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External contamination of antineoplastic drug vials: an occupational risk to consider
  1. Camille Cotteret1,
  2. Philippe-Henri Secretan1,
  3. Laurence Gilles-Afchain2,
  4. Julia Rousseau1,
  5. Fabrice Vidal1,
  6. Gabriel Salguero-Hernandez1,
  7. Jonathan Batista1,
  8. Vicky Valverde1,
  9. Jerome Guitton2,
  10. Salvatore Cisternino1,3,
  11. Joël Schlatter1
  1. 1Pharmacie clinique, Hôpital universitaire Necker–Enfants Malades, Paris, France
  2. 2Pharmacy, Centre Régional de Lutte Contre le Cancer Centre Léon Bérard, Lyon, France
  3. 3Faculté de Pharmacie, Université Paris Descartes, Inserm UMR-S1144, Paris, France
  1. Correspondence to Dr Joël Schlatter, Pharmacie clinique, Paris, France; joel.schlatter{at}


Risk management for workers involved in the handling and preparation of cytotoxic drugs is challenging. This study aims to investigate drug contamination of the exterior surfaces of cytotoxic drug vials. Two batches of commercially available cytotoxic drugs in unprotected vials (ifosfamide, etoposide phosphate and cyclophosphamide) and plastic shrink wrap vials (doxorubicin, cytarabine and busulfan) were tested without removing the flip-off cap or the plastic wrap, and without prewashing. The results showed significant trace amounts of cytotoxic drugs on the exterior surfaces in both unprotected (eg, cyclophosphamide, ifosfamide) and protected plastic shrink wrap vials (eg, cytarabine), indicating that the secondary packaging of protected vials does not systematically prevent exposure to the handlers. These results focus on the need for guidelines to prevent cytotoxic vial contamination and safety recommendations for staff in the handling and storage of these vials.

  • antineoplastic agents
  • chemical safety
  • environment
  • controlled
  • safety
  • occupational medicine

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