title: Association between occupational exposure and control measures for antineoplastic drugs in a pharmacy of a hospital.
abstract: OBJECTIVE
  To investigate the association between occupational contamination and exposure levels to antineoplastic drugs and the application of control measures in a hospital work environment.
  
  
  METHODS
  Wipe samples of equipments were collected at a hospital in Osaka Prefecture, Japan, from 2007 to 2011. These samples were subjected to measurements of cyclophosphamide (CP), gemcitabine (GEM), platinum-containing drugs (Pt), and fluorouracil (5FU). Additionally, 24-h urine samples were collected from pharmacists who handled antineoplastic drugs, which were analyzed for CP and alpha-fluoro-beta-alanine (AFBA). The application of control measures was scored according to a checklist, which consisted of the following five items: safety equipment and maintenance, training and documentation, devices for safe handling, personal protective equipment, and emergency care. The aim was to obtain a score of 80%.
  
  
  RESULTS
  The median CP, GEM, and 5FU concentrations of all wipe samples were significantly lower during the period when the mean score was >80% (attainment period) versus when the mean score was ≤80% (nonattainment period; all P < 0.001, Mann-Whitney's U-test). Additionally, the median urinary CP and AFBA concentrations of pharmacists during the attainment period tended to be lower than that of those during the nonattainment period (P = 0.061 and 0.061, respectively, using Mann-Whitney's U-test).
  
  
  CONCLUSIONS
  Contamination and levels of exposure to antineoplastic drugs decreased with a score higher than 80%. The scores of the items on the checklist appeared to adequately reflect the condition of the control measures, as increases in all five items were associated with reductions in the contamination by and levels of exposure to all drugs.
authors.affiliation: Department of Environmental Health, Osaka Prefectural Institute of Public Health, 1-3-69, Nakamichi, Higashinari-ku, Osaka-shi, Osaka-fu, 537-0025, Japan. JNYosida@iph.pref.osaka.jp
authors.forename: Jin
authors.initials: J
authors.lastname: Yoshida
authors.forename: Shigeki
authors.initials: S
authors.lastname: Koda
authors.forename: Shozo
authors.initials: S
authors.lastname: Nishida
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakano
authors.forename: Genshin
authors.initials: G
authors.lastname: Tei
authors.forename: Shinji
authors.initials: S
authors.lastname: Kumagai
mesh_terms: D000970:Antineoplastic Agents / Q000032:analysis* / Q000652:urine; D015415:Biomarkers / Q000652:urine; D004784:Environmental Monitoring / Q000379:methods*; D004866:Equipment Contamination / Q000706:statistics & numerical data; D015386:Hazardous Substances / Q000032:analysis / Q000592:standards; D006761:Hospitals; D006801:Humans; D006920:Hygiene; D007564:Japan; D016273:Occupational Exposure / Q000032:analysis*; D010604:Pharmacy; D011482:Protective Devices / Q000706:statistics & numerical data*
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D015386:Hazardous Substances