Background In spite of protective measures and equipment (spike, closed system, vertical laminar airflow safety hood, isolator) the handling of cytotoxic drugs is referred to as an occupational health hazard because it can lead to the contamination of the environment. Absorption through the skin is the main route by which cytotoxics pass into the body.¹

It is necessary to assess and quantify the contamination to protect operators, the environment, patients and their families.

Purpose To evaluate surface contamination with a cytotoxic drug 5 fluorouracil (5FU) in a unit that reconstitutes cytotoxic drugs.

Material and methods A total of 15 wipe samples were taken of surfaces (14 in a unit for reconstituting cytotoxic drugs and 1 in a container for transport of prepared cytotoxic drugs) and analysed for the presence of 5-FU.

The Limit of Quantitation (LoQ) was 0.02 µg.

Contamination is considered important if levels are above 5–10 times the LOQ.

Results Only three samples were above the LOQ: kitchen staff (3 × LOQ), container for transport of prepared cytotoxic drugs (5 × LOQ) and the dispensing area (705 × LOQ).

Contamination was considered major only for the dispensing area; it can be explained by the unprotected return of damaged preparations (septum leakage).

All other points of the UPA were below the limit of quantification reflecting appropriate methods of preparation, a good attitude of the operators and effective biocleaning.

Conclusion Of the 15 sampling points only 3 were positive, one of which was significant. This result demonstrates that working procedures and cleaning for some areas are appropriate and performed correctly; for further efforts must be made to control contamination (for example, a new procedure for the return of damaged preparations). New samples will be collected after implementation of the new procedures. The lack of a standard for surface contamination by cytotoxic drugs invites us to strengthen and continuously improve our working procedures and cleaning for the lowest possible contamination.

Reference

1. Sessink Arch Environ Health 1994

ReferenceNo conflict of interest.