title: Reduction in Surface Contamination With Cyclophosphamide in 30 US Hospital Pharmacies Following Implementation of a Closed-System Drug Transfer Device.
abstract: OBJECTIVE
  In a follow-up to a previous study, surface contamination with the antineoplastic drug cyclophosphamide was compared in 30 US hospital pharmacies from 2004 to 2010 following preparation with standard drug preparation techniques or the PhaSeal closed system drug transfer device (CSTD).
  
  
  METHODS
  Wipe samples were taken from biological safety cabinet (BSC) surfaces, BSC airfoils (the front leading edge of the BSC), floors in front of BSCs, and countertops in the pharmacy, and they were analyzed for contamination with cyclophosphamide. Contamination was reassessed after a minimum of 6 months following the implementation of the CSTD. Surface contamination (ng/cm(2)) was compared between the 2 techniques and between the previous and current test periods and evaluated with the Kruskal-Wallis test.
  
  
  RESULTS
  With the use of CSTD compared to the standard preparation techniques, a significant reduction in levels of contamination with cyclophosphamide was observed (P < .0001). Median values for surface contamination with cyclophosphamide were reduced by 86% compared to 95% in the previous study.
  
  
  CONCLUSIONS
  The CSTD significantly reduced, but did not totally eliminate, surface contamination with cyclophosphamide. In addition to other protective measures, increased usage of CSTDs should be employed to help protect health care workers from exposure to hazardous drugs.
authors.affiliation: Chemist and President, Exposure Control Sweden AB, Bohus-Björkö, Sweden.
authors.forename: Paul J M
authors.initials: PJ
authors.lastname: Sessink
authors.affiliation: Manager of Clinical Pharmacy Services, Baylor All Saints Medical Center, Fort Worth, Texas.
authors.forename: Jason
authors.initials: J
authors.lastname: Trahan
authors.affiliation: Vice President of Pharmacy Services, Cancer Treatment Centers of America, Schaumburg, Illinois. Corresponding author: Dr. Paul J.M. Sessink, Exposure Control Sweden AB, Backsippevägen 2, SE - 475 37 Bohus-Björkö, Sweden; phone: (46) 702 692260; e-mail: info@exposurecontrol.nl.
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Coyne
keywords: antineoplastic agents; closed system drug transfer device; cyclophosphamide; drug preparation; hospital pharmacies; surface contamination