Chemical contamination control in the step of routing cancer preparations

Introduction

In order to limit the exposure of healthcare workers handling cytotoxic preparations during the routing step towards services, three modes of transport were compared.

Materials and methods

During the investigation of environmental contamination in five cytotoxic preparation units, 18 preparation packagings containing preparations with cytotoxic drugs compounding platinum were evaluated. Moreover, the handled transport using boxes (4 units) was compared to semi-automated routing (1 unit) using boxes via pneumatic or a rail system. The quantity of platinum (cisplatin, carboplatin or oxaliplatin) was analyzed by graphite furnace atomic absorption [1] (LOD = 2ng platinum/sample notified in ng/100cm²).

Results and Discussion

31% of preparation packagings have a detectable contamination (max 15 ng) showing a risk of exposure during transport. The three modes show low contamination with a maximum of 6 ng for handled boxes (n = 16), 5 ng for pneumatic boxes (n = 6) and 17 ng for rail boxes (n = 2). Semi-automated transport limits the exposure of personnel during transport. However, the frequency of contamination is higher (58% for pneumatic boxes, 33% for rail boxes) than handled boxes (6%) because of the quantity of preparations and the low frequency of decontamination.

Conclusion

For each mode of transport, a chemical decontamination of transport tools, using evaluated and validated cleaning solutions and protocols [2], is required. In compliance with the recommendations, wearing protective equipment should always be applied to the routing step for optimal protection.