title: Occupational exposure to antineoplastic drugs in four Italian health care settings.
abstract: Exposure assessment of health care workers to antineoplastic drugs (ADs) is still an open issue since new, critical, and emerging factors may put pharmacists who prepare hazardous drugs or nurses who administer anti cancer agents to an increased risk of developing adverse health effects. Overall, eight pharmacies and nine patient areas have been surveyed in this study. Wipe and pad samples were experienced during the surveillance program in four Italian health care settings. Urine samples were collected from workers handling ADs. Cyclophosphamide (CP), ifosfamide (IF), and gemcitabine (GEM) were detected in all the work environments by using a LC-MS/MS method-based capable of analysing all the three drugs simultaneously. In total, 54% of wipe samples were positive for at least one drug and 19% of pad samples were shown to be contaminated by cyclophosphamide. Pharmacies were generally more contaminated than patient areas with the exception of one site where a nurse had an acute exposure during the cleaning-up of an hazardous drug solution spill. In total, 22 urine samples collected from pharmacists and 78 urine samples from nurses had no detectable concentrations of any antineoplastic drugs. Despite the adherence to the recommended safety practices residue contamination on surfaces and floors has continued to be assessed in all the investigated sites.
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: Marcello
authors.initials: M
authors.lastname: Imbriani
authors.forename: Claudio
authors.initials: C
authors.lastname: Minoia
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000032:analysis* / Q000652:urine; D003520:Cyclophosphamide / Q000009:adverse effects / Q000032:analysis / Q000652:urine; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000032:analysis / Q000652:urine; D006801:Humans; D007069:Ifosfamide / Q000009:adverse effects / Q000032:analysis / Q000652:urine; D007558:Italy; D009741:Nursing Staff, Hospital; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis*; D010564:Personnel, Hospital; D010607:Pharmacy Service, Hospital; D011795:Surveys and Questionnaires; D000093542:Gemcitabine
chemical_list: D000970:Antineoplastic Agents; D003841:Deoxycytidine; D003520:Cyclophosphamide; D007069:Ifosfamide; D000093542:Gemcitabine