Crul M, Simons-Sanders K
1 Department of Clinical Pharmacy, OLVG, Amsterdam, The Netherlands.
2 Department of Hospital Pharmacy Midden Brabant, TweeSteden Hospital, Tilburg, The Netherlands.
J Oncol Pharm Pract. 2018 Oct;24(7):483-489. doi: 10.1177/1078155217704990. Epub 2017 Apr 28.
Background To prevent occupational exposure of hospital staff to cytostatics, a mandatory national guideline describing a set of safety measures was issued in the Netherlands in 2004. The guideline includes, among other directives, obligatory annual wipe testing to assess the efficacy of the local cleaning protocol. Full implementation of this guideline was executed in all Dutch hospital pharmacies over the next couple of years. Objective We aimed to investigate the effect of the national guideline on contamination levels, and specifically on the phenomenon of carry-over of traces of antineoplastic drugs through contact with surfaces, since this is a potential route of exposure. Methods From a database including wipe sample results of 9 hospitals over 10 years, we extracted all sampled locations in the compounding areas as well as in adjacent or bypass rooms and locks. We considered only the locations outside safety cabinets or isolators, to examine the containment of contamination and to address possible routes of how a contamination can migrate through the preparation and distribution areas. The dataset consisted of 2647 wipe samples. Results In adjacent rooms, 18 out of 275 wipe samples were contaminated (6%). Inside the compounding room, the extracted locations away from the safety workbench showed a positive percentage for contamination of 13% (39 out of 297). When stratifying the data to sample year, it was shown that contaminations outside the preparation room were no longer detectable after 2008. Conclusion With this study, we show that implementation of a set of guidelines on safety measures can prevent spreading of cytostatic traces from the compounding area in hospital pharmacies.
背景 为防止医院工作人员职业暴露于细胞毒性药物，荷兰于2004年发布了一项描述一系列安全措施的国家强制性指南。该指南除其他指令外，还包括强制性年度擦拭检测，以评估局部清洁方案的效果。在接下来的几年里，荷兰所有医院药房都全面实施了该指南。目的 我们旨在调查国家指南对污染水平的影响，特别是对抗肿瘤药物痕迹通过与表面接触而残留这一现象的影响，因为这是一条潜在的暴露途径。方法 从一个包含9家医院10年擦拭样本结果的数据库中，我们提取了调配区域以及相邻或旁路房间和门锁处的所有采样位置。我们只考虑安全柜或隔离器外部的位置，以检查污染的控制情况，并找出污染物如何在制剂和分发区域迁移的可能途径。数据集包括2647个擦拭样本。结果 在相邻房间，275个擦拭样本中有18个被污染（6%）。在调配室内，远离安全工作台的提取位置污染阳性率为13%（297个中有39个）。将数据按采样年份分层时发现，2008年后制剂室外部不再检测到污染。结论 通过这项研究，我们表明实施一套安全措施指南可以防止医院药房调配区域的细胞毒性药物痕迹扩散。
