Viegas Susana, Oliveira de Ana Cebola, Carolino Elisabete, Pádua Mário
H&TRC- Health & Technology Research Center, ESTeSL - Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal.
Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, Lisbon, Portugal.
Arh Hig Rada Toksikol. 2018 Sep 1;69(3):238-249. doi: 10.2478/aiht-2018-69-3137.
Healthcare workers who prepare or administer cytotoxic agents run the risk of exposure, and the risks for health are real even at doses lower than those applied in cancer patients, because, in theory, no dose is safe. The most common and problematic route of exposure is through the skin, especially as work surfaces can remain contaminated even after cleaning. This pilot study aimed to demonstrate the importance of having an effective surface decontamination protocol by determining surface contamination with cyclophosphamide, 5-fluorouracil, and paclitaxel as the most common cytotoxic drugs in an oncology day service. Samples were collected before and after drug handling and analysed with high performance liquid chromatography with diode array detection (HPLC-DAD). Of the 29 samples collected before drug handling 23 were contaminated, five of which with more than one drug. Of the 30 samples collected after drug handling 25 were contaminated, eight of which with more than one drug. The two time points did not significantly differ, which evidences a widespread contamination and ineffective cleaning. This calls for revising the cleaning protocol and handling procedure to place contamination under control as much as possible.
制备或使用细胞毒性药物的医护人员面临接触风险，即使剂量低于用于癌症患者的剂量，健康风险也是真实存在的，因为从理论上讲，没有任何剂量是安全的。最常见且成问题的接触途径是通过皮肤，尤其是工作表面即使在清洁后仍可能被污染。这项初步研究旨在通过测定肿瘤日间护理中最常用的细胞毒性药物环磷酰胺、5-氟尿嘧啶和紫杉醇的表面污染情况，来证明制定有效的表面去污方案的重要性。在药物处理前后收集样本，并采用带二极管阵列检测的高效液相色谱法（HPLC-DAD）进行分析。在药物处理前收集的29个样本中，有23个被污染，其中5个被一种以上药物污染。在药物处理后收集的30个样本中，有25个被污染，其中8个被一种以上药物污染。这两个时间点没有显著差异，这证明了污染普遍存在且清洁无效。这就需要修订清洁方案和处理程序，以尽可能控制污染。
