Impact of the reassurance of the doxorubicin administration by syringe on the occupational exposure

O. Sidikou1, N. Simon1,2, M. Vasseur1, M. Pinturaud1, C. Richeval3, D. Allorge3, G. Sergent4, B. Décaudin1,2, P. Odou1,2 1 Institut de Pharmacie, CHRU, Lille, France
2 EA 4481, Laboratoire de Biopharmacie, Pharmacie Galénique et Hospitalière, Faculté de Pharmacie, Lille, France
3 Laboratoire de Toxicologie, CHRU, Lille, France
4 Service d’imagerie digestive diagnostique et interventionnelle, CHRU, Lille, France

Introduction - objective

In our institution, chemoembolization is currently administered in an operating room with doxorubicin (Dxr) solution compounded in syringes locked by luer-lock caps. During the administration, syringes are opened leading to a potential occupational exposure. This study aims to assess the ability of a specific syringe set to reduce the risk of occupational exposure to Dxr.

Methods

Twelve syringes (10mL, PlastipakTM, BD) of Dxr solution (3mL) were compounded in an isolator. Six syringes were locked with a luer-lock cap and 6 ones with a 10cm-extension set (KemolineTM, Doran International) primed with 0.9% NaCl. Kemoline consists of a 3-way stopcock connected to a 10 cm tube. Currently, in the operating room a Dxr syringe and a syringe containing a contrast agent are connected to a 3-way stopcock before connection to the vascular access device. Administration procedures with both assemblies were reproduced on different drapes (20 x 9 cm). Residual Dxr amounts were measured by LC-MS/MS before the first test and after each of one under drapes by wipe sampling and on drapes after desorption with methanol.

Results

4 drapes were highly contaminated (min-max: 32,2 ng – 2000 ng) with the current operating procedure. Only one drape was contaminated (44,8 ng) with the KemolineTM. No chemical contamination was retrieved under the drape for the 12 tests.

Discussion – conclusion

This study shows that closing syringes during the compounding procedure with a primed specific infusion set may decrease the occupational exposure during chemoembolization. Further studies are required to assess the impact of this device on the contamination in the operating room.

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