Biological monitoring of personnel during HIPEC procedure: Evaluation of platinum in blood and urine

H. Anundi1, S. Näslund-Andéason 2, H.Matheme 3. 1 Department of Occupational and Environmental Medicine,
2 Department of Main Operating Theatres,
3 Department of Surgery,
Uppsala University Hospital, Sweden

Treatment of patients with peritoneal carcinomatosis with removal of metastic tumours by electrocautery and subsequent perfusion with hyperthermic intraperitoneal chemotherapy (HIPEC) has improved the survival time of patients.
But the health risk for personnel handling high dosage of heated chemotherapy agent has not been fully evaluated.
The aim of this study was to measure the exposure to surgeon and perfusionist, the two main persons administering the cytotoxic agent and assess the risk for health symptoms.

Materials and Methods
Blood samples were collected from the surgeon and perfusionist before, during and after treatment with hyperthermic intraperitoneal chemotherapy and urine samples before and after treatment.
The cytotoxic agent measured was oxaliplatin at high dosage (460 mg/m3).
The samples were prepared for analysis of platinum by inductively coupled plasma-sector field mass spectrometry.

Analysis of blood samples, a total of 36 samples, 3 samples per person per treatment (before, during and after HIPEC) showed no detecterbara levels of platinum.
Detection limit for platinum in blood was 0.05 nmol / L.
Also urine samples, 3 per person a total of 36 samples were below the detection limit of 0.01 ug / L.

The risk for exposure to oxaliplatin measured as platinum seems low or negligible if protective garment and the safety procedure is followed.

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