title: Evaluation of surface contamination in a hospital hematology--oncology pharmacy.
abstract: OBJECTIVE
  To describe environmental contamination with hazardous drugs in a hospital pharmacy setting before and after reorganizing a hematology- oncology satellite pharmacy.
  
  
  METHODS
  This is a descriptive study of surface contamination with cyclophosphamide, ifosfamide, and methotrexate in two hematology-oncology satellite pharmacies. In order to measure surface contamination with hazardous drugs, samples from four distinct measurement sites within the pharmacy were taken in each of the two phases (pre-and postphases) using a sampling procedure and an analytical method modified from Larson et al.
  
  
  RESULTS
  A total of 133 samples from four measurement sites were taken and analyzed over the course of the study (specifically 60 prephase samples and 73 postphase samples). The study showed a significant increase in the number of positive samples (from 66.7% to 90.4%, p<0.001) from the pre- to the postphase. The increase, however, is only significant in terms of the location where completed preparations were placed after they had come out from under the hood (from 0/15 to 21/28, p<0.001) and the work surface (from 8/15 to 15/15, p=0.006) and only in terms of ifosfamide. Furthermore, for the other sites studied, the number of positive samples remained unchanged between the pre- and postphase. A statistically significant difference between the pre- and postphase was observed in terms of ifosfamide for three of the four measurement sites studied and methotrexate for one of the four sites. Average concentrations were higher in the post phase in three of the four cases.
  
  
  CONCLUSIONS
  This study describes environmental contamination with hazardous drugs in a hospital pharmacy setting before and after reorganizing a hematology-oncology satellite pharmacy. The study showed that a refitting of the hemato-oncology pharmacy is not a sufficient strategy to reduce the environmental contamination by ifosfamide because a significant increase in the number of positive samples from the pre- to the postphase have been observed. Many factors can contribute to influence the contamination of hazardous drugs such as the workflow and the training of the personal. Continuous environmental surveillance of hazardous drugs is required to document traces and help reduce risks.
authors.affiliation: Pharmacy Department and Pharmacy Practice Research Unit, CHU Sainte-Justine, Montreal, Quebec, Canada. karine.touzin.hsj@ssss.gouv.qc.ca
authors.forename: Karine
authors.initials: K
authors.lastname: Touzin
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Bussières
authors.forename: Eric
authors.initials: E
authors.lastname: Langlois
authors.forename: Michel
authors.initials: M
authors.lastname: Lefebvre
mesh_terms: D000970:Antineoplastic Agents / Q000032:analysis*; D003520:Cyclophosphamide / Q000032:analysis; D004339:Drug Compounding / Q000379:methods / Q000592:standards; D004784:Environmental Monitoring / Q000379:methods; D004866:Equipment Contamination; D006801:Humans; D007069:Ifosfamide / Q000032:analysis; D008727:Methotrexate / Q000032:analysis; D016273:Occupational Exposure / Q000032:analysis / Q000517:prevention & control; D010607:Pharmacy Service, Hospital / Q000458:organization & administration* / Q000592:standards
chemical_list: D000970:Antineoplastic Agents; D003520:Cyclophosphamide; D007069:Ifosfamide; D008727:Methotrexate