Contamination of the indoor environment by the antineoplastic drugs (ADs) is known to pose health risks to the exposed staff in hospitals or pharmacies. ADs may also contaminate households of the patients receiving chemotherapy but the exposure levels and potential risks to family members have not been studied. Our study focused on the level of surface contamination by ADs inside homes focusing on the households of oncology patients.
The main study included repeated samplings of surfaces (floors, desktops) in households of 17 ambulant oncology patients receiving different chemotherapies with cyclophosphamide (CP), platinum-based drugs (Pt), doxorubicin (DOX), 5-fluorouracil (FU) and other ADs. The wipe samples were analyzed by HPLC-MS/MS and ICP-MS/MS for 11 organic ADs and total Pt, marker of Pt-based ADs.
Patients treated with chemotherapy were a source of contamination for their households, representing thus a risk namely to sensitive family members such as children or elderly people. Carcinogenic CP was commonly found at relatively high concentrations, especially during the first 6 days after the chemotherapy (maximum 511 pg/cm2). Sweat seems to be a major medium for the spread of the contamination. High and long-time persisting CP levels (traces found after 6 months post-chemotherapy) were found on desktops including kitchen dining tables.
This is one of the first studies investigating the contamination by ADs in indoor environments outside of hospitals or pharmacies. Peak concentrations of the carcinogenic CP in households were comparable to those observed in hospitals. The guidance flier for patients with practical recommendations was prepared to improve the information and prevention of risks for family members.
Clinical trial identification
Legal entity responsible for the study
The research has been supported by Ministry of Health of the Czech Republic, grant nr. NV18-09-00188.
All authors have declared no conflicts of interest.