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Evaluation of chemical contamination of surfaces during the preparation of chemotherapies in 24 hospital pharmacies
  1. Sandrine Fleury-Souverain1,
  2. Marc Mattiuzzo1,
  3. Florence Mehl2,
  4. Susanne Nussbaumer1,2,
  5. Lucie Bouchoud1,
  6. Ludivine Falaschi1,
  7. Marianne Gex-Fabry3,
  8. Serge Rudaz2,
  9. Farshid Sadeghipour1,2,
  10. Pascal Bonnabry1,2
  1. 1Department of Pharmacy, Geneva University Hospitals, Geneva, Switzerland
  2. 2School of Pharmaceutical Sciences, University of Geneva/University of Lausanne, Geneva, Switzerland
  3. 3Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland
  1. Correspondence to Dr Sandrine Fleury-Souverain, Department of Pharmacy, Geneva University Hospitals, 4 rue Gabrielle Perret-Gentil, Geneva 1211, Switzerland; sandrine.fleury.souverain{at}hcuge.ch

Abstract

Purpose To evaluate the chemical contamination of surfaces by cytotoxic agents during preparation of injectable chemotherapies in hospital pharmacies.

Methods 526 wipe samples collected in 24 Swiss hospital pharmacies were analysed using a validated liquid chromatography–mass spectrometry/mass spectrometry method able to quantify 10 cytotoxic agents: cytarabine, gemcitabine, cyclophosphamide, ifosfamide, methotrexate, etoposide phosphate, irinotecan, doxorubicin, epirubicin and vincristine. Information on chemotherapies produced, equipment and production processes used were collected from all the hospital pharmacies on a voluntary basis in order to investigate their association with contamination rates.

Results In two pharmacies, no trace of the 10 cytotoxic agents was detected. Chemical contamination was found in the other 22 hospital pharmacies, with combined total contamination of the 10 cytotoxic agents ranging from 8 ng to more than 41 000 ng per sample. Most contaminated samples came from inside biosafety cabinets, but some came from other clean room areas and logistics rooms. Statistically significant associations were observed between contamination rates and sampling locations, the number of chemotherapies prepared per year and types of cleaning solutions used.

Conclusions This study demonstrated that most of the hospital pharmacies tested had some contamination of surfaces by different cytotoxic agents. Even if highest levels of contamination were mainly detected inside biosafety cabinets, technicians were also exposed to cytotoxic agents detected in logistical and storage areas. Protective measures should therefore be maintained or even reinforced in these areas in order to limit technicians’ risks of exposure when handling cytotoxic products.

  • cytotoxic
  • surface contamination
  • chemotherapies preparation

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