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Hygienic guidance values for wipe sampling of antineoplastic drugs in Swedish hospitals.

Hedmer, Maria LU and Wohlfart, Gertrud (2012) In Journal of Environmental Monitoring 14(7). p.1968-1975
Abstract
The use of antineoplastic drugs in health care steadily increases. Health care workers can be occupationally exposed to antineoplastic drugs classified as carcinogenic or teratogenic. Monitoring of surface contamination is a common way to assess occupational exposure to antineoplastic drugs, since wipe sampling is used as a surrogate measure of dermal exposure. Since no occupational limits for antineoplastic drugs in work environments exist, 'hygienic guidance values' (HGVs) should be used instead. HGVs are practicable, achievable levels, not health based, and can be calculated from exposure data from representative workplaces with good occupational hygiene practices. So far, guidance values for surface monitoring of antineoplastic drugs... (More)
The use of antineoplastic drugs in health care steadily increases. Health care workers can be occupationally exposed to antineoplastic drugs classified as carcinogenic or teratogenic. Monitoring of surface contamination is a common way to assess occupational exposure to antineoplastic drugs, since wipe sampling is used as a surrogate measure of dermal exposure. Since no occupational limits for antineoplastic drugs in work environments exist, 'hygienic guidance values' (HGVs) should be used instead. HGVs are practicable, achievable levels, not health based, and can be calculated from exposure data from representative workplaces with good occupational hygiene practices. So far, guidance values for surface monitoring of antineoplastic drugs only exist for pharmacies where antineoplastic drugs are prepared. The objective was to propose HGVs for surface monitoring of cyclophosphamide (CP) and ifosfamide (IF) in Swedish hospitals where antineoplastic drugs are administered to patients. In total, 17 workplaces located at six hospitals in Sweden were surveyed by wipe sampling. Wipe samples were collected, worked up and then analyzed with liquid chromatography tandem mass spectrometry. Surface contamination of CP and IF was found on 80% and 73% of the sampled surfaces, thus indicating that there is potential for health care workers to be exposed to CP and IF via the skin. The median surface load of CP was 3.3 pg cm(-2) (range <0.05-10 800 pg cm(-2)). The corresponding value for IF was 4.2 pg cm(-2) (range <0.13-95 000 pg cm(-2)). The highest surface loads were found on the floors. The proposed HGVs were set at 90th percentile values, and can be applicable to hospital workplaces where patients are treated with CP or IF. Surface monitoring combined with HGVs is a useful tool for health care workers to regularly benchmark their own surface loads which could control and reduce the occupational exposure to CP and IF in hospital workplaces. Thus, the occupational safety of the health care workers will be increased. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Environmental Monitoring
volume
14
issue
7
pages
1968 - 1975
publisher
Royal Society of Chemistry
external identifiers
  • wos:000305796500022
  • pmid:22692549
  • scopus:84863661523
ISSN
1464-0325
DOI
10.1039/c2em10704j
language
English
LU publication?
yes
id
dfb69553-3c80-44a1-b1b4-5314a352f990 (old id 2859493)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22692549?dopt=Abstract
date added to LUP
2012-07-04 17:22:46
date last changed
2017-09-10 03:07:22
@article{dfb69553-3c80-44a1-b1b4-5314a352f990,
  abstract     = {The use of antineoplastic drugs in health care steadily increases. Health care workers can be occupationally exposed to antineoplastic drugs classified as carcinogenic or teratogenic. Monitoring of surface contamination is a common way to assess occupational exposure to antineoplastic drugs, since wipe sampling is used as a surrogate measure of dermal exposure. Since no occupational limits for antineoplastic drugs in work environments exist, 'hygienic guidance values' (HGVs) should be used instead. HGVs are practicable, achievable levels, not health based, and can be calculated from exposure data from representative workplaces with good occupational hygiene practices. So far, guidance values for surface monitoring of antineoplastic drugs only exist for pharmacies where antineoplastic drugs are prepared. The objective was to propose HGVs for surface monitoring of cyclophosphamide (CP) and ifosfamide (IF) in Swedish hospitals where antineoplastic drugs are administered to patients. In total, 17 workplaces located at six hospitals in Sweden were surveyed by wipe sampling. Wipe samples were collected, worked up and then analyzed with liquid chromatography tandem mass spectrometry. Surface contamination of CP and IF was found on 80% and 73% of the sampled surfaces, thus indicating that there is potential for health care workers to be exposed to CP and IF via the skin. The median surface load of CP was 3.3 pg cm(-2) (range &lt;0.05-10 800 pg cm(-2)). The corresponding value for IF was 4.2 pg cm(-2) (range &lt;0.13-95 000 pg cm(-2)). The highest surface loads were found on the floors. The proposed HGVs were set at 90th percentile values, and can be applicable to hospital workplaces where patients are treated with CP or IF. Surface monitoring combined with HGVs is a useful tool for health care workers to regularly benchmark their own surface loads which could control and reduce the occupational exposure to CP and IF in hospital workplaces. Thus, the occupational safety of the health care workers will be increased.},
  author       = {Hedmer, Maria and Wohlfart, Gertrud},
  issn         = {1464-0325},
  language     = {eng},
  number       = {7},
  pages        = {1968--1975},
  publisher    = {Royal Society of Chemistry},
  series       = {Journal of Environmental Monitoring},
  title        = {Hygienic guidance values for wipe sampling of antineoplastic drugs in Swedish hospitals.},
  url          = {http://dx.doi.org/10.1039/c2em10704j},
  volume       = {14},
  year         = {2012},
}