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

Abstract

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.

Pilot Study Evaluating the Efficacy of Four Cleaning Solutions and Two Types of Mops in Delimited Areas of a Floor Contaminated with Cyclophosphamide

“…While sodium hypochlorite can cause discomfort to users in a room that is poorly ventilated, it should not be an issue in pharmacy cleanrooms where there are between 20 and 60 room air changes per hour. Numerous studies have been carried out with the aim of identifying an effective cleaning product able to decontaminate a surface contaminated with HDs [6][7][8][9][10][11][12][13]. Sodium hypochlorite alone or combined with sodium thiosulfate, hydrogen peroxide, potassium permanganate, isopropyl alcohol and Fenton reagent were among the most tested products.…”

“…Touzin et al showed that a combination of sodium hypochlorite and sodium thiosulfate reduced 99.8 % of a contaminated area exposed to CP and that itcould theoretically prevent damage to surfaces [8]. Detergents (cleaning solutions containing a surfactant agent) also proved to be effective [7,10,11,13].…”

A decontamination process adding a tensioactive agent and isopropanol to a closed-system drug transfer device for better control of isolator contamination. A prospective, parallel study

“…Several studies have been carried out to find the best decontaminating solution [ 17 – 19 ]. It has previously been shown that decontaminating solutions including tensioactive agents could have a significant effect on residual contamination [ 19 ].…”

Antineoplastic drugs and their analysis: a state of the art review

“…LOD of 1.7 ng mL −1 was reached for the analysis of 5FU in effluents using an SPE-CE-UV method. 106 Gas chromatography (GC) coupled to MS was also used for the analysis of 5FU, 113,114,27 but the time consuming and tedious derivatisation step means low popularity of GC for the analysis of these non-volatile compounds. 2.1.3.…”