Abstract CN22
Background
Antineoplastic drugs (ADs) used for treatment of cancer are substances with potentially hazardous properties. Nurses administering chemotherapy to the patients are especially vulnerable cohort considering exposures during intensive manipulation with ADs in the infusion bags or when handling contaminated materials. Since 2009, we organize annual monitorings of AD contamination in workplaces in the Czech Republic (CR), and the analyses were recently extended also to Slovak Republic (SR). The present study compares in detail levels of surface contamination and corresponding occupational risks in the CR and SR workplaces during years 2018-2020.
Methods
In our study were monitored 28 Czech and 4 Slovak hospitals. Samples were collected from application areas and nurse facilities. During the period 2018-2020, in total 334 surface wipe samples were processed from the CR, and 48 from the SR. Samples were analyzed for cyclophosphamide (CP), 5-fluorouracil (FU), paclitaxel (PX) and platinum (Pt) as they are among the most widely used ADs in both countries. CP, FU and PX were analyzed by LC-MS/MS and total Pt was analyzed by ICP-MS.
Results
The most contaminated hospital surfaces were floors under the infusion stand (IS) and in the patient WC. In the CR, the mean values for Pt at these two highly contaminated sites were 2 874 (60 556) and 1 221 (29 167) pg/cm2 for IS and WC, respectively. For CP, the mean concentrations were 1 531 (44 567) and 3 425 (141 806) pg/cm2 for IS and WC, respectively. Comparable profiles and concentrations for Pt and CP were also observed in the SR. With regard to FU, mean (maximum) concentrations were 2 052 (15 133) and 2 232 (15 449) pg/cm2 for IS and WC, respectively.
Conclusions
The study showed that both CR and SR nurses are at risk of exposure ADs when administering chemotherapy. In both countries, the most contaminated areas were the floors under the IS and the patients' WC. Concentrations of carcinogenic CP often exceeded (up to >100-times) the value of 1 ng/cm2, which is recommended by the US Pharmacopeia - USP 800 (2017). Supported by the Ministry of Health of the Czech Republic, grant No. NV18-09-00188.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.