Cleaning Efficiencies of Three Cleaning Agents on Four Different Surfaces after Contamination by Gemcitabine and 5-fluorouracile.
Occupational exposure to antineoplastic drugs has been documented for decades showing widespread contamination in preparation and administration areas. Apart from preventive measures, efficient cleaning of surfaces is indispensable to minimize the exposure risk. The aim of this study was to evaluate the efficiency of three cleaning agents after intentional contamination by gemcitabine (GEM) and 5-fluorouracile (5-FU) on four different surface types usually installed in healthcare settings. Glass, stainless steel, polyvinylchloride (PVC), and laminated wood plates were contaminated with 20 ng/μl GEM and 2 ng/μl 5-FU solutions. Wipe samples were analyzed for drug residues after cleaning with a) distilled water, b) aqueous solution containing sodium dodecyl sulfate (10 mM) and 2-propanol (SDS-2P), and c) Incides N (pre-soaked) alcoholic wipes. Quantification was performed by high-performance liquid chromatography (HPLC) for GEM and gas chromato-graphy-tandem mass spectrometry (GCMS/MS) for 5-FU. Recovery was determined and cleaning efficiency was calculated for each scenario. Mean recoveries were 77-89% for GEM and 24-77% for 5-FU and calculated cleaning efficiencies ranged between 95 and 100% and 89 and 100%, respectively. Residual drug amounts were detected in the range nd (not detected) - 84 ng GEM/sample and nd - 6.6 ng 5-FU/sample depending on surface type and cleaning agent. Distilled water and SDS-2P had better decontamination outcomes than Incides N wipes on nearly all surface types, especially for GEM. Regarding 5-FU, the overall cleaning efficiency was lower with highest residues on laminated wood surfaces. The tested cleaning procedures are shown to clean glass, stainless steel, PVC, and laminated wood with an efficiency of 89-100% after contamination with GEM and 5-FU. Nevertheless, drug residues could be verified by wipe samples. Pure distilled water and SDS in an alcoholic-aqueous solution expressed an efficient cleaning performance, especially with respect to GEM. The study results demonstrate the need to adapt cleaning procedures to the variety of drugs and surface types to develop effective decontamination strategies.
a Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Clinical Center , Ludwig Maximilians University , Munich , Germany.
Antje
A
Böhlandt
Svenja
S
Groeneveld
Elke
E
Fischer
Rudolf
R
Schierl
D000438:Alcohols; D000970:Antineoplastic Agents / Q000032:analysis*; D003666:Decontamination / Q000379:methods*; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000032:analysis; D004866:Equipment Contamination / Q000517:prevention & control*; D005472:Fluorouracil / Q000032:analysis*; D005898:Glass; D016273:Occupational Exposure / Q000517:prevention & control; D011143:Polyvinyl Chloride; D013193:Stainless Steel; D013501:Surface-Active Agents; D014867:Water; D014934:Wood; D000093542:Gemcitabine
D000438:Alcohols; D000970:Antineoplastic Agents; D013501:Surface-Active Agents; D014867:Water; D003841:Deoxycytidine; D013193:Stainless Steel; D011143:Polyvinyl Chloride; D005472:Fluorouracil; D000093542:Gemcitabine
antineoplastic drugs; cleaning; decontamination