How safe is occupational exposure to citostatic drugs? Results from environmental and biological monitoring.

OBJECTIVE: Occupational exposure to cytostatic drugs has been associated with acute and chronic toxicity. Despite the publication of guidelines and measures for safety handling, contamination is still reported in most recent studies. The aim of the present work was to assess contamination of cytostatic drugs in a hospital from the North of Spain. METHODS: Working surfaces from the Pharmacy and the Onco-Hematology services were tested for gemcitabine, dacarbazine, methotrexate, cyclophosphamide, doxorubicinol, doxorubicin, epirubicin, irinotecan, vinorelbine, etoposide, docetaxel and paclitaxel. Urine samples from workers were also analyzed. RESULTS: Within the Pharmacy service, contamination was detected in 57.6% of the collected samples, with cyclophosphamide and gemcitabine being the most detected compounds. At the Onco-Hematology service, contamination was present in 32.3% of the samples collected from infusion pumps, armchairs and surrounding floors, and in all samples collected from the toilets (all positive for gemcitabine, irinotecan and paclitaxel). Low concentrations (<100 pg/cm2) were detected in ≥76% of the contaminated samples in all the locations, except for the outpatients' area bathrooms, where this value was <40%. In addition, 60.7% of vials, blisters and infusion bags sampled were contaminated. Only 2 of the 82 bracelets worn by workers showed contamination with cyclophosphamide. Finally, all the urine samples were negative. CONCLUSIONS: Despite the low levels of contamination, it is advisable to carry out monitoring campaigns to maintain workers' awareness and to take corrective actions to minimize occupational exposure.