Technical Safety Services, LLC, Berkeley, CA.
Northern California Pharmacy Operations, Kaiser Permanente, Modesto, CA.
Am J Health Syst Pharm. 2019 Apr 17;76(9):599-607. doi: 10.1093/ajhp/zxz030.
This study investigates the use of a canopy-connected recirculating class II type A2 biological safety cabinet (BSC) as an alternative to the B2 when preparing volatile, sterile compounded preparations. Selection of the appropriate BSC for processes that use subgram levels of volatile chemicals is difficult due to a lack of quantitative containment evidence by cabinet type. There is a perception that hazardous compounding must be done in a B2 cabinet due to the potential for vapors, and this study seeks to challenge that perception.
In total, 5 tests, 3 prequalification tests and 2 containment capability tests, were conducted on a single cabinet of each type at sterile compounding pharmacies. Prequalification tests were performed to verify that each BSC was operating properly. Each cabinet was certified to NSF-ANSI 49-2016, particle counted per ISO 14644-1:1999, and subjected to a qualitative video smoke study. Once these tests confirmed the expected working conditions, 2 containment capability tests were conducted. The containment testing included tracer gas testing per ASHRAE 110:2016 section 8.1.1 through 8.1.13, and cyclophosphamide sampling during sterile compounding of the drug material.
Both cabinets passed all the prequalification tests. During the ASHRAE tracer gas testing the A2 cabinet was able to contain a tracer gas 92% to 160% as effectively as the B2 cabinet depending on the position of the gas ejection. During sterile compounding the airborne cyclophosphamide sampling captured samples of less than 1.0 ng at all locations for both the A2 and B2 cabinets.
The data generated from this study demonstrate that use of an A2 for hazardous compounding can provide a comparable level of safety for the environment, users, and product while having less stringent airflow requirements relative to a B2. The simpler requirements for an A2 make them an appealing alternative as they have the potential to reduce the overall operating costs associated with a compounding pharmacy while maintaining safe levels of containment.
本研究调查了在制备挥发性无菌复合制剂时,使用带顶棚的循环二级 A2 型生物安全柜(BSC)替代 B2 的情况。由于缺乏按 BSC 类型进行的定量密闭性证据,因此对于使用亚克级挥发性化学品的工艺,选择合适的 BSC 较为困难。由于存在潜在的蒸气风险,人们认为危险的复合操作必须在 B2 型 BSC 中进行,本研究旨在挑战这一观点。
总共对每个类型的单个 BSC 进行了 5 项测试,包括 3 项预筛选测试和 2 项密闭性测试,在无菌复合药剂室进行。预筛选测试是为了验证每个 BSC 是否正常运行。每个 BSC 均经过 NSF-ANSI 49-2016、ISO 14644-1:1999 规定的每单位体积颗粒计数和定性视频烟雾研究的认证。在这些测试确认了预期的工作条件后,进行了 2 项密闭性测试。密闭性测试包括按照 ASHRAE 110:2016 第 8.1.1 至 8.1.13 节进行示踪气体测试,以及在无菌复合药物材料时对环磷酰胺进行采样。
两个 BSC 均通过了所有预筛选测试。在 ASHRAE 示踪气体测试中,A2 型 BSC 能够有效地容纳示踪气体,在气体喷射位置的不同条件下,容纳效果比 B2 型 BSC 高 92%至 160%。在无菌复合操作期间,在所有位置对空气中的环磷酰胺进行采样,A2 和 B2 型 BSC 都捕捉到的样品含量均低于 1.0ng。
本研究产生的数据表明,在危险复合操作中使用 A2 型 BSC 可为环境、用户和产品提供可比水平的安全性,同时与 B2 型相比,其气流要求较低。A2 型 BSC 的要求较简单,因此作为一种有吸引力的替代方案,它们有可能降低与复合药剂室相关的总体运营成本,同时保持安全的密闭水平。