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Technology (including: robots for production, Incompatibilities, drug production and analytics, CRS)
Cytotoxic surface contamination in 24 Swiss hospital pharmacies
  1. M. Mattiuzzo,
  2. S. Nussbaumer,
  3. F. Sadeghipour,
  4. S. Fleury-Souverain,
  5. P. Bonnabry
  1. 1Geneva University Hospitals, Pharmacy, Geneva, Switzerland


Background Exposure to cytotoxic drugs is a risk to healthcare professionals. To improve safety, most hospitals have introduced centralised preparation of cytotoxics, but the infrastructure and protective measures can vary between places. To determine the performance of confinement methods, it is important to benchmark the contamination levels between similar structures.

Purpose To establish an overview of chemical surface contamination by cytotoxic drugs in a large panel of Swiss hospital pharmacies.

Materials and methods A sampling campaign was conducted voluntarily in Swiss hospital pharmacies. At each site, wipe samples were collected in the preparation and logistics areas (most collection spots were common to all pharmacies, but each site could choose a few points of interest to itself). Chemical surface contamination of 10 cytotoxic agents (cyclophosphamide, ifosfamide, gemcitabine, doxorubicin, epirubicin, irinotecan, methotrexate, etoposide phosphate, cytarabine and vincristine) was determined by a validated wiping procedure and LC-MS/MS analysis.

Results Twenty-four hospital pharmacies (out of 46 contacted, 52%) participated in the study: 12 to 29 wiping samples were collected in each site. The surface contamination was generally lower than 100 ng per 100 cm2, with wide variability between sites. In 2 pharmacies, no contamination at all was detected. The heaviest contamination (> 30 µg) was found on a CATO keyboard. Preparation areas (especially work benches, objects inside the safety cabinets and cleanroom floors) were more contaminated than logistics areas. Ifosfamide, cyclophosphamide and cytarabine were the drugs detected in the highest quantities.

Conclusions Despite recommended safe handling practices, workplace surface contamination was observed. Most contamination was confined to manipulation areas, reducing the risk of exposure for operators. Possible correlations between structural and/or organisational characteristics and the level of contamination will be evaluated.

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