1883 - EONS - Safe administration of 5-fluorouracil with elastomeric pumps

Background

Occupational exposure to cytotoxic drugs may cause adverse health effects. Nurses administrating cytotoxic drugs may face exposure risk when disconnecting infusion lines especially with elastomeric pumps as they are frequently disconnected during an infusion period of several days.

Methods

Potential contamination when disconnecting infusion lines of elastomeric pumps containing 5-fluorouracil was monitored. Three different connections were evaluated: 1) Luer Lock Male + Female 2) Luer Lock Male + Needleless connector (BD-Q-Syte®) 3) QimoMale® + QimoFemale® The evaluation was performed on a tissue mimicking patient’s arm. During disconnection, potential leakage will contaminate the tissue and the gloves used for personal protection. After disconnection, both end parts of the connection were cleaned with a wipe. The wipe, the pair of gloves, and the tissue were analysed separately for contamination with 5-fluorouracil usingLC-MSMS. Ten elastomeric pumps (Baxter-Folfusor®) were used for each type of connection. All disconnections were performed by one trained nurse after about 40 hrs of infusion.

Results

Contamination with 5-fluorouracil is found for all thirty pumps but the level of contamination differs a lot. The highest contamination is measured for the wipes (end parts). Contamination on the tissues and on the gloves is substantially lower. For the wipes, a significant difference is found between the three connections (p = 0.007). Median contamination is 50% lower for connection 3 (76 μg; p = 0.013) compared to connection 1 (152 μg) and 44% lower compared to connection 2 (135 μg; p = 0.031). There is no difference in contamination between the connections 1 and 2.

Conclusions

1) The lowest contamination with 5-fluorouracil is found for connection 3. 2) Contamination with 5-fluorouracil does not differ between the connections 1 and 2. 3) The presence of 5-fluorouracil on the gloves supports the need of wearing gloves to protect nurses from exposure by skin contact during administration of cytotoxic drugs.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Exposure Control Sweden AB.

Funding

Vygon SA, Ecouen, France.

Disclosure

All authors have declared no conflicts of interest.