Assessment of workplace environmental contamination and occupational exposure to cisplatin and doxorubicin aerosols during electrostatic pressurized intraperitoneal aerosol chemotherapy.


Journal

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
ISSN: 1532-2157
Titre abrégé: Eur J Surg Oncol
Pays: England
ID NLM: 8504356

Informations de publication

Date de publication:
11 2021
Historique:
received: 30 01 2021
revised: 28 03 2021
accepted: 07 05 2021
pubmed: 27 5 2021
medline: 6 1 2022
entrez: 26 5 2021
Statut: ppublish

Résumé

Electrostatic precipitation pressurized intraperitoneal aerosol chemotherapy (ePIPAC) is a novel approach for intraperitoneal drug delivery. As ePIPAC using cisplatin and doxorubicin is performed in an operating room, the challenge is to safely deliver the chemotherapeutic aerosol intraperitoneally while preventing exposure to healthcare workers. The objective of this study was to describe cisplatin and doxorubicin workplace environmental contamination and healthcare worker exposure during ePIPAC. Antineoplastic drugs concentrations of cisplatin and doxorubicin were measured in wipe samples from the operating room, and urine samples were collected from healthcare workers. The air samples were collected in order to detect Cisplatin contamination. Cisplatin was analysed by inductively coupled plasma-mass spectrometry and doxorubicin by ultra-high-performance liquid chromatography coupled with tandem mass spectrometry. No trace of cisplatin was found in the air. Cisplatin and doxorubicin were detected on the operating room floor, surfaces, devices and personal protective equipment even after a cleaning protocol. No traces of cisplatin or doxorubicin were found in the urine samples. In this study, no internal contamination was found in the ePIPAC surgical team even after implementing two successive ePIPAC procedures. These results showed the effectiveness of the individual and collective protective measures applied. However, the cleaning procedure during ePIPAC should be respected to limit environmental exposure to chemotherapy to cisplatin and doxorubicin during ePIPAC.

Sections du résumé

BACKGROUND
Electrostatic precipitation pressurized intraperitoneal aerosol chemotherapy (ePIPAC) is a novel approach for intraperitoneal drug delivery. As ePIPAC using cisplatin and doxorubicin is performed in an operating room, the challenge is to safely deliver the chemotherapeutic aerosol intraperitoneally while preventing exposure to healthcare workers. The objective of this study was to describe cisplatin and doxorubicin workplace environmental contamination and healthcare worker exposure during ePIPAC.
METHODS
Antineoplastic drugs concentrations of cisplatin and doxorubicin were measured in wipe samples from the operating room, and urine samples were collected from healthcare workers. The air samples were collected in order to detect Cisplatin contamination. Cisplatin was analysed by inductively coupled plasma-mass spectrometry and doxorubicin by ultra-high-performance liquid chromatography coupled with tandem mass spectrometry.
RESULTS
No trace of cisplatin was found in the air. Cisplatin and doxorubicin were detected on the operating room floor, surfaces, devices and personal protective equipment even after a cleaning protocol. No traces of cisplatin or doxorubicin were found in the urine samples.
CONCLUSION
In this study, no internal contamination was found in the ePIPAC surgical team even after implementing two successive ePIPAC procedures. These results showed the effectiveness of the individual and collective protective measures applied. However, the cleaning procedure during ePIPAC should be respected to limit environmental exposure to chemotherapy to cisplatin and doxorubicin during ePIPAC.

Identifiants

pubmed: 34034944
pii: S0748-7983(21)00496-0
doi: 10.1016/j.ejso.2021.05.020
pii:
doi:

Substances chimiques

Aerosols 0
Doxorubicin 80168379AG
Cisplatin Q20Q21Q62J

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2939-2947

Informations de copyright

Copyright © 2021 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare no conflicts of interest.

Auteurs

Fanny Roussin (F)

Pharmacy Department, Dupuytren Limoges University Hospital, France.

Abdelkader Taibi (A)

Digestive Surgery Department, Dupuytren Limoges University Hospital, France; University Limoges, CNRS, XLIM, UMR 7252, F-87000 Limoges, France. Electronic address: abdelkader.taibi@hotmail.fr.

Mireille Canal-Raffin (M)

INSERM U1219, Université de Bordeaux, 33076, Bordeaux, France; Laboratoire de Pharmacologie Clinique et Toxicologie, CHU de Bordeaux, 33076, Bordeaux, France; University of Bordeaux, 33076, Bordeaux, France.

Lucile Cantournet (L)

Pharmacy Department, Dupuytren Limoges University Hospital, France.

Sylvaine Durand-Fontanier (S)

Digestive Surgery Department, Dupuytren Limoges University Hospital, France; University Limoges, CNRS, XLIM, UMR 7252, F-87000 Limoges, France.

Michel Druet-Cabanac (M)

Occupational Medicine Department, Dupuytren Limoges University Hospital, France.

Souleiman El Balkhi (S)

Pharmacology-Toxicology and Pharmacovigilance Department, CHU Limoges, France; INSERM, IPPRITT,U1248, F-87000, Limoges, France.

Gaëlle Maillan (G)

Pharmacy Department, Dupuytren Limoges University Hospital, France.

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Classifications MeSH