Environmental assessment of cytotoxic drugs in the Oncology Center of Cyprus.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2020
Historique:
received: 10 04 2019
accepted: 27 12 2019
entrez: 6 3 2020
pubmed: 7 3 2020
medline: 27 5 2021
Statut: epublish

Résumé

Cytotoxic drugs constitute an important workplace hazard in the hospital environment. Our aim was to conduct an environmental assessment of hazardous drugs in the Oncology Center of Cyprus. Wipe samples were obtained from 42 workplace areas of the Oncology Center including two pairs of gloves in an initial assessment, while 10 samples were obtained at follow-up 3 years later. Potential contamination with cyclophosphamide (CP), ifosphamide (IF) and 5-fluorouracil (5-FU) and other cytotoxic medications was examined using the GC-MSMS system (CP, IF) and the HPLC system with UV detection (5-FU) method, respectively. Wipe sample contamination was detected at 11.9% and 15% in the initial and follow-up assessment, respectively. Both pairs of gloves assessed were free from contamination. The results showed contamination with cyclophosphamide on the work space inside the isolator, on a day-care office phone and on the central pharmacy bench. Ifosphamide was only detected on the floor of a patient's room. Contamination with 5-fluorouracil was found only on the surface of a prepared IV infusion bag. The levels of contamination in the positive samples ranged from 0.05 to 10.12 ng/cm2. The overall percentage of sample contamination at the Oncology Center was very low compared to other centers around the world. In addition, the detected levels of contamination with cytotoxic drugs were relatively low with the exception of the workspace inside the biological safety cabinet. These results in both assessments may reflect the implementation of comprehensive control measures including employee training, technological equipment and effective cleaning procedures.

Sections du résumé

BACKGROUND
Cytotoxic drugs constitute an important workplace hazard in the hospital environment. Our aim was to conduct an environmental assessment of hazardous drugs in the Oncology Center of Cyprus.
METHODS
Wipe samples were obtained from 42 workplace areas of the Oncology Center including two pairs of gloves in an initial assessment, while 10 samples were obtained at follow-up 3 years later. Potential contamination with cyclophosphamide (CP), ifosphamide (IF) and 5-fluorouracil (5-FU) and other cytotoxic medications was examined using the GC-MSMS system (CP, IF) and the HPLC system with UV detection (5-FU) method, respectively.
RESULTS
Wipe sample contamination was detected at 11.9% and 15% in the initial and follow-up assessment, respectively. Both pairs of gloves assessed were free from contamination. The results showed contamination with cyclophosphamide on the work space inside the isolator, on a day-care office phone and on the central pharmacy bench. Ifosphamide was only detected on the floor of a patient's room. Contamination with 5-fluorouracil was found only on the surface of a prepared IV infusion bag. The levels of contamination in the positive samples ranged from 0.05 to 10.12 ng/cm2.
CONCLUSIONS
The overall percentage of sample contamination at the Oncology Center was very low compared to other centers around the world. In addition, the detected levels of contamination with cytotoxic drugs were relatively low with the exception of the workspace inside the biological safety cabinet. These results in both assessments may reflect the implementation of comprehensive control measures including employee training, technological equipment and effective cleaning procedures.

Identifiants

pubmed: 32134912
doi: 10.1371/journal.pone.0216098
pii: PONE-D-19-10237
pmc: PMC7058296
doi:

Substances chimiques

Antineoplastic Agents 0
Cyclophosphamide 8N3DW7272P
Fluorouracil U3P01618RT
Ifosfamide UM20QQM95Y

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0216098

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Elpidoforos S Soteriades (ES)

College of Medicine and Health Sciences, Institute of Public Health, United Arab Emirates University, Al Ain, UAE.
Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America.

Sofia C Economidou (SC)

University of Cyprus Medical School, Nicosia, Cyprus.

Artemis Tsivitanidou (A)

Department of Nursing, Bank of Cyprus Oncology Center, Nicosia, Cyprus.

Petros Polyviou (P)

Department of Radiology, Bank of Cyprus Oncology Center, Nicosia, Cyprus.

Amanda Lorimer (A)

Department of Nursing, Bank of Cyprus Oncology Center, Nicosia, Cyprus.

Nikos Katodritis (N)

Department of Radiation Oncology, Bank of Cyprus Oncology Center, Nicosia, Cyprus.

Stavroula Theophanous-Kitiri (S)

Department of Pharmacy, Bank of Cyprus Oncology Center, Nicosia, Cyprus.

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Classifications MeSH