Abstract

Many studies into surface contamination of hospital environments have demonstrated that occupational exposure to cytotoxics through the dermal route remains a possible risk. In this study, we assess the actual dermal exposure of the hands of pharmacy technicians and cleaning personnel in a panel of hospitals performing tasks that pose a risk of exposure. We compare the dermal exposure to a tentative limit value for cyclophosphamide. Pharmacy technicians and cleaning personnel were asked for hand rinsing after performance of nine tasks previously identified as posing a risk of occupational exposure. All samples were analyzed for the presence and quantity of eight antineoplastic drugs. By using data on both the frequency of the performance of the tasks and the measured dermal contamination during these tasks, weekly exposure to the marker drug (cyclophosphamide) was calculated. In five Dutch hospitals, 70 hand rinse samples and 8 blanks were collected. These were analyzed and results were used to calculate weekly exposure. The tentative limit value used was 0.74 µg of cyclophosphamide. For cleaning personnel, all results remained below this threshold value. For pharmacy technicians, the compounding itself also remained well below the limit; however, the task involving preparatory work, as well as the checking of compounded drugs, had a 13% chance of exceeding the limit. All of the highest values were found when employees were not wearing gloves on these tasks. Cleaning personnel and pharmacy technicians compounding cytotoxic drugs in our study were sufficiently protected from occupational exposure. In contrast, pharmacy technicians who perform preparatory and finishing tasks (before and after the actual compounding) are not protected enough when they do not wear gloves.

摘要

关于医院环境表面污染的许多研究表明，通过皮肤途径职业性暴露于细胞毒素仍然是可能的风险。在这项研究中，我们评估了执行任务有暴露风险的医院小组中药房技术人员和清洁人员的实际皮肤暴露。我们将皮肤暴露与环磷酰胺的暂定极限值进行比较。在执行之前被确定为具有职业性暴露风险的九项任务后，要求药房技术人员和清洁人员进行手冲洗。分析所有样品中八种抗肿瘤药的存在和数量。通过使用有关任务执行频率和这些任务执行期间测得的皮肤污染的数据，计算每周一次暴露于标记药物（环磷酰胺）。在荷兰的五家医院中，收集了70个洗手液样本和8个空白样本。对这些进行了分析，并将结果用于计算每周暴露量。暂定的极限值为0.74μg的环磷酰胺。对于清洁人员，所有结果均保持在此阈值以下。对于药房技术人员而言，配方本身也远远低于极限值。但是，涉及准备工作以及复方药物检查的任务有超过13％的机会超过限制。当员工在执行这些任务时没有戴手套时，发现所有最高值。在我们的研究中，配制细胞毒性药物的清洁人员和药学技术人员受到充分保护，免受职业接触。相反，