Unité de Recherche en Pratique Pharmaceutique, Département de pharmacie, CHU Sainte-Justine, Montréal, Canada.
Centre de Toxicologie du Québec, Institut national de santé publique du Québec, Québec City, Canada.
J Oncol Pharm Pract. 2020 Dec;26(8):1921-1930. doi: 10.1177/1078155220907125. Epub 2020 Mar 1.
The primary objective was to describe environmental contamination with National Institute for Occupational Safety and Health Group 1 hazardous drugs in oncology pharmacies and outpatient clinics in Canada in 2019, as part of an annual surveillance project.
In each participating center, 12 standardized sites (6 in the oncology pharmacy and 6 in outpatient clinic) were sampled. Each sample was prepared to allow quantification of six antineoplastic drugs (cyclophosphamide, ifosfamide, methotrexate, gemcitabine, 5-fluorouracil, and irinotecan) by ultra-performance liquid chromatography-tandem mass spectrometry. Samples were also tested for three additional antineoplastic drugs (docetaxel, paclitaxel, and vinorelbine) without quantification. The impact of certain characteristics of the sampling sites was evaluated with a Kolmogorov-Smirnov test for independent samples.
Ninety-three Canadian centers participated in 2019, with a total of 1045 surfaces sampled. Cyclophosphamide was the drug most often found in the surface samples (32.4% of samples with positive result), followed by gemcitabine (20.3%). The front grille inside the biological safety cabinet (81.5% of samples positive for at least one antineoplastic drug) and the armrest of a treatment chair (75.8%) were the most frequently contaminated surfaces. Centers with more oncology inpatient and outpatient beds, those that prepared more antineoplastic drugs each year, and those that used more cyclophosphamide each year had higher concentrations of cyclophosphamide contamination on the surfaces tested (<0.0001).
Traces of dangerous drugs were found in oncology pharmacies and oncology outpatient clinics in 93 Canadian hospitals in 2019. However, the quantities measured were very small. Every healthcare worker should consider these work areas to be contaminated and should wear appropriate protective equipment.
本研究旨在描述 2019 年加拿大肿瘤药房和门诊化疗室中美国国立职业安全与健康研究所（NIOSH）第 1 组危害药物的环境污染情况，该研究是年度监测项目的一部分。
在每个参与中心，对 12 个标准化采样点（肿瘤药房 6 个，门诊化疗室 6 个）进行采样。每个样本都经过处理，以便通过超高效液相色谱-串联质谱法对六种抗肿瘤药物（环磷酰胺、异环磷酰胺、甲氨蝶呤、吉西他滨、氟尿嘧啶和伊立替康）进行定量分析。还对另外三种抗肿瘤药物（多西他赛、紫杉醇和长春瑞滨）进行了检测，但不进行定量分析。使用独立样本 Kolmogorov-Smirnov 检验评估采样点某些特征的影响。
2019 年，93 家加拿大中心参与了该研究，共采集了 1045 个表面样本。在表面样本中，环磷酰胺是最常被发现的药物（阳性样本占 32.4%），其次是吉西他滨（20.3%）。生物安全柜内部的前格栅（至少有 1 种抗肿瘤药物阳性的样本占 81.5%）和治疗椅扶手（75.8%）是污染最严重的表面。拥有更多肿瘤住院和门诊床位、每年配制更多抗肿瘤药物以及每年使用更多环磷酰胺的中心，其测试表面的环磷酰胺污染浓度更高（<0.0001）。
2019 年，在加拿大 93 家医院的肿瘤药房和肿瘤门诊化疗室中发现了危险药物的痕迹。然而，测量到的数量非常小。每个医护人员都应认为这些工作区域受到污染，应穿戴适当的防护设备。
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