title: Sampling and mass spectrometric analytical methods for five antineoplastic drugs in the healthcare environment.
abstract: BACKGROUND
  Healthcare worker exposure to antineoplastic drugs continues to be reported despite safe handling guidelines published by several groups. Sensitive sampling and analytical methods are needed so that occupational safety and health professionals may accurately assess environmental and biological exposure to these drugs in the workplace.
  
  
  OBJECTIVE
  To develop liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) analytical methods for measuring five antineoplastic drugs in samples from the work environment, and to apply these methods in validating sampling methodology. A single method for quantifying several widely used agents would decrease the number of samples required for method development, lower cost, and time of analysis.
  
  
  METHODS
  for measuring these drugs in workers' urine would also be useful in monitoring personal exposure levels.
  
  
  RESULTS
  LC-MS/MS methods were developed for individual analysis of five antineoplastic drugs in wipe and air sample media projected for use in field sampling: cyclophosphamide, ifosfamide, paclitaxel, doxorubicin, and 5-fluorouracil. Cyclophosphamide, ifosfamide, and paclitaxel were also measured simultaneously in some stages of the work. Extraction methods for air and wipe samples were developed and tested using the aforementioned analytical methods. Good recoveries from the candidate air and wipe sample media for most of the compounds, and variable recoveries for test wipe samples depending on the surface under study, were observed. Alternate LC-MS/MS methods were also developed to detect cyclophosphamide and paclitaxel in urine samples.
  
  
  CONCLUSIONS
  The sampling and analytical methods were suitable for determining worker exposure to antineoplastics via surface and breathing zone contamination in projected surveys of healthcare settings.
authors.affiliation: Division of Applied Research and Technology, National Institute for Occupational Safety and Health, U.S. Centers for Disease Control and Prevention, Cincinnati, OH 45226, USA. jrp0@cdc.gov
authors.forename: Jack R
authors.initials: JR
authors.lastname: Pretty
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Connor
authors.forename: Ivan
authors.initials: I
authors.lastname: Spasojevic
authors.forename: Kristine S
authors.initials: KS
authors.lastname: Kurtz
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: McLaurin
authors.forename: Clayton
authors.initials: C
authors.lastname: B'Hymer
authors.forename: D Gayle
authors.initials: DG
authors.lastname: Debord
mesh_terms: D000395:Air Pollutants, Occupational / Q000032:analysis; D000970:Antineoplastic Agents / Q000032:analysis* / Q000652:urine; D002851:Chromatography, High Pressure Liquid / Q000379:methods*; D004784:Environmental Monitoring / Q000379:methods*; D004866:Equipment Contamination / Q000517:prevention & control; D017408:Guidelines as Topic; D006801:Humans; D016273:Occupational Exposure / Q000517:prevention & control; D053719:Tandem Mass Spectrometry / Q000379:methods*; D017132:Workplace
chemical_list: D000395:Air Pollutants, Occupational; D000970:Antineoplastic Agents