title: Exposures of health-care workers to ribavirin aerosol: a pharmacokinetic study.
abstract: We assessed health risks to nurses and therapists exposed occupationally to ribavirin aerosol, a known rodent teratogen, by measuring uptake as a function of exposure concentration. During a 4-d period, healthy, nonsmoking, young adult volunteers (N = 14) were exposed 4 h/d respirable ribavirin aerosol at concentrations that exceeded occupational levels. Intermittent exercise occurred during exposure, and all activities occurred in a simulated hospital room. Ribavirin was assayed in plasma, red cells, and urine; lung function and symptoms were also measured. In 7 volunteers who were exposed to 30 mg/m3 (i.e., received approximately 10% of therapeutic dose), postexposure ribavirin concentrations in plasma and urine were similar on all 4 d, averaging (0.89 mumol/l and 131 mumol/l, respectively. These concentrations decreased after exposure, with half-times of 37-39 h. Red-cell concentrations averaged 31 mumol/l on d 4, accounting for < 5% of inhaled ribavirin mass, and they remained stable for 4 d afterward. In 7 volunteers exposed to 3 mg/m3 (i.e., approximately 1% of therapeutic dose), plasma averaged 0.075 mumol/l and red cells averaged 3 mumol/l on d 4 (i.e., near detection limits). Small variations occurred in lung function, reported symptoms, and hematologic values for exposures to both 3 and 30 microgram/m3; therefore, these effects were most likely not caused by ribavirin. Typical occupational exposures to ribavirin, without recommended protective measures, should result in undetectable or barely detectable body burdens, i.e., approximately 0.1%-1% of levels reported to be toxic to laboratory animals.
authors.affiliation: Environmental Health Service, Rancho Los Amigos Medical Center, Downey, California, USA.
authors.forename: W S
authors.initials: WS
authors.lastname: Linn
authors.forename: H
authors.initials: H
authors.lastname: Gong
authors.forename: K R
authors.initials: KR
authors.lastname: Anderson
authors.forename: K W
authors.initials: KW
authors.lastname: Clark
authors.forename: D A
authors.initials: DA
authors.lastname: Shamoo
mesh_terms: D000293:Adolescent; D000328:Adult; D000336:Aerosols / Q000633:toxicity; D001007:Anxiety / Q000523:psychology; D003627:Data Interpretation, Statistical; D004912:Erythrocytes / Q000737:chemistry; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D016273:Occupational Exposure; D012129:Respiratory Function Tests; D012254:Ribavirin / Q000493:pharmacokinetics* / Q000633:toxicity*
chemical_list: D000336:Aerosols; D012254:Ribavirin