Böhlandt Antje, Sverdel Yulia, Schierl Rudolf
Occupational, Social and Environmental Medicine, LMU Munich, Germany.
Int J Hyg Environ Health. 2017 Jun;220(4):757-765. doi: 10.1016/j.ijheh.2017.03.005. Epub 2017 Mar 27.
Chemotherapy treatment of cancer patients has shifted from inpatient to outpatient administration. Thus, family members are potentially exposed to cytotoxic drug residues from patients' excretions inside their homes. The study's aim was to evaluate the surface contamination and the potential uptake of antineoplastic drug residues by family members at home of chemotherapy patients. Overall, 265 wipe samples from 13 homes were taken at two times after chemotherapy from different surfaces (toilet, bathroom, kitchen). 62 urine samples were collected from patients and family members on three days. Samples were analyzed for cyclophosphamide, 5-fluorouracil (urine: FBAL) and platinum (as marker for cis-, carbo- and oxaliplatin). Substantial contamination was found on every surface type (PT: 0.02-42.5pg/cm, 5-FU: ND-98.3pg/cm, CP: ND-283.3pg/cm) with highest concentrations on toilet and bathroom surfaces. While patients' urinary drug concentrations often were elevated for more than 48h after administration, no drug residues were detectable in the family members' urine. This study provided an insight in the exposure situation against antineoplastic drug residues at home of chemotherapy patients. As contamination could be found on various surfaces adequate hygienic and protective measures are necessary to minimize the exposure risk for cohabitants.
癌症患者的化疗治疗已从住院给药转变为门诊给药。因此，家庭成员有可能在家中接触到患者排泄物中的细胞毒性药物残留。该研究的目的是评估化疗患者家中家庭成员对抗肿瘤药物残留的表面污染情况及潜在摄入量。总体而言，在化疗后的两个时间点，从13个家庭的不同表面（厕所、浴室、厨房）采集了265个擦拭样本。在三天内从患者和家庭成员处收集了62份尿液样本。对样本进行环磷酰胺、5-氟尿嘧啶（尿液：FBAL）和铂（作为顺铂、卡铂和奥沙利铂的标志物）分析。在每种表面类型上均发现了大量污染（铂：0.02-42.5皮克/平方厘米，5-氟尿嘧啶：未检出-98.3皮克/平方厘米，环磷酰胺：未检出-283.3皮克/平方厘米），厕所和浴室表面的浓度最高。虽然患者给药后尿液中的药物浓度通常会在48小时以上保持升高，但在家庭成员的尿液中未检测到药物残留。这项研究揭示了化疗患者家中对抗肿瘤药物残留的暴露情况。由于在各种表面都发现了污染，因此需要采取适当的卫生和防护措施，以尽量降低同居者的暴露风险。
