Chemical degradation of wastes of antineoplastic agents

Castegnaro, M.; Méo, Michel De; Laget, M.; Michelon, Jocelyne; Garren, Liliane; Sportouch, M. H.; Hansel, Sylvie

doi:10.1007/s004200050232

Cited by 46 publications

(7 citation statements)

References 2 publications

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“…(11,(29)(30)(31)(32)(33) A number of studies have shown the efficiency of deactivating agents, such as sodium hypochlorite, to degrade severalif not all-investigated antineoplastic agents, but mutagenicity and other health impairing risks of the degradation products have not been excluded. (31,(34)(35)(36)(37)(38) Mostly, investigated surfaces comprised stainless steel and glass as major components of biological safety cabinets (BSCs), while other surface materials have been less considered despite the evidence that contamination could be spread in the entire preparation and administration area. Although 5-FU is the most prescribed parenteral chemotherapy agent for cancer therapy in Germany and in many other countries and also the preparation numbers of GEM have been constantly increasing during recent years, literature data on decontamination strategies for both compounds are scarce.…”

Section: Please Scroll Down For Articlementioning

confidence: 99%

“…Sodium hypochlorite, which chemically degrades antineoplastic drugs, is restricted for use at stainless steel surfaces due to its oxidizing effects and its environmental toxicity and health impairing degradation products, i.e., other chemically active metabolites with potential mutagenic risks. (35,37,38) There is also the risk of deterioration of cleaned surfaces, which requires rinsing the surfaces with water after use to avoid corrosion phenomena. (29,39) None of the cleaning agents tested led to residual contaminations markedly exceeding 10% of the original contamination of both drugs tested.…”

Section: Cleaning Proceduresmentioning

confidence: 99%

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Cleaning Efficiencies of Three Cleaning Agents on Four Different Surfaces after Contamination by Gemcitabine and 5-fluorouracile

Böhlandt

Groeneveld

Fischer

et al. 2015

Journal of Occupational and Environmental Hygiene

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Occupational exposure to antineoplastic drugs has been documented for decades showing widespread contamination in preparation and administration areas. Apart from preventive measures, efficient cleaning of surfaces is indispensable to minimize the exposure risk. The aim of this study was to evaluate the efficiency of three cleaning agents after intentional contamination by gemcitabine (GEM) and 5-fluorouracile (5-FU) on four different surface types usually installed in healthcare settings. Glass, stainless steel, polyvinylchloride (PVC), and laminated wood plates were contaminated with 20 ng/μl GEM and 2 ng/μl 5-FU solutions. Wipe samples were analyzed for drug residues after cleaning with a) distilled water, b) aqueous solution containing sodium dodecyl sulfate (10 mM) and 2-propanol (SDS-2P), and c) Incides N (pre-soaked) alcoholic wipes. Quantification was performed by high-performance liquid chromatography (HPLC) for GEM and gas chromato-graphy-tandem mass spectrometry (GCMS/MS) for 5-FU. Recovery was determined and cleaning efficiency was calculated for each scenario. Mean recoveries were 77-89% for GEM and 24-77% for 5-FU and calculated cleaning efficiencies ranged between 95 and 100% and 89 and 100%, respectively. Residual drug amounts were detected in the range nd (not detected) - 84 ng GEM/sample and nd - 6.6 ng 5-FU/sample depending on surface type and cleaning agent. Distilled water and SDS-2P had better decontamination outcomes than Incides N wipes on nearly all surface types, especially for GEM. Regarding 5-FU, the overall cleaning efficiency was lower with highest residues on laminated wood surfaces. The tested cleaning procedures are shown to clean glass, stainless steel, PVC, and laminated wood with an efficiency of 89-100% after contamination with GEM and 5-FU. Nevertheless, drug residues could be verified by wipe samples. Pure distilled water and SDS in an alcoholic-aqueous solution expressed an efficient cleaning performance, especially with respect to GEM. The study results demonstrate the need to adapt cleaning procedures to the variety of drugs and surface types to develop effective decontamination strategies.

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Section: Please Scroll Down For Articlementioning

confidence: 99%

Section: Cleaning Proceduresmentioning

confidence: 99%

Cleaning Efficiencies of Three Cleaning Agents on Four Different Surfaces after Contamination by Gemcitabine and 5-fluorouracile

Böhlandt

Groeneveld

Fischer

et al. 2015

Journal of Occupational and Environmental Hygiene

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“…in secondary sewage treatment). This has led to an intensive search for methods of chemical degradation, using oxidants such as sodium hypochlorite, hydrogen peroxide, and Fenton reagent (Fe 2+ / H 2 O 2 ) [21,22], as well as so-called ''Advanced Oxidation Processes'' using reagents such as O 3 [23][24][25][26][27][28].…”

Section: Introductionmentioning

confidence: 99%

Electrochemical waste water treatment: Electrooxidation of acetaminophen

et al. 2005

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Oxidation of acetaminophen at boron-doped diamond (BDD) and at Ti/SnO 2 anodes in a plug-flow divided electrochemical reactor led to electrochemical combustion, whereas at Ti/IrO 2 benzoquinone was the exclusive product except at very long electrolysis times. The difference is explicable in terms of the different mechanisms of oxidation: direct oxidation at the anode for Ti/IrO 2 vs. indirect oxidation involving electrogenerated hydroxyl radicals at BDD and Ti/SnO 2 . At BDD, at which the efficiency of degradation of acetaminophen was greatest, the rate of electrolysis at constant concentration was linearly dependent on the current, and at constant current linearly dependent on the concentration. Current efficiencies for mineralization up to 26% were achieved without optimization of the cell design.

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“…Several authors have tried to find a an agent capable of inactivating, degrading, and reducing contamination with cytotoxic drugs in oncology services (48)(49)(50)(51)(52)(53)(54)(55), but the issue remains. Our study only confirms that, as we found contamination even on supposedly cleaned surfaces before drug handling began.…”

Section: Cleaning Issues and Recommendationsmentioning

confidence: 99%

Occupational exposure to cytotoxic drugs: the importance of surface cleaning to prevent or minimise exposure

Viegas

Oliveira

Carolino

et al. 2018

Archives of Industrial Hygiene and Toxicology

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Healthcare workers who prepare or administer cytotoxic agents run the risk of exposure, and the risks for health are real even at doses lower than those applied in cancer patients, because, in theory, no dose is safe. The most common and problematic route of exposure is through the skin, especially as work surfaces can remain contaminated even after cleaning. This pilot study aimed to demonstrate the importance of having an effective surface decontamination protocol by determining surface contamination with cyclophosphamide, 5-fluorouracil, and paclitaxel as the most common cytotoxic drugs in an oncology day service. Samples were collected before and after drug handling and analysed with high performance liquid chromatography with diode array detection (HPLC-DAD). Of the 29 samples collected before drug handling 23 were contaminated, five of which with more than one drug. Of the 30 samples collected after drug handling 25 were contaminated, eight of which with more than one drug. The two time points did not significantly differ, which evidences a widespread contamination and ineffective cleaning. This calls for revising the cleaning protocol and handling procedure to place contamination under control as much as possible.

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Chemical degradation of wastes of antineoplastic agents

Abstract: Sodium hypochlorite (5.25%) is an efficient reagent for the chemical degradation of the nine drugs tested thus far.

Cited by 46 publications

References 2 publications

Cleaning Efficiencies of Three Cleaning Agents on Four Different Surfaces after Contamination by Gemcitabine and 5-fluorouracile

Cleaning Efficiencies of Three Cleaning Agents on Four Different Surfaces after Contamination by Gemcitabine and 5-fluorouracile

Electrochemical waste water treatment: Electrooxidation of acetaminophen

Occupational exposure to cytotoxic drugs: the importance of surface cleaning to prevent or minimise exposure

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