Chu Winnie C, Hon Chun-Yip, Danyluk Quinn, Chua Prescillia P S, Astrakianakis George
School of Environmental Health, University of British Columbia, Vancouver, Canada.
J Oncol Pharm Pract. 2012 Mar;18(1):46-51. doi: 10.1177/1078155211402106. Epub 2011 Jul 7.
We undertook a pilot study involving six British Columbian hospital pharmacies to determine if antineoplastic drug contamination of surfaces exists and whether residual drugs remain on these surfaces despite being cleaned.
At each site, the pharmacy technician responsible for preparing the antineoplastic drugs was observed to determine which surfaces were contacted and to ascertain the frequency of contact. Surfaces observed to be most frequently contacted were subsequently wiped after drug preparation pre- and post-clean. The wipe samples were then analyzed by liquid chromatography tandem mass spectrometry to determine the amount of contamination. Cyclophosphamide (CP) and methotrexate (MTX) were used as representative markers to reflect overall antineoplastic drug contamination levels.
Fourteen of the 23 surfaces sampled pre-clean (61%) were contaminated with either MTX or CP. The pre-clean wipe samples had a geometric mean concentration of 0.0135 ng/cm(2) for MTX (range <Limit of Detection {LOD} to 12.45 ng/cm(2)) and 0.114 ng/cm(2) for CP (range <LOD to 8.53 ng/cm(2)). Post-clean contamination levels were generally lower than its pre-clean equivalent; the concentration difference post- vs. pre-clean was statistically significant for CP only. However, some samples appeared to have higher post-clean contamination levels.
The results suggest that drug contamination is common in hospital pharmacies we sampled and that current cleaning practices in British Columbia may not be effective in removing residual drug from the surfaces. A more extensive study is recommended to confirm these results as well as a review of cleaning protocols to ensure their effectiveness in reducing contamination levels.
我们开展了一项涉及不列颠哥伦比亚省六家医院药房的试点研究，以确定表面是否存在抗肿瘤药物污染，以及尽管进行了清洁，这些表面是否仍残留有药物。
在每个站点，观察负责制备抗肿瘤药物的药房技术人员，以确定哪些表面被接触以及接触的频率。在药物制备前和清洁后，对观察到最常接触的表面进行擦拭。然后通过液相色谱串联质谱法分析擦拭样本，以确定污染量。使用环磷酰胺（CP）和甲氨蝶呤（MTX）作为代表性标志物来反映总体抗肿瘤药物污染水平。
清洁前采样的23个表面中有14个（61%）被MTX或CP污染。清洁前擦拭样本中MTX的几何平均浓度为0.0135 ng/cm²（范围<检测限{LOD}至12.45 ng/cm²），CP为0.114 ng/cm²（范围<LOD至8.53 ng/cm²）。清洁后的污染水平通常低于清洁前；仅CP清洁后与清洁前的浓度差异具有统计学意义。然而，一些样本的清洁后污染水平似乎更高。
结果表明，在我们采样的医院药房中药物污染很常见，并且不列颠哥伦比亚省目前的清洁做法可能无法有效去除表面的残留药物。建议进行更广泛的研究以证实这些结果，并审查清洁规程以确保其在降低污染水平方面的有效性。
