title: Pilot study comparing the efficacy of two cleaning techniques in reducing environmental contamination with cyclophosphamide.
abstract: OBJECTIVE
  Compare the efficacy of the cleaning technique usually employed in our healthcare facility to eliminate environmental contamination with cyclophosphamide with that of the Surface Safe commercial kit.
  
  
  METHODS
  This is a three-step evaluative and comparative study involving: (i) the voluntary contamination of the surface of a hood with a pre-established quantity of cyclophosphamide (20,000,000 ng), (ii) the cleaning of the work surface of the hood using a cleaning technique usually employed in our healthcare facility or that of the product Surface Safe, and (iii) the quantification of cyclophosphamide detected on the work surface. The usual cleaning technique involves the use of a mixture of 0.05% chlorhexidine and 70% ethyl alcohol to clean surfaces, whereas the product Surface Safe involves a combined two-step sodium hypochlorite and sodium thiosulfate wash.
  
  
  RESULTS
  The median concentrations of cyclophosphamide detected after the use of the usual technique and the product Surface Safe came to 165 ng cm(-2) (40-570) and 65 ng cm(-2) (57-110), respectively. The results obtained showed an average 99.5% efficacy in reducing the quantity of cyclophosphamide (ng) detected on the work surface for each of the two techniques that were evaluated.
  
  
  CONCLUSIONS
  The study demonstrates that reducing the residual concentration of cyclophosphamide on work surfaces to levels lower than 1 ng cm(-2) remains difficult despite the use of cleaning techniques with a high percentage of efficacy. It stressed the importance of combining two successive cleaning techniques to maximally restrict the residual concentration of hazardous drugs and suggests the use of a combination of sodium hypochlorite and sodium thiosulfate to best reduce environmental contamination levels.
authors.affiliation: Pharmacy Practice Research Unit, Pharmacy Department, Centre Hospitalier Universitaire Sainte-Justine, 3175, chemin de la Côte Sainte-Catherine, Montreal, Quebec H3T 1C5, 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
authors.forename: Angélique
authors.initials: A
authors.lastname: Métra
mesh_terms: D002710:Chlorhexidine / Q000737:chemistry; D003520:Cyclophosphamide / Q000032:analysis* / Q000737:chemistry; D003666:Decontamination / Q000379:methods*; D004784:Environmental Monitoring; D004787:Environmental Pollution / Q000517:prevention & control*; D004866:Equipment Contamination / Q000517:prevention & control; D000431:Ethanol / Q000737:chemistry; D015386:Hazardous Substances / Q000032:analysis*; D006801:Humans; D009153:Mutagens / Q000032:analysis*; D016273:Occupational Exposure / Q000517:prevention & control*; D010607:Pharmacy Service, Hospital / Q000379:methods; D010865:Pilot Projects; D012973:Sodium Hypochlorite / Q000737:chemistry; D013885:Thiosulfates / Q000737:chemistry; D017132:Workplace
chemical_list: D015386:Hazardous Substances; D009153:Mutagens; D013885:Thiosulfates; D000431:Ethanol; D003520:Cyclophosphamide; D012973:Sodium Hypochlorite; C017717:sodium thiosulfate; D002710:Chlorhexidine