Evaluation of a novel rapid chemical contaminationdetection device: BD HD Check^®

Introduction
Contamination from anticancer medications is a risk for all medical professions, extending from the drugs’reception to their elimination. Controlling this risk involves monitoring the chemical contamination levels of surfaces. In most cases, these controls are subcontracted to other companies, and they often take several weeks to get results after surface sampling. These delays are not suitable for certain situations, like validating the absence of anticancer drug traces after vial breakage. The BD HD Check^® system Analyser (Becton Dickinson) is presented as a rapid chemical contamination detection device, and could meet this need. The purpose of this work was to evaluate this device in our unit.

Materials and Methods
The BD HD Check^® uses an indirect immunochromatography method to qualitatively detect 3 molecules (cyclophosphamide, methotrexate and doxorubicine) in 10 minutes. The Limits of Detection (LOD) advertised by the supplier (0.5ng/cm² for cyclophosphamide and 0.1ng/cm² for methotrexate and doxorubicin) were verified by the deposit of the 3 molecules on a single-use plastic surface of 30 by 30 cm. A negative control with water was performed. We additionally looked for interferences with solvents (NaCl 0.9%, Glucose 5%) and with 5 detergents commonly used in our hospital [Surfanios Premium^®, 3 en 1 Premium^® and Surfa’Safe^®(Anios) ; Eyrnet sol^® (Eyrein) et NOV^®(Elco Pharma)]. Each sample was collected with the ‘S’ swabbing technique. The swabs were kept in a buffer solution for 30 seconds and then the solution was analysed by the BD HD Check^® after deposition on a cartridge specific to the anti-cancer drug sought.

Results
The LODs match the supplier’s specifications. No interference was found with the solvents. Interferences between the detection of methotrexate, cyclophosphamide and detergents were found (false positives): methotrexate/Surfanios Premium®/3 en 1 Premium^® as well as cyclophosphamide/Surfanios Premium^®/Surfa’Safe^®. In the first case, the interference source is believed to be a guanidine group. In the second case, the interference source is believed to be an amine group, present on both the cyclophosphamide and the two detergents. No interference was found regarding doxorubicin detection.

Conclusion
The existence of interferences between the detection of methotrexate, cyclophosphamide and the detergents used in our establishment shows that the BD HD Check^® is not suited to detect methotrexate and cyclophosphamide contaminations. The supplier must take corrective measures to make the BD HD Check^® suitable for routine use.