Environmental Contamination and Occupational Exposure of Algerian Hospital Workers

Abstract

Guidelines are in place to assure limited occupational exposure to cytostatic drugs. Even though this has led to a reduction in exposure, several studies reported quantifiable concentrations of these compounds in healthcare workers. In this study, we evaluated occupational exposure to cytostatic drugs in hospital workers from the University Hospital in Tlemcen, Algeria. Monitoring was performed by collecting wipe samples from surfaces, objects, personal protective equipment (gloves and masks) and from the skin of employees at an Algerian university hospital. Wipe samples were analyzed with ultra-performance liquid chromatography coupled to a mass spectrometer. Concentrations ranged from below the limit of quantification up to 208.85, 23.45, 10.49, and 22.22 ng/cm² for cyclophosphamide, ifosfamide, methotrexate and 5-fluorouracil, respectively. The highest values were observed in the oncology department. Nowadays, there are still no safe threshold limit values for occupational exposure to cytostatic agents. Therefore, contamination levels should be kept as low as reasonably achievable. Yet, healthcare workers in this hospital are still exposed to cytostatic agents, despite the numerous guidelines, and recommendations. Consequently, actions should be taken to reduce the presence of harmful agents in the work environment.

Blood contamination of the pharmaceutical staff by irinotecan and its two major metabolites inside and outside a compounding unit

“…Despite these safety guidelines, the studies carried out over the recent years still have reported a residual contamination with antineoplastic drugs on surfaces and on the hands of hospital employees, including pharmaceutical workers. 6–10 Since the dermal route is considered as the major contamination pathway, these data reinforce the relevance of conducting further studies on occupational AD contamination, preferably with direct methods to detect traces of antineoplastic drugs or of their metabolites in healthcare workers. 5 , 11 , 12 These methods are essential in order to measure workers’ effective uptake of AD in the healthcare environment.…”

LC–MS-MS Determination of Cytostatic Drugs on Surfaces and in Urine to Assess Occupational Exposure

“…Nevertheless, ESI was the selected ionization source employed in the developed methods, as mentioned previously, due to the absence of signal for some compounds by US. To our knowledge, only one article has been published using US for the determination of 5-fluorouracil in wipe samples ( 20 ).…”

Pencegahan Keluarga Pasien Kanker Terhadap Paparan Obat Kemoterapi

“…Yang sering menjadi perhatian adalah petugas kesehatan yang terlibat selama persiapan dan pemberian obat. Paparan dapat terjadi melalui kontak dengan permukaan kerja yang terkontaminasi, peralatan, kotoran/ekskresi pasien, atau secara inhalasi dengan menghirup partikel yang dihasilkan akibat melakukan manipulasi terhadap larutan yang mengandung agen sitostatik tersebut (Verscheure et al, 2020).…”

“…Sisasisa obat tersebut mungkin menimbulkan efek jangka panjang pada keluarga saat beraktivitas dengan pasien seperti membersihkan pasien, menggunakan toilet yang sama dan mengganti alas kasur yang terkontaminasi oleh urin, feses, muntah atau keringat pasien tanpa menggunakan alat pelindung diri (Hon et al, 2014). Efek tersebut dapat berupa efek mutagenik, perkembangan, reproduksi ataupun efek sitogenik (Verscheure et al, 2020).…”

“…Anak-anak, wanita hamil dan lansia rentan terhadap efek sekunder kemoterapi akibat belum maturnya sel-sel tubuh pada anak-anak, penurunan fungsi tubuh pada lansia dan efek mutagenik/sitogenik pada ibu hamil. Hal ini dapat menyebabkan gangguan pertumbuhan, reproduksi, bahkan dapat menimbulkan kanker 10 tahun kemudian (Verscheure et al, 2020).…”