Effectiveness of a closed-system device in containing surface contamination with cyclophosphamide and ifosfamide in an i.v. admixture area

Environmental contamination, product contamination and technicians exposure were measured following preparation of iv bags with cyclophosphamide using the robotic system CytoCare. Wipe samples were taken inside CytoCare, in the clean room environment, from vials, and prepared iv bags including ports and analysed for contamination with cyclophosphamide. Contamination with cyclophosphamide was also measured in environmental air and on the technicians hands and gloves used for handling the drugs. Exposure of the technicians to cyclophosphamide was measured by analysis of cyclophosphamide in urine. Contamination with cyclophosphamide was mainly observed inside CytoCare, before preparation, after preparation and after daily routine cleaning. Contamination outside CytoCare was incidentally found. All vials with reconstituted cyclophosphamide entering CytoCare were contaminated on the outside but vials with powdered cyclophosphamide were not contaminated on the outside. Contaminated bags entering CytoCare were also contaminated after preparation but non-contaminated bags were not contaminated after preparation. Cyclophosphamide was detected on the ports of all prepared bags. Almost all outer pairs of gloves used for preparation and daily routine cleaning were contaminated with cyclophosphamide. Cyclophosphamide was not found on the inner pairs of gloves and on the hands of the technicians. Cyclophosphamide was not detected in the stationary and personal air samples and in the urine samples of the technicians. CytoCare enables the preparation of cyclophosphamide with low levels of environmental contamination and product contamination and no measurable exposure of the technicians.

Section: Discussionmentioning

confidence: 99%

Environmental contamination, product contamination and workers exposure using a robotic system for antineoplastic drug preparation

Sessink

Leclercq

Wouters

et al. 2014

“…Numerous reports have been published that describe the effectiveness of CSTDs at decreasing surface contamination and exposure of healthcare personnel after implementation of the devices. 13,14,[16][17][18][19][20][21] The National Institute for Occupational Safety and Health (NIOSH) 22 and The United States Pharmacopeia's current USP 797 23 standards recommend the use of CSTDs when preparing and administering chemotherapy in addition to the use of PPE.…”

Section: Introductionmentioning

confidence: 99%

Use of a closed system drug-transfer device eliminates surface contamination with antineoplastic agents

Clark

Sessink

2013

“…This system makes it possible to handle solutions and additives in a fully closed system. 16,17 Taking into account the large amount of preparations, the high workload and consequently the increased risk of exposure, it was decided to investigate if the PhaSeal † system could reduce the possibility of contamination with HD in the pharmacy of the University Hospital in Leuven. This preliminary study was intended to evaluate the contamination of surfaces and gloves while using different preparation techniques.…”

Section: Introductionmentioning

confidence: 99%

Comparative contamination study with cyclophosphamide, fluorouracil and ifosfamide: standard technique versus a proprietary closed-handling system

Tans¹,

Willems²

2004