Monitoring of occupational exposure to cytostatic anticancer agents

Sorsa, Marja; Anderson, Diana

doi:10.1016/0027-5107(96)00031-0

Cited by 111 publications

(77 citation statements)

References 39 publications

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“…Sessink 8) and Sorsa 48) estimated the carcinogenic risk by CP absorption. Sessink 8) presumed that urinary excretion of unchanged CP was 1 5％ and 180 ng of CP was continuously excreted in urine for 200 days ×40 years, and estimated that the occupational risk of developing cancer was 120 600 per million by extrapolation of incidences of tumors in rats, and proposed regular monitoring of urinary CP excretion.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Environmental Contaminations and Occupational Exposures Involved in Preparation of Chemotherapeutic Drugs

et al. 2010

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Many healthcare workers are concerned about the risk of occupational exposures to hazardous drugs. The Japanese Society of Hospital Pharmacists (JSHP) revised the``Guidelines for the Handling of Antineoplastic Drugs in Hospitals'', however, the precautions and awareness of handling drugs varied in institutions. We assessed the levels of environmental contaminations in our hospital and urinary excretion of cyclophosphamide (CP) and ifosfamide (IF) in pharmacists and nurses. In environmental studies, we obtained samples by wiping the surfaces around two biological safety cabinets (BSCs) on eight days for four months. One BSC was equipped in hospital pharmacy and the other was equipped in an oncology ward, and used for preparing chemotherapeutic drugs for outpatients and for inpatients, respectively. We obtained the urine samples from 6 pharmacists and 2 nurses. We used solid phase extraction (SPE) as a convenient extraction procedure and liquid chromatography/mass spectrometry/mass spectrometry (LC/MS/MS) for the analysis of the samples. CP was detected on the working surfaces inside both BSCs, and detected at low levels on the back surfaces of the BSCs and at the working tables around the BSCs. IF over the LLOQ was not detected in both BSCs. CP and IF were not detected in all urine samples of pharmacists and nurses. Detection frequencies and amounts of these drugs were low levels, compared with previous reports in Japan, and our results showed that improving awareness about handling hazardous drugs could reduce the risk of the occupational exposures.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Environmental Contaminations and Occupational Exposures Involved in Preparation of Chemotherapeutic Drugs

et al. 2010

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“…Some studies have evidenced a reduced risk when effective protective measures were adopted 10,11) , so in the last few years the interest of occupational medicine in preventing workers' health risks related to antiblastic drugs exposure has been increasing and worldwide attempts have been made to prevent exposure [20][21][22][23] . In particular, recent attention has also focused on nursing staff handling antiblastic drugs that have to be administered to patients, and many European Directives (and related National Legislative Decrees and Guidelines) have been issued, aiming to protect nursing personnel potentially exposed to high amounts of various antiblastic drugs on a daily basis [24][25][26][27] .…”

Section: Journal Of Occupational Healthmentioning

confidence: 99%

Evaluation of Occupational Exposure to Antiblastic Drugs in an Italian Hospital Oncological Department

Castiglia

Miraglia

Pieri

et al. 2008

Journal of Occupational Health

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Evaluation of Occupational Exposure to Antiblastic Drugs in an Italian Hospital OncologicalDepartment: Loredana CASTIGLIA, et al. Department of Public Medicine and Social Health, University of Naples "Federico II", Italy-The determination of the current antiblastic drug contamination levels in an Italian hospital oncology ward was carried out. Statistical evaluation of data aiming to identify potential exposure causes was performed. Cyclophosphamide (CP), ifosfamide (IF) and 5-fluorouracil (5-FU) were determined by wipe tests, extracted with diatomaceous earths and quantified by GC/MSMS or HPLC/UV. Data were analysed with respect to the potential contamination levels of sampled surfaces, and various amounts of handled analyte. χ 2 tests and Spearman correlation coefficients were calculated. Median concentration levels of 0.086, 0.071, 2.363 µg/dm 2 were obtained, (CP, IF, 5-FU, respectively). 3.8 and 13.5% of investigated surfaces showed CP and IF concentrations higher than 1 µg/dm 2 (up to 26.96 µg/ dm 2 ) and 13.4% of samples contained 5-FU concentrations in the range 20-208.9 µg/dm 2 . Analytes' concentration levels were dependent on sampling sites, with significant correlations showing a progressive contamination decrement going from workbenches, floor, hood planes and other surfaces. A diffuse contamination (traces of all the three analytes) was found on all investigated surfaces, even when analytes had not been used during the sampling days. A significant correlation (ρs=0.303, p=0.001) between the measured analyte concentration and the analyte handled amount was found only in the case of IF. The risk management strategy should be improved, as suggested by the measured and widespread levels of contamination. Since contamination also depends on other factors attributable to working modalities and cleaning procedures, the obtained results suggest that performance of specific training courses as well as scheduling environmental monitoring plans to achieve an actual decrement of the observed contamination levels should be implemented. (J Occup Health 2008; 50: 48-56)

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“…1 It has also been associated with mutagenic, teratogenic, and reproductive effects. [2][3][4][5][6][7][8][9][10] Pharmacists and pharmacy technicians handle this and other chemotherapy drugs in their most concentrated form over prolonged periods of time. The risk associated with this chronic, low-grade exposure has not been fully established.…”

Section: Introductionmentioning

confidence: 99%