzed wipe samples from the airconditioning filters of 2 hospitals for cyclophosphamide and obtained positive results. On this basis, it could be postulated that central air heating systems, which are connected to various parts of a hospital, may be similarly affected.…”

Safe handling of cytotoxics: guideline recommendations

“…There is evidence from studies [21][22][23][24][25][26] that closed-drug transfer systems can reduce contamination during preparation. Further emerging evidence suggests that when these devices are not used as specified, they could become open to the environment.…”