Background Contamination with cytotoxic drugs in hospital units has been reported in several studies in the past few years. No multicentre studies have been conducted in different European hospitals.
Purpose To obtain an overview of the current situation in European hospitals concerning cytotoxic contamination at various sites, including drug preparation (pharmacy) and administration areas (ward); and to develop additional steps and programmes to improve working conditions and quality control.
Material and methods To investigate surface contamination with 12 antineoplastic drugs in preparation and administration areas before (part I) and after (part II) implementation of cleaning recommendations. Wipe samples were taken from 10 surfaces (5 in preparation areas and 5 in administration areas) in each participating hospital. Wipe samples were analysed by LC MS/MS.
Results The database includes results collected from 15 European hospitals. Of 1764 results analysed in part I, 505 were positive (29%). In 11 of 15 hospitals (73%), substances were detected which were not prepared or administrated in the sampling day. After implementation of the ESOP cleaning recommendations, only 17% of samples were positive (274/1584). Measurable amounts of at least one agent were detected on sampled surfaces in each hospital. Contamination was detected mostly on the work surfaces of BSCs/isolators, floors (in pharmacies and wards) and the armrests of the patient’s chairs. The highest number of positive results were recorded with gemcitabine, 5-fluorouracil, cyclophosphamide and paclitaxel. The highest values were recorded for gemcitabine (171 ng/cm2) and 5-fluorouracil (37 ng/cm2) in parts I and II, respectively. There was no correlation between contamination and the amounts of prepared drugs.
Conclusion The ESOP pilot study has provided a brief overview of the local procedures for safe handling of cytotoxic drugs in European hospitals. In part II of the study there were reductions in the number of positive samples, the amount of surface concentration detected and in the 90th percentile, from 0.030 ng/cm2 to 0.021 ng/cm2. Based on the results of this pilot study, wipe sampling and the ESOP cleaning recommendations will be used in the next phase of the ESOP project.
No conflict of interest.
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