Background Long term exposure to cytotoxic substances can lead to serious side effects. In reaction to a constant increase in activity in our oncology department, we decided to organise a campaign of surface tests to evaluate the environmental contamination and staff exposure to cytotoxics.

Purpose To measure contamination in different areas of our preparation unit, corresponding to different stages of the preparation. We then proposed adapted corrective measures.

Material and methods We identified 7 sensitive areas to be tested: gloves of the technician’s helper, transfer airlock, telephone, two keyboards from the desk where the preparations were controlled, the case used to carry the preparations and the handle of the preparation unit’s door. Samples were collected by rubbing a sterile compress soaked with 0.1 mL of sterile water for injection onto a surface of 10 cm² of each zone. A quantitative analysis by ultraperformance liquid chromatography combined with mass spectrometry was used to measure contamination in each sample by 10 different cytotoxics. We tested the following drugs: cytarabine, cyclophosphamide, ganciclovir, gemcitabine, ifosfamide, irinotecan, methotrexate, dacarbazine, doxorubicin (detection limit 1 ng) and fluorouracil (detection limit 10 ng).

Results None of these molecules was found on the different areas tested, with the exception of the technician helper’s gloves, which were contaminated with 462.4 ng of cyclophosphamide, 180.1 ng of doxorubicin and 1.8 ng of ifosphamide.

Conclusion This study revealed contamination of the technician helper’s gloves by cytotoxics. Because the technician’s helper is required to pack the preparations, he may be responsible for contamination of the whole transportation network from the pharmacy to the oncology department. To avoid this contamination, corrective measures were implemented: cytotoxic drug preparations are now labelled and packed directly inside the isolator and the outer packaging is made on the way out of the isolator, using a reversible plastic bag. Thus there is no contact between the technician helper’s gloves and the preparation. Another campaign of tests will be carried out to evaluate the impact of these corrective measures on environmental contamination.

No conflict of interest