title: Surface contamination of chemotherapy drug vials and evaluation of new vial-cleaning techniques: results of three studies.
abstract: OBJECTIVE
  The results of three studies that describe the external contamination of chemotherapy drug vials are presented. New techniques for the improved decontamination of vials containing cisplatin are also described.
  
  
  CONCLUSIONS
  Study 1 evaluated the external contamination of drug vials with cyclophosphamide and ifosfamide in a pharmacy setting. Widespread contamination of the outside of drug vials was found with each drug. Study 2 evaluated the surface contamination of drug vials with cyclophosphamide and fluorouracil in three pharmacies. Sporadic contamination with fluorouracil was detected, while cyclophosphamide was found on most vials. In study 3, investigators compared the decontamination abilities of a standard decontamination procedure at the manufacturer level with an improved decontamination procedure and the use of sleeves to further decrease contamination. Though the methods of each study reported herein differed, the outcomes were similar. All chemotherapy drug vials studied demonstrated levels of contamination with the drug well above the limit of detection. Improved decontamination procedures, combined with the use of protective sleeves, reduced the level of platinum contamination by 90%, suggesting that standard decontamination procedures should be reconsidered.
  
  
  CONCLUSIONS
  The results of these studies are consistent with several others that have reported contamination of the outside surface of drug vials for a number of chemotherapy drugs. Contamination can be reduced by using decontamination equipment and protective sleeves during the manufacturing process.
authors.affiliation: Division of Applied Research and Technology, National Institute for Occupational Safety and Health (NIOSH), Cincinnati, OH 45226, USA. tmc6@cdc.gov
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Connor
authors.forename: Paul J M
authors.initials: PJ
authors.lastname: Sessink
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Harrison
authors.forename: Jack R
authors.initials: JR
authors.lastname: Pretty
authors.forename: Byron G
authors.initials: BG
authors.lastname: Peters
authors.forename: Raul M
authors.initials: RM
authors.lastname: Alfaro
authors.forename: Appie
authors.initials: A
authors.lastname: Bilos
authors.forename: Gwendolyn
authors.initials: G
authors.lastname: Beckmann
authors.forename: Michael R
authors.initials: MR
authors.lastname: Bing
authors.forename: Lakisha M
authors.initials: LM
authors.lastname: Anderson
authors.forename: Robert
authors.initials: R
authors.lastname: Dechristoforo
mesh_terms: D000970:Antineoplastic Agents / Q000032:analysis / Q000302:isolation & purification*; D003666:Decontamination / Q000379:methods*; D004349:Drug Packaging; D004866:Equipment Contamination / Q000517:prevention & control; D010607:Pharmacy Service, Hospital
chemical_list: D000970:Antineoplastic Agents