Characteristics of North American Providers of Antineoplastic Drug Dosage

Introduction
Several societies have published guidelines to limit the occupational exposure of
workers. Several of these guidelines recommend periodic (once or twice yearly) environmental monitoring of specific sites where hazardous drugs are prepared and administered. However, most of the guidelines provide no guidance concerning which hazardous drugs should be monitored, the preferred sampling sites, appropriate test methods or limits of detection. The aim of this study was to establish a set of characteristics to be considered in choosing the service provider best suited to meet our hospital’s needs.

Methods
This was a cross-sectional descriptive study. To identify service providers offering environmental monitoring tests, we searched the PubMed database and used the Google search engine. We contacted each service provider by email between June 3 and June 15, 2020, specifying the objective of our survey and describing the variables of interest. For some of the respondents, we had additional questions, to which they responded by email or via teleconference. Twenty-two variables were selected. No statistical analyses were performed.

Results
We identified six providers offering services to Canadian hospitals, either based in Canada orin the United States. Five of these providers were private companies and one was a public organization.
Each service provider was able to measure trace contamination of 3 to 17 antineoplastic drugs. Five of the providers quantified drugs using ultra performance liquid chromatography coupled with tandem mass spectrometry (UPLC-MSMS), which allowed for lower LODs. The sixth provider offered quantification by immunoassay, which has higher LODs, but also has the advantage of near real-time results (i.e., testing on the spot); the surface area to be sampled with this method was also smaller than with UPLC-MSMS. The services offered varied among the service providers. Furthermore, because the information about LODs supplied by each company was often insufficient and the units were not standardized, the LODs could not be meaningfully compared. Similarly, we could not perform a meaningful cost comparison.

Conclusion
Few data are available from Canadian service providers concerning the characteristics of wipe sampling methods for antineoplastics. This study identified six providers. Users of these services should compare the full range of benefits and costs before making a choice.