Background and importance Several studies have shown that antineoplastic drug contamination is found on various work surfaces in hospitals and varies widely on wards. The MASHA project (research about environmental contamination by cytotoxics and management of safe handling procedures) was to set up to conduct new research, in cooperation with the European Society for Medical Oncology, into contamination levels in hospital wards.
Aim and objectives To obtain an overview of the current levels of cytotoxic contamination in European hospital wards and increase awareness among healthcare workers and their employers about the risks associated with working with hazardous drugs, and to provide them with additional measures to improve safety.
Material and methods The assessment of surface contamination with cytotoxic drugs was done by evaluating wipe samples collected from four comparable surfaces on the wards (work benches, floors, armrest of patient’s chair and lids of waste containers). Each sample was analysed for the presence of five commonly used cytotoxic drugs (cyclophosphamide, 5-fluorouracil, paclitaxel, gemcitabine and total platinum for platinum drugs), using ICP-MS for total platinum and LC-MS/MS for other substances.
Results The database includes results collected from 28 hospital units from 16 European countries. Of the 560 samples collected, 268 were positive (48%). Measurable amounts of at least one substance were detected on investigated surfaces in every hospital: 21/28 (75%) hospitals had over 30% positive samples. Contamination was detected mostly on the floors (58%), armrests (50%), lids (42%) and work benches (40%). The highest values were found for cyclophosphamide (380 ng/cm2) and 5-fluorouracil (130 ng/cm2) on the lids. The highest number of positive results were recorded with platinum drugs (33%), 5-fluorouracil (25%), gemcitabine (19%) and cyclophosphamide (18%). Substances were detected on 45/112 of surfaces (40%) which had not been used for cytotoxic drug preparation on the day of the wipe sampling.
Conclusion and relevance Contamination is detectable on the ward but at different levels in different hospitals. Cleaning procedures are still not effective. Therefore, evaluation of exposure of healthcare workers is crucial. Greater collaboration with medical and nurse societies, to improve safe handling procedures in hospitals and thus improve the safety of all healthcare workers, is required.
References and/or acknowledgements No conflict of interest.
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