A wall-mounted tubing transfer system: a solution to prevent chemical contamination !

Objectifve
Chemical contamination within centralized cytotoxic preparation units is a well-known concern. One of the riskiest stage is the transfer of preparations from the production area (PA) to the administrative area (AA) for release and dispensation. To confine the chemical risk within the PA, a wall-mounted tubing transfer system has been installed in our new unit between the PA and the AA. The aim of this study is to analyse chemical contamination on both sides of the tubing after 6 months of operation.

Materials and methods
A chemical contamination analysis is conducted on 15 points, after 6 months of production in our new unit. Samples are collected using a surface sampling kit and then analysed by UPLC-MS/MS. The sampled areas on the AA side are the pass-through, the computer mouse, the office exit door, the welder at the tubing exit, a transport case, the break room’s table, the handle of the unit exit door ; on the PA side, the computer mouse and the table, the tubing on the loading side, the PA exit button, the changing room exit button, the dressing airlock’s broom, the manipulator and the assistant manipulator’s (AM) gloves.
In total, 16 molecules are screened in our analysis : 5-fluorouracil (5-FU), carboplatin, cyclophosphamide, cytarabine, dacarbazine, doxorubicin, epirubicin, etoposide, ganciclovir, gemcitabine, ifosfamide, irinotecan, methotrexate, pemetrexed, vinblastine and vincristine.

Results
On the 15 sampling points, only three were tested positive and all located in the PA : the table, the manipulator and the AM’s gloves. Among the screened molecules, only 5-FU and gemcitabine were found.
The 5-FU was quantified at 46.7 ng on the PA’s table, 143.2 ng on the manipulator’s gloves and 47.8 ng on those of the AM. Traces of 5-FU were also found on the tubing on the loading side in the PA but could not be quantified. For gemcitabine, the quantities were 1.6 ng on the table, 3.2 ng on the manipulator’s gloves and 1.0 ng on the AM’s gloves.

Discussion/Conclusion
To conclude, our analysis revealed that cytotoxic molecules were only found in the PA. Despite traces of 5-FU found around the tubing on the production side, no molecules were detected in the AA. The tubing provides satisfaction by stopping chemical contamination as soon as it leaves the PA. The administrative area and the entire transport chain are preserved. The wall-mounted tubing transfer system provides an additional safety measure to hygiene protocols, preventing the spread of chemical contamination within the hospital. Other tools such as closed-system transfer devices could be considered to further reduce chemical contamination in the production area.