title: An analysis to study trends in occupational exposure to antineoplastic drugs among health care workers.
abstract: The use of antineoplastic agents for the treatment of cancer and other non-neoplastic diseases is an increasingly common practice in hospitals. As a result, workers involved with handling antineoplastic drugs may be accidentally exposed to these agents, placing them at potential risk for long term adverse effects. To date, the challenge of protecting workers' health is persisting and expanding, with an increasing number of publications demonstrating that contamination of antineoplastic drugs (ADs) is still present on work surfaces after cleaning procedures are concluded. In this paper, five workplaces were selected for surveillance of professional exposure to ADs. Hospital pharmacies involved in the study were set in the North (Units A1 and B2), Center (Units C3 and D4) and South (Unit E5) of Italy. Contamination levels on a number of work surfaces and trends over a 10-year period are presented. Environmental and biological levels were obtained by high performance liquid chromatography (HPLC) coupled with tandem mass spectrometry (MS/MS). A strong reduction of surface contamination was evidenced since 2003, when the recommended procedures for the safe handling of antineoplastic drugs started to be followed by health care workers. Employers' adherence to these recommendations allowed risk characterisation to achieve other important goals. The percentage of positive urine samples was found to be around 30% in the 1990s and 2% in the 2000s. Moreover, no positive samples were detected in 2006 or 2007. In conclusion, our study emphasized that one helpful strategy to reduce risk to all potentially exposed workers is also provided by a data-storage system that allows potential risks of working to be rapidly identified and controlled.
authors.affiliation: Laboratory for Environmental and Toxicological Testing, IRCCS Pavia, S. Maugeri Foundation, via S. Maugeri 10, Pavia, Italy. cristina.sottani@fsm.it
authors.forename: Cristina
authors.initials: C
authors.lastname: Sottani
authors.forename: Benedetta
authors.initials: B
authors.lastname: Porro
authors.forename: Mario
authors.initials: M
authors.lastname: Comelli
authors.forename: Marcello
authors.initials: M
authors.lastname: Imbriani
authors.forename: Claudio
authors.initials: C
authors.lastname: Minoia
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D002851:Chromatography, High Pressure Liquid; D006282:Health Personnel; D006801:Humans; D016273:Occupational Exposure; D053719:Tandem Mass Spectrometry
chemical_list: D000970:Antineoplastic Agents