University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC.
UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC.
Am J Health Syst Pharm. 2019 Apr 17;76(9):591-598. doi: 10.1093/ajhp/zxz033.
The surface contamination levels of 5 commonly used hazardous drugs in hospital pharmacies are summarized, identifying practice patterns associated with contamination.
Contamination testing data were compiled to evaluate surface contaminants of 5 hazardous drugs (docetaxel, paclitaxel, cyclophosphamide, ifosfamide, and 5-fluorourcil). Data from 5,842 wipes over 6 years were collected from 338 hospital pharmacies. The contamination level for each drug was categorized as nondetectable (ND; ≤10 ng/ft2), low (between 10 and ≤100 ng/ft2), medium (between 100 and ≤1,000 ng/ft2) or high (>1,000 ng/ft2). Surface exposures for each drug were summarized based on location, contamination at first and subsequent wipe events, and the use of a closed system transfer device (CSTD).
The majority of contamination results corresponded to locations at or near hazardous drug preparation, but also occurred in areas where hazardous drugs were not prepared. There was a higher incidence of contamination levels (high, medium, and low, respectively) at first wipe event (10.2%, 17.4%, and 17.7%) compared to subsequent wipe events (5.8%, 12.2%, and 13.6%) (p < 0.0001). There was a lower incidence of contamination levels at institutions that used CSTDs (6.3%, 12.8%, and 14.4%) compared to institutions that did not use CSTDs (14.2%, 17.9%, and 17.3%) (p < 0.0001).
The majority of highest contamination levels corresponded to locations where hazardous drugs were prepared. While the rate of contamination was lower at subsequent wipe events and at institutions that used CSTDs, contamination was not completely eliminated in either scenario.
总结了医院药房 5 种常用危险药物的表面污染水平，确定了与污染相关的实践模式。
为了评估 5 种危险药物（多西他赛、紫杉醇、环磷酰胺、异环磷酰胺和 5-氟尿嘧啶）的表面污染物，收集了污染测试数据。从 338 家医院药房收集了 6 年来 5842 次擦拭的数据。将每种药物的污染水平分为不可检测（ND；≤10ng/ft2）、低（10-≤100ng/ft2）、中（100-≤1000ng/ft2）或高（>1000ng/ft2）。根据位置、第一次和随后的擦拭事件的污染情况以及使用密闭式转移装置（CSTD），总结了每种药物的表面暴露情况。
大多数污染结果与危险药物制备地点或附近的地点相对应，但也发生在未制备危险药物的区域。第一次擦拭事件的污染水平（高、中、低）发生率较高（分别为 10.2%、17.4%和 17.7%），而随后的擦拭事件发生率较低（分别为 5.8%、12.2%和 13.6%）（p<0.0001）。使用 CSTD 的机构的污染水平发生率较低（分别为 6.3%、12.8%和 14.4%），而不使用 CSTD 的机构的污染水平发生率较高（分别为 14.2%、17.9%和 17.3%）（p<0.0001）。
最高污染水平的大多数结果与危险药物制备的地点相对应。虽然在随后的擦拭事件和使用 CSTD 的机构中，污染率较低，但在这两种情况下，污染都没有完全消除。
