A new approach to assessing occupational exposure to antineoplastic drugs in hospital environments

  • Stefano Dugheri Careggi University Hospital, Medicina del Lavoro-Laboratorio di Igiene e Tossicologia Industriale; University of Florence, Dipartimento di Medicina Sperimentale e Clinica, Florence
  • Alessandro Bonari University of Florence, Dipartimento di Medicina Sperimentale e Clinica, Florence
  • Ilenia Pompilio University of Florence, Dipartimento di Medicina Sperimentale e Clinica, Florence
  • Pierpaolo Boccalon Careggi University Hospital, Medicina del Lavoro-Laboratorio di Igiene e Tossicologia Industriale, Florence
  • Nicola Mucci University of Florence, Dipartimento di Medicina Sperimentale e Clinica, Florence
  • Giulio Arcangeli Careggi University Hospital, Medicina del Lavoro-Laboratorio di Igiene e Tossicologia Industriale; University of Florence, Dipartimento di Medicina Sperimentale e Clinica, Florence
Keywords: inductively coupled plasma mass spectrometry, liquid chromatography-mass spectrometry, surface contamination, wipe test, workplace safety

Abstract

Cytotoxic antineoplastic drugs (ADs) pose occupational risk and therefore require safe handling practices. We created, optimised, and validated an innovative monitoring protocol for simultaneously assessing 21 ADs in the healthcare environment, and also proposed surface exposure levels (SELs) to facilitate the interpretation of monitoring results, as there are currently no occupational exposure limits for ADs. The environmental AD monitoring data were collected in nine Italian hospitals between 2008 and 2017 and include 74,565 measurements in 4,814 wipe samples. Excellent overall recovery and sensitivity of the analytical methods along with innovative desorption automation make this protocol useful for routine monitoring. AD contamination was found in 3,081 measurements, confirming potential exposure in healthcare workers. Samples taken at the beginning and the end of work shifts, allowed to calculate 75th and 90th percentile values for each ADs both in preparation and administration units and we created a traffic-light colour-coding system to facilitate interpretation of the findings. The introduction of SELs will provide a solid basis for improving occupational safety and focusing on contamination control.

Published
2018-09-11
How to Cite
1.
Dugheri S, Bonari A, Pompilio I, Boccalon P, Mucci N, Arcangeli G. A new approach to assessing occupational exposure to antineoplastic drugs in hospital environments. Arh Hig Rada Toksikol [Internet]. 2018Sep.11 [cited 2021Jan.19];69(3). Available from: https://arhiv.imi.hr/index.php/arhiv/article/view/940
Section
Original article