Background Many cross sectional studies have been published about surface contamination with hazardous drugs in healthcare settings.
Purpose The aim was to review the surface contamination of three hazardous drugs within a teaching hospital and comment on the different strategies put in place over the years.
Material and methods This was a descriptive, retrospective, longitudinal study. The study was conducted in a 500 bed mother–child teaching hospital. Closed system transfer devices are not used. 12 standardised sampling sites, 6 in pharmacy areas and 6 in outpatient patient care areas, were selected and collected every year. 12 additional points of measure were identified for 2 inpatient care wards that were sampled in May 2016. For each sample, a standardised surface of about 600 cm² was sampled with one wipe and quantified by ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS-MS).
Results A total of 72 samples (eg, 36 in pharmacy and 36 in outpatient care areas) were obtained between 2010 and 2016 for 216 analyses (3 drugs/sample tested). The proportion of positive samples was 50% (36/72) for cyclophosphamide, 32% (23/72) for ifosfamide and 19% (14/72) for methotrexate. There were a similar proportion of positive results in the pharmacy (35% (38/108)) than in the outpatient care areas (32% (35/108)). Cyclophosphamide concentrations varied from undetectable to 400 pg/cm2, from undetectable to 830 pg/cm2 for ifosfamide and from undetectable to 660 pg/cm2 for methotrexate. The median value of cyclophosphamide was 16.0 pg/cm2 in 2010, 3.0 in 2012, 0.0 in 2013, 0.0 in 2014, 0.0 in 2015 and 1.7 in 2016. The 24 additional samples obtained in two patient care wards were all negative. Numerous factors may explain this low and reduced contamination, including targeted training, increased awareness, improved cleaning strategies and centralised priming of IV tubing in pharmacy hoods.
Conclusion This study provides a longitudinal perspective of the surface contamination of hazardous drugs in a teaching mother–child hospital. Every hospital should review its annual scorecard of contamination with a longitudinal perspective to minimise drug contamination. It is possible to contain surface contamination with hazardous drugs with different strategies.
No conflict of interest