Background
Studies from Europe, the US and Australia have shown measurable levels of cytotoxic contamination in health facilities. Cytotoxic drug residue has been detected in the air and on surfaces in preparation areas even though work was undertaken in biological safety cabinets. Several studies have found substantial levels of surface contamination in pharmacy drug preparation and administration areas. At the time this study was conducted there were no published Australian studies investigating surface contamination when cytotoxic drug safety cabinets are in use.
Aim
To determine if surface contamination with cytotoxic drugs occurs when cytotoxic drug safety cabinets are used by pharmacy personnel to prepare cytotoxic chemotherapy.
Method
A multicentre study conducted at 10 hospital pharmacy departments in metropolitan Melbourne. All sites were tested to measure the amount of cytotoxic contamination present using cyclophosphamide as a surrogate marker for all cytotoxic drugs. Surface wipe sampling was performed at specified locations within the cytotoxic suites.
Results
Cyclophosphamide contamination was detected in 78% of samples taken within the cytotoxic drug safety cabinet, with 100% contamination detected in the sump. Positive results were also found in 89% of floor samples (cleanroom and anteroom) and 67% of checking benches.
Conclusion
Cytotoxic drug contamination was detected on a variety of surfaces in the cytotoxic drug preparation areas that used cytotoxic drug safety cabinets. The potential risk of exposure to cytotoxic drugs exists in the workplace despite adherence to the recommended safe handling guidelines.
