Miyake Tomohiro, Iwamoto Takuya, Tanimura Manabu, Okuda Masahiro
Department of Pharmacy, Ise Red Cross Hospital, Mie, Japan ; Department of Clinical Pharmacy and Biopharmaceutics, Mie University Graduate School of Medicine, Mie, Japan.
Springerplus. 2013 Jun 21;2(1):273. doi: 10.1186/2193-1801-2-273. Print 2013 Dec.
In spite of current recommended safe handling procedures, the potential for the exposure of healthcare providers to hazardous drugs exists in the workplace. A reliance on biological safety cabinets to provide total protection against the exposure to hazardous drugs is insufficient. Preventing workplace contamination is the best strategy to minimize cytotoxic drug exposure in healthcare providers. This study was conducted to compare surface contamination and personnel exposure to cyclophosphamide before and after the implementation of a closed-system drug transfer device, PhaSeal, under the influence of cleaning according to the Japanese guidelines. Personnel exposure was evaluated by collecting 24 h urine samples from 4 pharmacists. Surface contamination was assessed by the wiping test. Four of 6 wipe samples collected before PhaSeal indicated a detectable level of cyclophosphamide. About 7 months after the initiation of PhaSeal, only one of 6 wipe samples indicated a detectable level of cyclophosphamide. Although all 4 employees who provided urine samples had positive results for the urinary excretion of cyclophosphamide before PhaSeal, these levels returned to minimal levels in 2 pharmacists after PhaSeal. In combination with the biological safety cabinet and cleaning according to the Japanese guidelines, PhaSeal further reduces surface contamination and healthcare providers exposure to cyclophosphamide to almost undetectable levels.
尽管目前有推荐的安全操作程序，但医疗保健人员在工作场所仍有接触危险药物的可能性。仅依靠生物安全柜来提供针对危险药物接触的全面防护是不够的。预防工作场所污染是将医疗保健人员细胞毒性药物接触降至最低的最佳策略。本研究旨在比较在按照日本指南进行清洁的影响下，使用封闭系统药物转移装置PhaSeal前后环磷酰胺的表面污染情况和人员接触情况。通过收集4名药剂师的24小时尿液样本评估人员接触情况。通过擦拭试验评估表面污染情况。在使用PhaSeal之前收集的6个擦拭样本中有4个显示环磷酰胺水平可检测到。在开始使用PhaSeal约7个月后，6个擦拭样本中只有1个显示环磷酰胺水平可检测到。尽管在使用PhaSeal之前提供尿液样本的所有4名员工环磷酰胺尿排泄结果均为阳性，但在使用PhaSeal后，其中2名药剂师的这些水平恢复到了最低水平。结合生物安全柜和按照日本指南进行的清洁，PhaSeal进一步将表面污染和医疗保健人员对环磷酰胺的接触降低到几乎无法检测的水平。
