Environmental Contamination Assessment in the Process of Application of Aerosolized Therapeutic Substances

Abstract

Background: PIPAC (Pressurized Intraperitoneal aerosol chemotherapy) acts by applying aerosolized chemotherapy in the peritoneal cavity, enhancing tissue penetration of chemotherapeutic agents. This method of chemotherapy delivery still raises concerns related to the operating room's environmental exposure, arousing discussions related to the occupational risks of this technique. This work aims to demonstrate the pattern of aerosolization distribution in the absence of safety mechanisms in an operating room. Methods: A cross-sectional experimental work was carried out of 31 aerosol applications. Aerosolization was performed with a 1% aqueous solution of caffeine Cellulose. Nitrate membranes were used to capture the concentration of caffeine in different sites within the operating room for 5 periods of fixed exposure times.Results: 930 samples obtained in 31 rounds of aerosolization. Comparing the changes in concentration per minute between the different time intervals, there were statistically significant differences between the 0-2 minutes interval and the 15-30 interval (P <0.001). Surgeon site show a significant difference between the times (P=0.010). There were no differences between changes in concentrations in the time intervals for the anesthetist site (P = 0.094). At the injector site, a statistically significant difference (P <0.001). The time assessment between 30-35 exposure showed a median of 0. Conclusions: The study pointed out that the moment of greatest risk of contamination of the surgical environment occurs during aerosolization, especially during the first 15 minutes after the start of aerosolization. The sites that were most exposed to contamination were the patient, the surgeon and the injector, respectively.