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职业性接触抗肿瘤药物风险评估在医疗卫生领域:第一部分-医用手套。

Evaluation of the risk of occupational exposure to antineoplastic drugs in healthcare sector: part I - medical gloves.

机构信息

1University Hospital Careggi, Industrial Hygiene and Toxicology Laboratory, Florence, Italy.

2University of Florence, Department of Experimental and Clinical Medicine, Florence, Italy.

出版信息

Arh Hig Rada Toksikol. 2023 Sep 30;74(3):187-197. doi: 10.2478/aiht-2023-74-3734. eCollection 2023 Sep 1.

Abstract

Antineoplastic drugs (ADs) are essential tools in cancer treatment, but their cytotoxicity poses a risk to workers involved in their handling. In a hospital environment fundamental strategies for minimising exposure involve proper use of safety cabinets and closed-circuit transfer devices, along with personnel training and increased awareness of risks. However, medical gloves remain the first line of defence. In this respect the evaluation of glove materials and best choices can improve hospital safety management and prevent potential hazards and long-term consequences. The aim of this study was to assess contamination of gloves in samples taken from AD administration and preparation units of nine Italian hospitals and to raise awareness of the importance of evaluating chemico-physical properties of gloves. Our findings show that 33 % of the analysed gloves were positive for at least one AD, with contaminations ranging from 0.6 to 20,729 pg/ cm. We proposed the (AGVs) for each AD as a limit value for contamination assessment and good practice evaluation. Our findings also point to multiple AD contamination (43 % of positive findings in preparation units), calculated as total AGV (AGV-T), and confirm that gloves should be replaced after 30 min of AD handling, based on cumulative permeation and area under the curve (AUC), to maintain safety and limit dermal exposure.

摘要

抗肿瘤药物(ADs)是癌症治疗的重要工具,但它们的细胞毒性对接触它们的工作人员构成风险。在医院环境中,减少接触的基本策略包括正确使用安全柜和闭路转移装置,以及人员培训和提高对风险的认识。然而,医用手套仍然是第一道防线。在这方面,评估手套材料和最佳选择可以改善医院安全管理,防止潜在的危害和长期后果。本研究的目的是评估意大利 9 家医院的 AD 给药和准备单位采集的手套样本中的污染情况,并提高对手套化学物理性能评估重要性的认识。我们的研究结果表明,在分析的手套中,有 33%至少对一种 AD 呈阳性,污染程度从 0.6 到 20729 pg/cm 不等。我们提出了(AGVs)作为污染评估和良好实践评估的限值。我们的研究结果还表明,在准备单元中存在多种 AD 污染(阳性发现的 43%),计算为总 AGV(AGV-T),并证实手套应在接触 AD 30 分钟后更换,以保持安全并限制皮肤接触。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1cc/10549893/d6814f224a1c/j_aiht-2023-74-3734_fig_001.jpg

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