Antineoplastic drug residues inside homes of chemotherapy patients

被引:26
作者
Boehlandt, Antje [1 ,2 ]
Sverdel, Yulia [1 ,2 ]
Schierl, Rudolf [1 ,2 ]
机构
[1] Ludwig Maximilians Univ Munchen, Occupat Social & Environm Med, Munich, Germany
[2] Ludwig Maximilians Univ Munchen, Inst & Outpatient Clin Occupat Social & Environm, Ziemssenstr 1, D-80336 Munich, Germany
关键词
Drug exposure; Platinum; 5-Fluorouracil; Cyclophosphamide; Monitoring; Family member; ENVIRONMENTAL CONTAMINATION; OCCUPATIONAL-EXPOSURE; SURFACE CONTAMINATION; MASS-SPECTROMETRY; FAMILY-MEMBERS; CYCLOPHOSPHAMIDE; CANCER; URINE; MULTICENTER; WORKERS;
D O I
10.1016/j.ijheh.2017.03.005
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Chemotherapy treatment of cancer patients has shifted from inpatient to outpatient administration. Thus, family members are potentially exposed to cytotoxic drug residues from patients' excretions inside their homes. The study's aim was to evaluate the surface contamination and the potential uptake of antineoplastic drug residues by family members at home of chemotherapy patients. Overall, 265 wipe samples from 13 homes were taken at two times after chemotherapy from different surfaces (toilet, bathroom, kitchen). 62 urine samples were collected from patients and family members on three days. Samples were analyzed for cyclophosphamide, 5-fluorouracil (urine: FBAL) and platinum (as marker for cis-, carbo- and oxaliplatin). Substantial contamination was found on every surface type (PT: 0.02-42.5 pg/cm(2), 5-FU: ND-98.3 pg/cm(2), CP: ND-283.3 pg/cm(2)) with highest concentrations on toilet and bathroom surfaces. While patients' urinary drug concentrations often were elevated for more than 48 h after administration, no drug residues were detectable in the family members' urine. This study provided an insight in the exposure situation against antineoplastic drug residues at home of chemotherapy patients. As contamination could be found on various surfaces adequate hygienic and protective measures are necessary to minimize the exposure risk for cohabitants. (C) 2017 Elsevier GmbH. All rights reserved.
引用
收藏
页码:757 / 765
页数:9
相关论文
共 38 条
[21]   Cytotoxic drug contamination on the outside of vials delivered to a hospital pharmacy [J].
Mason, HJ ;
Morton, J ;
Garfitt, SJ ;
Iqbal, S ;
Jones, K .
ANNALS OF OCCUPATIONAL HYGIENE, 2003, 47 (08) :681-685
[22]  
Meijster T, 2006, ANN OCCUP HYG, V50, P657, DOI [10.1093/annhyg/mel023, 10.1093/annhyg/me1023]
[23]   Multicenter study of environmental contamination with antineoplastic drugs in 33 Canadian hospitals [J].
Merger, Delphine ;
Tanguay, Cynthia ;
Langlois, Eric ;
Lefebvre, Michel ;
Bussieres, Jean-Francois .
INTERNATIONAL ARCHIVES OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH, 2014, 87 (03) :307-313
[24]   Biological monitoring of occupational exposure to 5-fluorouracil: Urinary α-fluoro-β-alanine assay by high performance liquid chromatography tandem mass spectrometry in health care personnel [J].
Ndaw, S. ;
Denis, F. ;
Marsan, P. ;
d'Almeida, A. ;
Robert, A. .
JOURNAL OF CHROMATOGRAPHY B-ANALYTICAL TECHNOLOGIES IN THE BIOMEDICAL AND LIFE SCIENCES, 2010, 878 (27) :2630-2634
[25]  
Popeau C., 2016, J ONCOL PHARM PRACT, P1
[26]  
Schierl R., 2002, ANAL HAZARDOUS SUBST, V8, P221
[27]  
Schierl R., 2016, MAX COLLECTION OCCUP
[28]  
Schierl Rudolf, 2016, J Oncol Pharm Pract, V22, P37, DOI 10.1177/1078155214551316
[29]   Silicone implants - a possible confounder for urinary platinum background concentrations? [J].
Schierl, Rudolf ;
Lemmer, Anke ;
Boehlandt, Antje ;
Friedl, Lilia ;
Haneder, Sebastian ;
Nowak, Dennis .
ENVIRONMENTAL RESEARCH, 2014, 132 :269-272
[30]   Guidance Values for Surface Monitoring of Antineoplastic Drugs in German Pharmacies [J].
Schierl, Rudolf ;
Boehlandt, Antje ;
Nowak, Dennis .
ANNALS OF OCCUPATIONAL HYGIENE, 2009, 53 (07) :703-711