Review of urine biological monitoring of toxic drugs

After several years of environmental monitoring in Quebec and numerous publications on the subject, the Unité de recherché en pratique pharmaceutique (URPP) believes it is appropriate to provide in the mid-term, a biological monitoring program including the measure of the hazardous drugs in the urine of Quebec health care workers, exposed or not exposed to these drugs. In view of the implementation of this program, a literature search was conducted. The objective of this paper is to present a review of the literature on urinary monitoring of hazardous drugs, and the challenges and opportunities of a biological monitoring program in Quebec. Of the 109 articles reviewed, 60 were selected for our analysis. Of these, 17 articles were excluded. A total of 43 articles were included in the literature review. The authors report the presence of cyclophosphamide, ifosfamide, anthracyclines, methotrexate, 5-fluorouracil, paclitaxel, gemcitabine or platinum in the urine of exposed workers in different countries. Among other things, the proportion of workers with positive urine samples cyclophosphamide tends to diminish over time or following interventions to reduce contamination. However, precautions should be maintained for workers. In collaboration with the URPP and the Institut national de santé publique du Québec, this literature review paves the way for a pilot study to measure traces of hazardous drugs in urine samples of workers in the healthcare network in Quebec.