Biomonitoring of occupational exposure to 5-FU by assaying α-fluoro-β-alanine in urine with a highly sensitive UHPLC-MS/MS method

Dhersin, Alice; Atgé, Benoît; Martínez, Béatrice; Titier, Karine; Rousset, Marine; Moustaph, Mohamed Sidatt Cheikh El; Verdun-Esquer, Catherine; Molimard, Mathiéu; Villa, Antoine; Canal-Raffin, Mireille

doi:10.1039/c8an00479j

Cited by 13 publications

(6 citation statements)

References 24 publications

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“…Among the 45 nurses with an internal AD contamination investigated by Villa et al [ 31 ], 17.8% presented positive results for FBAL, with the highest median concentration of 41.5 ng/L. When 73 French and African healthcare professionals were examined for 5-FU contamination through the analysis of the FBAL urinary content, 9.6% presented results above the LOQ [ 43 ]. Regarding the job categories, 5 nurses, 1 assistant nurse and 1 cleaning person were positive from the biological monitoring investigation.…”

Section: Resultsmentioning

confidence: 99%

Exposure to Antineoplastic Drugs in Occupational Settings: A Systematic Review of Biological Monitoring Data

Leso

Sottani

Santocono

et al. 2022

IJERPH

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The high toxicity of antineoplastic drugs (ADs) makes them dangerous not only for patients, but also for exposed workers. Therefore, the aim of this review was to provide an updated overview of the biological monitoring of occupational AD exposure in order to extrapolate information useful to improve risk assessment and management strategies in workplaces. Several studies demonstrated that remarkable portions of healthcare workers may have traces of these substances or their metabolites in biological fluids, although with some conflicting results. Nurses, directly engaged in AD handling, werethe occupational category at higher risk of contamination, although, in some cases, personnel not involved in AD-related tasks also showed quantifiable internal doses. Overall, further research carried out on greater sample sizes appears necessary to gain deeper insight into the variability retrieved in the reported results. This may be important to understand the impact of the extent of ADs use, different handling, procedures, and cleaning practices, spill occurrence, training of the workforce, as well as the adoption of adequate collective and personal protective equipment in affecting the occupational exposure levels. This may support the achievement of the greatest clinical efficiency of such therapies while assuring the health and safety of involved workers.

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Section: Resultsmentioning

confidence: 99%

Exposure to Antineoplastic Drugs in Occupational Settings: A Systematic Review of Biological Monitoring Data

Leso

Sottani

Santocono

et al. 2022

IJERPH

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“…Two methods have been already validated33 but the limit of quantification (LOQ) will be improved. Two other methods are developed for this study for the determination of 5-fluorouracil metabolite (FBAL)35 and doxorubicin urine biomarkers. These methods will be robust and highly sensitive with LOQ adapted to this type of study, that is, very low LOQ values allowing detection of urine AD traces of the order of ng/L.…”

Section: Methodsmentioning

confidence: 99%

“…More than 17 ADs or their urine metabolites can be detected with these methods. The limit of detection (LOD) value in urine, for six of them, is from 0.0132–34 to 0.02 ng/L 35. For the others, the LOD value in urine is from 0.05 to 1 ng/L 36…”

Section: Introductionmentioning

confidence: 99%

“…In order to limit these exposures and to guarantee the safety of employees, centralised reconstitution units for chemotherapies have been created in healthcare establishments and recommendations have been drawn up by government agencies and other occupational health organisations 3 38. Despite the recommendations and the improvements made in terms of safety on the handling and transport of these drugs, several recent studies show that the problem of contamination is still relevant, both in the working environment23 39–43 and for the professionals themselves 33 35 39 44–51. Currently, scientific reviews report that there is no significant correlation between AD surface monitoring and AD urine monitoring 40.…”

Section: Introductionmentioning

confidence: 99%

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Study protocol for the assessment of nurses internal contamination by antineoplastic drugs in hospital centres: a cross-sectional multicentre descriptive study

et al. 2019

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IntroductionAntineoplastic drugs (AD) are potentially carcinogenic and/or reprotoxic molecules. Healthcare professionals are increasingly exposed to these drugs and can be potentially contaminated by them. Internal contamination of professionals is a key concern for occupational physicians in the assessment and management of occupational risks in healthcare settings. Objectives of this study are to report AD internal contamination rate in nursing staff and to identify factors associated with internal contamination.Methods and analysisThis trial will be conducted in two French hospital centres: University Hospital of Bordeaux and IUCT-Oncopole of Toulouse. The target population is nurses practicing in one of the fifteen selected care departments where at least one of the five studied AD is handled (5-fluorouracil, cyclophosphamide, doxorubicin, ifosfamide, methotrexate). The trial will be conducted with the following steps: (1) development of analytical methods to quantify AD urine biomarkers, (2) study of the workplace and organization around AD in each care department (transport and handling, professional practices, personal and collective protection equipments available) (3) development of a self-questionnaire detailing professional activities during the day of inclusion, (4) nurses inclusion (urine samples and self-questionnaire collection), (5) urine assays, (6) data analysis.Ethics and disseminationThe study protocol has been approved by the French Advisory Committee on the Treatment of Information in Health Research (CCTIRS) and by the French Data Protection Authority (CNIL). Following the opinion of the Regional Committee for the Protection of Persons, this study is outside the scope of the provisions governing biomedical research and routine care (n°2014/87). The results will be submitted to peer-reviewed journals and reported at suitable national and international meetings.Trial registration numberNCT03137641.

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“…Recently, the European Biosafety Network has published a brochure in 8 languages on the amendments where a value of 0.1 ng/cm 2 of the surface threshold contamination is recommended for ADs [7]. Until today, several manuscripts [8][9][10] have been published showing that ADs were detected in urine samples of healthcare workers employed in preparation and administration units. The dermal absorption is the major exposure route [11]; direct contact with the drugs (manipulate vials producers and/or pharmacological solutions in intravenous bags), or indirect contact as a result of touching contaminated surfaces, could be considered the main routes of dermal exposure.…”

Section: Introductionmentioning

confidence: 99%

Occupational exposure to antineoplastic drugs in hospital environments: potential risk associated with contact with cyclophosphamide- and ifosfamide-contaminated surfaces

Mucci¹,

Dugheri

Farioli³

et al. 2020

Med Pr

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Background: Cyclophosphamide (CP) and ifosfamide (IP) contaminations have been detected in hospital environments. This study was conducted to determine if there was any contamination in the spaces (floors and door handles) between the hospital exit and the antineoplastic drugs (ADs) preparation and administration units. At the same time, the authors proposed a new automation of the analytical procedure to considerably decrease the time needed for sample preparation and analysis. Material and Methods: To evaluate the ADs contamination of surfaces, 829 wipe tests were performed in a campaign involving 3 hospitals located in Italy. Sampling was performed using an innovative kit. The levels of ADs were measured in each wipe sample using liquid chromatography/ triple quadrupole. Results: On-line solid-phase extraction guarantees the construction of a robust and reproducible analytical method. The CP and IP recoveries from stainless steel, polycarbonate and polyvinyl chloride ranged >80%, and the wipe holders and the automation tested ensured desorption efficiencies close to 100% for both the ADs. Of the 552 wipes taken on the spaces between the hospital exit and the preparation, administration and pharmacy warehouse units, 22 were greater than or equal to the limit of quantification, all adjacent to the administration units. Conclusions: This study provides an insight into the exposure situation against ADs residues. In order to improve environmental monitoring programs, the authors propose to evaluate the ADs contamination also outside the preparation, administration and pharmacy warehouse units.

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Biomonitoring of occupational exposure to 5-FU by assaying α-fluoro-β-alanine in urine with a highly sensitive UHPLC-MS/MS method

Cited by 13 publications

References 24 publications

Exposure to Antineoplastic Drugs in Occupational Settings: A Systematic Review of Biological Monitoring Data

Exposure to Antineoplastic Drugs in Occupational Settings: A Systematic Review of Biological Monitoring Data

Study protocol for the assessment of nurses internal contamination by antineoplastic drugs in hospital centres: a cross-sectional multicentre descriptive study

Occupational exposure to antineoplastic drugs in hospital environments: potential risk associated with contact with cyclophosphamide- and ifosfamide-contaminated surfaces

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