title: [Evaporation of selected cytotoxic drugs and permeation of protective gloves--research into the occupational risks of health care personnel handling hazardous cytotoxic drugs (CYTO project)].
abstract: BACKGROUND
  The CYTO project studies an important aspect of healthcare provision -long-term occupational exposure, both threshold and below-threshold, to chemical agents with carcinogenic and mutagenic properties, with the major focus on antineoplastic drugs.This contribution presents experimental results from the first stages of the project's experimental work, i.e. an evaluation of the physico-chemical characteristics of cytostatic agents (evaporation) and an investigation into protective glove permeation.
  
  
  METHODS
  In co-operation with IUTA (Institut für Energie- und Umwelttechnik e.V., Duisburg, Germany), the vapour pressure of paclitaxel, doxorubicin and dacarbazine was measured following OECD guideline No. 104: Vapour pressure curve--vapour pressure balance. Furthermore, the evaporation of cytostatic drugs was examined in actual laboratory conditions by monitoring the airborne concentration using the passive sampling technique. Besides the evaporation of selected drugs, the permeation of cisplatin, cyclophosphamide, doxorubicin, 5-fluorouracil and paclitaxel through different types of gloves (vinyl, latex, nitrile) was assessed.
  
  
  RESULTS
  Although our experiments showed relatively slow evaporation of the evaluated cytostatic drugs (the highest pressure in paclitaxel was 0.024 Pa), equilibrium concentrations may go up to milligrams per cubic metre. Nevertheless, analytical measurements of airborne contamination did not confirm these concentration levels. The glove permeation experiments with cytostatics showed good resistance of nitrile gloves (which were impermeable to all five drugs). Other materials should be avoided while handling cytostatic agents (e.g. maximum permeation of cyclophosphamide through latex was 19 microg/sq cm/hr).
  
  
  CONCLUSIONS
  Although the volatility of cytostatic agents is low, it cannot be neglected considering the chronic character of exposure. However, in order to estimate actual occupational exposure, future research should focus on the development of sensitive analytical methods. Nevertheless, dermal uptake is supposed to be the major route of exposure and use of protective gloves is necessary to minimize potential risks. Our simulated time-dependent permeation experiments with cytostatic agents and different glove materials showed that good protection is provided only by nitrile gloves. The results obtained in this study will be used for the modelling of exposure doses and health risk assessment in the subsequent stages of the CYTO research project.
authors.affiliation: Ustavní Iékárna, Masarykův onkologický ustav, Brno. dolezalova@mou.cz
authors.forename: L
authors.initials: L
authors.lastname: Dolezalová
authors.forename: P
authors.initials: P
authors.lastname: Odráska
authors.forename: L
authors.initials: L
authors.lastname: Gorná
authors.forename: M
authors.initials: M
authors.lastname: Prudilová
authors.forename: R
authors.initials: R
authors.lastname: Vejpustková
authors.forename: L
authors.initials: L
authors.lastname: Bláha
mesh_terms: D000395:Air Pollutants, Occupational / Q000032:analysis*; D000970:Antineoplastic Agents / Q000737:chemistry*; D004784:Environmental Monitoring; D017575:Gloves, Protective; D006282:Health Personnel; D006801:Humans; D007840:Latex; D009570:Nitriles; D016273:Occupational Exposure; D010539:Permeability; D014753:Vinyl Compounds; D014835:Volatilization
chemical_list: D000395:Air Pollutants, Occupational; D000970:Antineoplastic Agents; D007840:Latex; D009570:Nitriles; D014753:Vinyl Compounds