Environmental and biological monitoring on an oncology ward during a complete working week

Toxicol Lett. 2018 Dec 1:298:158-163. doi: 10.1016/j.toxlet.2018.05.002. Epub 2018 May 5.

Abstract

Workplace exposure to antineoplastic drugs (AD) is still of evident concern to all occupationally exposed persons in the healthcare sector as residues in relevant concentrations continue to be present. With respect to the carcinogenic and mutagenic potential of ADs and their toxicity on reproduction, occupational exposure should be kept as low as reasonably achievable (ALARA). In the oncology patient care, the medical staff is involved both in chemotherapy administration and handling of AD-contaminated body fluids of the patients. For this purpose, in this study, surface monitoring on an oncology ward and concurrent urine monitoring of the complete healthcare staff was performed during five consecutive days for 5-fluorouracil (5-FU), cyclophosphamide (CP) and platinum (Pt). Contamination was detected on all surfaces in various ranges (5-FU 0.7-12,600 pg/cm2, Pt 0.2-181,800 pg/cm2, CP (<LOD - 221 pg/cm2). However, regarding 5-FU and CP, all urine samples (n = 98) were below the detection limits and urinary platinum was below the German reference value (10 ng/l) in 98% of the samples, when gloves were regularly worn. This indicates that gloves may be an important protection measure against dermal AD uptake.

Keywords: Antineoplastic drugs; Biological monitoring; Environmental monitoring; Occupational exposure; Ward.

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / urine*
  • Environmental Monitoring / methods*
  • Equipment Contamination*
  • Germany
  • Gloves, Surgical
  • Health Personnel*
  • Humans
  • Occupational Exposure* / adverse effects
  • Occupational Exposure* / prevention & control
  • Occupational Health*
  • Oncology Service, Hospital*
  • Personnel Staffing and Scheduling
  • Protective Factors
  • Risk Assessment
  • Skin Absorption
  • Time Factors
  • Urinalysis
  • Workplace

Substances

  • Antineoplastic Agents