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International Archives of Occupational and Environmental Health

Erschienen in:

18.03.2021 | Original Article

The efficiency of antineoplastic drug contamination removal by widely used disinfectants–laboratory and hospital studies

verfasst von: Lucie Bláhová, Jan Kuta, Lenka Doležalová, Šárka Kozáková, Tereza Krovová, Luděk Bláha

Erschienen in: International Archives of Occupational and Environmental Health | Ausgabe 7/2021

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Abstract

Objective

Antineoplastic drugs (ADs) pose risks to healthcare staff. Surface disinfectants are used in hospitals to prevent microbial contamination but the efficiency of disinfectants to degrade ADs is not known. We studied nine disinfectants on ten ADs in the standardized laboratory and realistic in situ hospital conditions.

Methods

A survey in 43 hospitals prioritized nine most commonly used disinfections based on different ingredients. These were tested on inert stainless steel and in situ on contaminated hospital flooring. The effects against ten ADs were studied by LC–MS/MS (Cyclophosphamide CP; Ifosfamide IF; Capecitabine CAP; Sunitinib SUN; Methotrexate MET; Doxorubicin DOX; Irinotecan IRI; Paclitaxel PX; 5-Fluorouracil FU) and ICP-MS (Pt as a marker of platinum-based ADs).

Results

Monitoring of the floor contamination in 26 hospitals showed that the most contaminated are the outpatient clinics that suffer from a large turnover of staff and patients and have limited preventive measures. The most frequent ADs were Pt, PX, FU and CP with maxima exceeding the recommended 1 ng/cm² limit by up to 140 times. IRI, FU, MET, DOX and SUN were efficiently removed by hydrolysis in clean water and present thus lower occupational risk. Disinfectants based on hydrogen peroxide were efficient against PX and FU (> 70% degradation) but less against other ADs, such as carcinogenic CP or IF, IRI and CAP. The most efficient were the active chlorine and peracetic acid-based products, which however release irritating toxic vapors. The innovative in situ testing of ADs previously accumulated in hospital flooring showed highly problematic removal of carcinogenic CP and showed that alcohol-based disinfectants may mobilize persistent ADs contamination from deeper floor layers.

Conclusion

Agents based on hydrogen peroxide, peracetic acid, quaternary ammonium salts, glutaraldehyde, glucoprotamine or detergents can be recommended for daily use for both disinfection and AD decontamination. However, they have variable efficiencies and should be supplemented by periodic use of strong chlorine-based disinfectants efficient also against the carcinogenic and persistent CP.

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Titel: The efficiency of antineoplastic drug contamination removal by widely used disinfectants–laboratory and hospital studies
verfasst von: Lucie Bláhová
Jan Kuta
Lenka Doležalová
Šárka Kozáková
Tereza Krovová
Luděk Bláha
Publikationsdatum: 18.03.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: International Archives of Occupational and Environmental Health / Ausgabe 7/2021
Print ISSN: 0340-0131
Elektronische ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-021-01671-5

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The efficiency of antineoplastic drug contamination removal by widely used disinfectants–laboratory and hospital studies

Abstract

Objective

Methods

Results

Conclusion

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