Background There is a lack of awareness of contamination levels on surfaces in Polish hospitals and pharmacies where antineoplastic drugs are handled. No studies so far have evaluated the surface contamination with these hazardous drugs in Poland.

Purpose To evaluate the surface contamination with 8 antineoplastic drugs in 4 Polish hospitals in the pharmacy (pharmaceutical preparation) and on the ward (use).

Materials and methods Wipe samples were taken from 5 comparable surfaces in the pharmacy (workbench inside biological safety cabinet (BSC), floor in front of BSC, checking counter inside and outside the preparation room, refrigerator door) and 5 similar surfaces on the ward (checking counter at nurses' station, lid of cytotoxic waste container, top of patient armchair, floor under the drip infusion stand, phone). The samples were analysed using LC-MS/MS for surface contamination with cyclophosphamide, docetaxel, etoposide, 5-fluorouracil, gemcitabine, ifosfamide, methotrexate, paclitaxel.

Results 37 of the 40 surfaces sampled were contaminated with at least one substance (92%).The most contaminated surfaces in preparation areas were: workbenches in BSC (total: 8.21 ng/cm²), floors (5.43 ng/cm²), checking counters (3.63 ng/cm²). The administration areas with the highest total contamination were: floors (145 ng/cm²), top of patient armchairs (10.76 ng/cm²) and phones (3.71 ng/cm²). Two pharmacies with the highest number of drug preparations had significantly less cytotoxic drug contamination than the other pharmacies. The most common surface contaminant in all pharmacies was identified as gemcitabine (on 80% surfaces) but the highest concentration was found of ifosfamide. 26 surfaces (17 in 4 wards; 9 in 2 pharmacies) were contaminated with drugs that were not used on the day of sampling. This old contamination shows that the cleaning procedures must be improved as well as the preparation procedures.

Conclusions Measurable amounts of at least one agent were detected on almost all of the sampled surfaces in the preparation and administration areas in all hospitals investigated. The level of surface contamination was significantly higher in wards than in pharmacies.