Environmental and Biological Monitoring of Platinum-Containing Drugs in Two Hospital Pharmacies Using Positive Air Pressure Isolators

• Published in: The Annals of occupational hygiene 2013-04, Vol.57 (3), p.374-383
• Main Authors: KOPP, Bettina, CRAUSTE-MANCIET, Sylvie, GUIBERT, Agnès, MOURIER, Wilhelmine, GUERRAULT-MORO, Marie-Noelle, FERRARI, Sylvie, JOMIER, Jean-Yves, BROSSARD, Denis, SCHIERL, Rudolf
• Format: Article
• Language: English
• Subjects: Air; Antineoplastic Agents - adverse effects; Biological and medical sciences; Chemical and industrial products toxicology. Toxic occupational diseases; Drug Packaging; Environmental Monitoring - methods; Environmental pollutants toxicology; France; Gloves, Protective - utilization; Humans; Medical sciences; Metals and various inorganic compounds; Occupational Exposure - analysis; Occupational Exposure - prevention & control; Occupational medicine; Pharmacies; Platinum - adverse effects; Platinum - analysis; Platinum - urine; Public health. Hygiene-occupational medicine; Toxicology
• ISSN: 0003-4878; 1475-3162; 1475-3162
• DOI: 10.1093/annhyg/mes073

Environmental and biological monitoring of platinum containing drugs was implemented in two French hospital pharmacies using positive air pressure isolators and having similar working procedures when preparing antineoplastic drugs. Wipe sampling of surfaces, gloves, and vials was performed in the preparation room and in storage areas. All employees involved in the preparation of antineoplastic drugs were tested for urinary platinum on Monday before work and Friday after shift. Only traces of platinum were detected on surfaces in the preparation room outside the isolators (less than 1.61 pg cm(-2)). However, in one center, significant contamination was found in the storage area of the drug vials, which can most likely be linked to the rupture of a platinum vial and due to inefficient cleaning procedures. Surfaces inside the isolators were found to be contaminated (maximum: 198.4 pg cm(-2)). A higher level of contamination was detected in one pharmacy and could be explained by the lack of overgloving with regular changes during the preparation process. Nitrile gloves used during drug handling outside the isolator showed the highest platinum concentration (maximum: 5.86 ng per pair). With regards to platinum urine concentration, no significant difference was found between exposed and unexposed pharmacy personnel. Isolator technology combined with individual protective measures seems to be efficient to protect workers from occupational exposure to antineoplastic drugs, whereas specific individual protective procedures implemented were focussing on the risk of handling vials outside the isolator (e.g. high frequency of glove changing). Moreover, overgloving inside the isolator would contribute to substantially decrease inner surface contamination and should be recommended in order to limit the transfer of chemical contamination to the end products.