Association between occupational exposure levels of antineoplastic drugs and work environment in five hospitals in Japan.
OBJECTIVE
The aim of the present study was to evaluate the measurement of contamination by antineoplastic drugs for safer handling of such drugs by medical workers. We investigated the relationship between the contamination level of antineoplastic drugs and the conditions of their handling.


METHODS
Air samples and wipe samples were collected from equipment in the preparation rooms of five hospitals (hospitals A-E). These samples were subjected to measurement of the amounts of cyclophosphamide (CPA), fluorouracil (5FU), gemcitabine (GEM), and platinum-containing drugs (Pt). Twenty-four-hour urine samples were collected from the pharmacists who handled or audited, the antineoplastic drugs were analyzed for CPA and Pt.


RESULTS
Pt was detected from air samples inside BSC in hospital B. Antineoplastic drugs were detected from wipe samples of the BSC in hospitals A, B, D, and E and of other equipment in the preparation rooms in hospitals A, B, C, and D. Cyclophosphamide and 5FU were detected from wipe samples of the air-conditioner filter in hospital A, and CPA was detected from that in hospital D. Cyclophosphamide was detected from urine samples of workers in hospitals B, D, and E.


CONCLUSIONS
The contamination level of antineoplastic drugs was suggested to be related with the amount of drugs handled, cleaning methods of the equipment, and the skill level of the technique of maintaining negative pressure inside a vial. In order to reduce the contamination and exposure to antineoplastic drugs in the hospital work environment very close to zero, comprehensive safety precautions, including adequate mixing and cleaning methods was required in addition to BSC and closed system device.
Yoshida
Jin
J
Department of Environmental Health, Osaka Prefectural Institute of Public Health, Higashinari-ku, Osaka, Japan. jnyosida@iph.pref.osaka.jp
Koda
Shigeki
S
Nishida
Shozo
S
Yoshida
Toshiaki
T
Miyajima
Keiko
K
Kumagai
Shinji
S
D000970:Antineoplastic Agents / Q000032:analysis* / Q000652:urine; D004339:Drug Compounding; D004784:Environmental Monitoring / Q000379:methods*; D004866:Equipment Contamination; D006761:Hospitals; D006801:Humans; D007564:Japan; D016273:Occupational Exposure / Q000032:analysis* / Q000517:prevention & control; D016272:Occupational Health; D010595:Pharmacists
D000970:Antineoplastic Agents