Background The potential for contamination associated with handling cytostatic drugs exists in the workplace despite compliance with the protective measures for the safe handling of cytostatics.
Purpose To investigate the efficacy of using closed system drug transfer devices and implementing a new cleaning procedure for environmental cytostatics contamination in the central cytostatics department.
Materials and Methods Wipe samples were taken from five defined areas in March, 2011: Laminar air flow (LAF) cabinet, workbench, floor in front of the LAF cabinet, transport box and the handle of the refrigerator located in the make-ready room. They were tested for contamination with 8 substances (5-Fluorouracil (5-FU), cyclophosphamide (CP), ifosfamide (Ifos), gemcitabine (Gem), etoposide (Eto), methotrexate (MTX), pacli-taxel (Pac), docetaxel (Doc)) using LC-MS/MS. After seven months the test was repeated on the same surfaces (except the refrigerator handle) after the implementation of PhaSeal closed-system drug transfer device and 0.1 m NaOH decontamination solution.
Results In the first test the level of substances wiped from the refrigerator handle was under the detection limit. The LAF cabinet was the most contaminated area, where the 5-FU, Gem, MTX and CP levels were above the German reference value (0.1 ng/cm2) and the Ifos and Doc contamination levels were also high. The levels detected on the other three surfaces, ranked in descending order were as follows: workbench, floor and transport box. 5-FU, Gem and CP were present on these surfaces in large quantities.
After seven months the levels of surface contamination showed significant improvement on every surface. MTX, CP, Ifos, Doc were not detectable in the LAF cabinet and the levels of 5-FU and Gem had reduced dramatically.
Conclusions The results suggest that implementing an appropriate decontamination method and preparing with closed system drug transfer devices can minimise environmental cytostatics contamination.
No conflict of interest.
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