Kunming Medical University, Kunming, Yunnan, China.
920th Hospital of Joint Logistics Support Force, PLA, Kunming, Yunnan, China.
J Oncol Pharm Pract. 2023 Oct;29(7):1548-1554. doi: 10.1177/10781552221127698. Epub 2022 Sep 19.
Occupational exposure is a long-standing public health concern, which has drawn more and more attention in recent years to the problem of how to carry out occupational protection effectively. Gloves are regarded as the most critical protective equipment for cytotoxic medications. However, there is still little research conducted on the protective performance of gloves made of different materials and the optimal glove combination for cytotoxic agents.
In this research, a specific instrument intended for glove permeation experiment was designed, with various methods of liquid chromatography-tandem mass spectrometry (LC-MS/MS) developed and validated. By using the specific instrument and LC-MS/MS methods, a study was conducted on the permeation ability of eight selected cytotoxic drugs (fluorouracil, epirubicin (EPI), docetaxel (DCT), methotrexate (MTX), cyclophosphamide (CTX), etoposide (ETP), vincristine sulfate (VCR), and cisplatin derivatives Pt-(DDTC)) into five kinds of gloves (rubber (RB), nitrile (NT), chlorinated polyethylene (CPE), low-density polyethylene, and polyvinylchloride (PVC) resin) given different contact times. Then, the experimental data were analyzed through a generalized estimation equation and Pearson correlation analysis.
The results show that within a short period of time (less than five minutes), ETP, CTX, fluorouracil, DCT, and cisplatin passed through five types of gloves but the level of MTX, VCR, and EPI permeation was minimal, despite the duration of contact between the three drugs and the gloves reaching as long as three hours. Furthermore, the permeation of DCT and ETP was found to be positively correlated with time.
Chlorinated polyethylene and PVC resin perform well in protecting against most cytotoxic drugs and are recommendable for clinical practice. Due to the poor protective ability, RB gloves are not recommended for this purpose. Based on the performance of various gloves in offering protection, the protection grade of two gloves can be deduced. Chlorinated polyethylene + PVC resin, CPE + NT glove combination shows good protective performance against most target drugs and can be recommended for clinical practice.
职业暴露是一个长期存在的公共卫生问题，近年来越来越受到关注，如何有效地进行职业防护。手套被认为是细胞毒性药物最关键的防护设备。然而，对于不同材料制成的手套的防护性能以及细胞毒性药物的最佳手套组合，仍缺乏研究。
本研究设计了一种专门用于手套渗透实验的仪器，开发并验证了各种液相色谱-串联质谱（LC-MS/MS）方法。通过使用特定仪器和 LC-MS/MS 方法，研究了八种选定的细胞毒性药物（氟尿嘧啶、表柔比星（EPI）、多西他赛（DCT）、甲氨蝶呤（MTX）、环磷酰胺（CTX）、依托泊苷（ETP）、硫酸长春新碱（VCR）和顺铂衍生物 Pt-(DDTC)) 在不同接触时间下渗透到五种手套（橡胶（RB）、丁腈（NT）、氯化聚乙烯（CPE）、低密度聚乙烯和聚氯乙烯（PVC）树脂）的能力。然后，通过广义估计方程和 Pearson 相关分析对实验数据进行分析。
结果表明，在短时间内（不到五分钟），ETP、CTX、氟尿嘧啶、DCT 和顺铂通过了五种手套，但 MTX、VCR 和 EPI 的渗透水平最小，尽管三种药物与手套的接触时间长达三个小时。此外，DCT 和 ETP 的渗透与时间呈正相关。
氯化聚乙烯和 PVC 树脂对大多数细胞毒性药物具有良好的防护作用，推荐用于临床实践。由于 RB 手套的防护能力较差，不建议使用 RB 手套。基于各种手套的防护性能，可以推断出两种手套的防护等级。氯化聚乙烯+PVC 树脂、CPE+NT 手套组合对大多数靶药物具有良好的防护性能，可推荐用于临床实践。
