Browse > Article

A Study on Environmental Monitoring of Fluorouracil and Decontamination Reagents  

Lee, Su-Gil (Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide)
Lee, Nae-Woo (Division of Safety Engineering, Pukyong National University)
Publication Information
Journal of the Korean Society of Safety / v.24, no.4, 2009 , pp. 47-52 More about this Journal
Abstract
This study has been to examine the occupational exposure levels of Fluorouracil (5-FU) in a hospital and to investigate the most effective cleaning reagent for control. Fluorouracil is one of the cytotoxic drugs which are therapeutic agents used to treat cancer. The health practitioners working in the cytotoxic work room and oncology ward areas are exposed to adverse health risks like cytogenetic and DNA damage from cytotoxic drugs exposure by frequent skin contact from contaminated surfaces. Four kinds of cleaning reagents has been examined to degrade the 5-FU. It was found that 5-FU was only degraded soon after the reaction in 0.5%(w/v) NaClO solution. Therefore, 0.5%(w/v) NaClO solution has been chosen to decompose any residues on the contamination surfaces. A substantial level of contamination was found on the surfaces of cytotoxic work room and oncology ward areas. The contamination ranges of the surfaces in cytotoxic work room and oncology ward areas were from 2.0 to $13.8{\mu}g/m^2$ and 5.39 to $11.53{\mu}g/m^2$ respectively. Consequently, regulation of the occupational exposure limit, procedure of special cleaning, and the use of personal protective equipment are recommended during the manipulation and administration of the drugs to avoid skin contamination from cytotoxic drugs like 5-FU.
Keywords
Fluorouracil; cytotoxic drugs; degradation; health practitioners; contamination surfaces;
Citations & Related Records
연도 인용수 순위
  • Reference
1 OSHA, "Controlling Occupational Exposure to Hazardous Drugs. OSHA Technical Manual(TED 01-00-015). Section VI: Chapter 2", U.S Department of Labor, Occupational Safety & Health Administration. Washington, DC. URL : http://www.osha.gov/dts/ostai/otm/otm vi/otm vi 2.html. 1999
2 NIOSH, "Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Healthcare Settings", National Institute for Occupational Safety and Health: U.S. Department of Health and Human Services, Public Health Service, Centres for Disease Control and Prevention, 2004-165, 2004
3 W. Fransman, R. Vermeulen and H. Kromhout, 'Dermal exposure to cyclophosphamide in hospitals during preparation, nursing and cleaning activities', Int Arch Occup Environ Health, Vol. 78, pp. 403-412, 2005   DOI   ScienceOn
4 Queensland Workplace Health and Safety Strategy,'Guide for handling Cytotoxic Drugs and Related Waste', Department of Industrial Relations, Workplace Health and safety Queensland. Queensland Government; 2005
5 J. Siderov, 'Is the death knell for cytotoxic manufacturing in hospitals ringing?', J Pharm Prac Res, Vol. 36, p. 78, 2006
6 S. Crauste-Manciet, PJM. Sessink, S. Ferrari, JY. Jomier, D. Brossard, 'Environmental contamination with cytotoxic drugs in healthcare using positive air pressure isolators', Ann Occup Hyg, Vol. 49, pp. 619-628,2005   DOI   ScienceOn
7 E. Ziegler, HJ. Mason, PJ. Baxter, 'Occupational exposure to cytotoxic drugs in the two UKoncology wards', Occup Environ Med, Vol. 59, pp. 608-612, 2002   DOI   ScienceOn
8 K. Labuhn, B. Valanis, R. Schoeny, K. Loveday, WM. Vollmer, 'Nurses' and pharmacists' exposure to antineoplastic drugs: findings from industrial hygiene and urine mutagenicity tests', Cancer Bursing, Vol. 21, pp. 79-89, 1998   DOI   ScienceOn
9 CA. Jackson, DA. Wilson, 'World at work: Hospital pharmacy clean-rooms', Occup Environ Med, Vol. 63, pp. 68-70, 2006   DOI   ScienceOn
10 CL. Ursini, D. Cavallo, A. Colombi, M. Giglio, A. Marinaccio, S. lavicoli, 'Evaluation of early DNA damage in healthcare workers handling antineoplastic drugs', Int Arch Occup Environ Health, Vol. 80, pp.134-140, 2006   DOI   ScienceOn
11 TH. Connor, PJ. Sessink, BR. Harrison, JR. Pretty, BG. Peters, RM. Alfaro, et al. 'Surface contamination of chemotheraphy drug vials and evaluation of new vial-cleaning techniques: results of three studies', Am J Syst Pharm, Vol. 62, pp. 475-484, 2005   ScienceOn
12 W. Fransman, R. Vermeulen and H, Kromhout, 'Occupationnal dermal exposure to cyclophosphamide in dutch hospital: a pilot study', Ann Occup Hyg., Vol. 48, pp. 237 -244,2004   DOI   ScienceOn
13 Authority; 2003, 'Handling Cytotoxic Drugs in the Workplace; Managing Health & Safety Risks Associated with Handling Cytotoxic Drugs in the Healthcare Industry', WorkCover Advisory Service. Worksafe Victoria: Division of the Victorian WorkCover Authority; 2003
14 P. Gilbar, 'External contamination of antineoplastic agent vials( editorial)', J Pharm PractRes, Vol. 35, pp. 264-265, 2005   DOI
15 M. Hedmer, A. Georgiadi, R. Bremberg, BAG. Jonsson and S. Eksborg, 'Surface contamination of cyclophosphamide packaging and surface contamination with antineoplastic drugs in a hospital pharmacy in Sweden', Ann Occup Hyg, Vol. 49, pp. 629-637, 2005   DOI   ScienceOn
16 TH. Connor, MA. McDiarmid, 'Preventing occupational exposures to antineoplastic drugs in health care settings, CA Cancer', J Clin, Vol. 56, pp. 354- 365, 2006   DOI
17 SHPA Committee of Specialty Practice in Oncology, 'SHPA standards of practice for the safe handling of cytotoxic drugs in pharmacy departments', J Pharm Pract Res, Vol. 35, pp. 44-52, 2005   ScienceOn
18 MG. Jakab, J. Major, A. Tompa, 'Follow-up genotoxicological monitoring of nurses handling antineoplastic drugs', J Toxicol Environ Health A, Vol. 62, pp. 307-318, 2001   DOI   ScienceOn
19 A. Acapora, L. Castigia, N. Miraglia, M.Pieri, C. Soave, F. Liotti, et aI, 'A case study: Surface contamination of cyclophosphamide due to working practices and cleaning procedures in two Italian hospitals', Ann Occup Hyg. Vol 49, pp. 611-618, 2005   DOI   ScienceOn
20 PJ. Sessink, Be. Wittenhorst, RB. Anzion, RP. Bos, 'Exposure to pharmacy to antineoplastic agents: reevaluation after additional protective measures', Arch Environ Health, Vol. 52, pp. 240-244, 1997   DOI   ScienceOn
21 HJ. Mason, S. Blair, e. Sams, K. Jones, SJ. Garfitt, MJ. Cuschieri, et al. 'Exposure to antineoplastic drugs in two UK hospital pharmacy units', Ann Occup Hyg, Vol. 49, pp. 603-610, 2005   DOI   ScienceOn
22 G. Dranitsaris, M. Johnston, S. Poirier, T. Schueller, D. Milliken, E. Green, B. Zanke, 'Are health care providers who work with cancer drugs at an increased risk for toxic events? A systematic review and meta-analysis of the literature', J Oncol Pharm Prac, Vol. II, pp. 69-78,2005   DOI
23 K. Touzin, JF. Bussieres, E. Langlois, M. Lefebvre, C. Gallant, 'Cyclophosphamide contamination observed on the external surfaces of drug vials and the efficiency of cleaning on vial contamination', Ann. Occup. Hyg,. Vol. 52, No.8, pp. 765-771,2008   DOI   ScienceOn