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

J 2021

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

BLÁHOVÁ, Lucie, Jan KUTA, Lenka DOLEŽALOVÁ, Šárka KOZÁKOVÁ, Tereza HOJDAROVÁ et. al.

Základní údaje

Originální název

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

Autoři

BLÁHOVÁ, Lucie (203 Česká republika, domácí), Jan KUTA (203 Česká republika, domácí), Lenka DOLEŽALOVÁ (203 Česká republika), Šárka KOZÁKOVÁ (203 Česká republika), Tereza HOJDAROVÁ (203 Česká republika, domácí) a Luděk BLÁHA (203 Česká republika, garant, domácí)

Vydání

International Archives of Occupational and Environmental Health, New York, Springer, 2021, 0340-0131

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30304 Public and environmental health

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.851

Kód RIV

RIV/00216224:14310/21:00120136

Organizační jednotka

Přírodovědecká fakulta

DOI

http://dx.doi.org/10.1007/s00420-021-01671-5

UT WoS

000630269700001

Klíčová slova anglicky

Occupational exposure; Hazardous drugs; Surface contamination; Disinfectants; Antineoplastic drugs

Štítky

rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 8. 12. 2021 13:12, Mgr. Marie Šípková, DiS.

Anotace

V originále

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/cm(2) 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.

Návaznosti

LM2018121, projekt VaV

Název: Výzkumná infrastruktura RECETOX (Akronym: RECETOX RI)

Investor: Ministerstvo školství, mládeže a tělovýchovy ČR, RECETOX RI

NV18-09-00188, projekt VaV

Název: Monitoring expozice cytotoxickým léčivům u pracovníků ve zdravotnictví a rodinných příslušníků onkologických pacientů, analýza rizik, zpracování doporučených postupů

Investor: Ministerstvo zdravotnictví ČR, Monitoring expozice cytotoxickým léčivům u pracovníků ve zdravotnictví a rodinných příslušníků onkologických pacientů, analýza rizik, zpracování doporučených postupů

Citovat

BLÁHOVÁ, Lucie, Jan KUTA, Lenka DOLEŽALOVÁ, Šárka KOZÁKOVÁ, Tereza HOJDAROVÁ a Luděk BLÁHA. The efficiency of antineoplastic drug contamination removal by widely used disinfectants-laboratory and hospital studies. International Archives of Occupational and Environmental Health. New York: Springer, 2021, roč. 94, č. 7, s. 1687-1702. ISSN 0340-0131. Dostupné z: https://dx.doi.org/10.1007/s00420-021-01671-5.

@article{1789791,
   author = {Bláhová, Lucie and Kuta, Jan and Doležalová, Lenka and Kozáková, Šárka and Hojdarová, Tereza and Bláha, Luděk},
   article_location = {New York},
   article_number = {7},
   doi = {http://dx.doi.org/10.1007/s00420-021-01671-5},
   keywords = {Occupational exposure; Hazardous drugs; Surface contamination; Disinfectants; Antineoplastic drugs},
   language = {eng},
   issn = {0340-0131},
   journal = {International Archives of Occupational and Environmental Health},
   title = {The efficiency of antineoplastic drug contamination removal by widely used disinfectants-laboratory and hospital studies},
   url = {https://link.springer.com/article/10.1007%2Fs00420-021-01671-5},
   volume = {94},
   year = {2021}
}

TY  - JOUR
ID  - 1789791
AU  - Bláhová, Lucie - Kuta, Jan - Doležalová, Lenka - Kozáková, Šárka - Hojdarová, Tereza - Bláha, Luděk
PY  - 2021
TI  - The efficiency of antineoplastic drug contamination removal by widely used disinfectants-laboratory and hospital studies
JF  - International Archives of Occupational and Environmental Health
VL  - 94
IS  - 7
SP  - 1687-1702
EP  - 1687-1702
PB  - Springer
SN  - 03400131
KW  - Occupational exposure
KW  - Hazardous drugs
KW  - Surface contamination
KW  - Disinfectants
KW  - Antineoplastic drugs
UR  - https://link.springer.com/article/10.1007%2Fs00420-021-01671-5
N2  - 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/cm(2) 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.
ER  -

BLÁHOVÁ, Lucie, Jan KUTA, Lenka DOLEŽALOVÁ, Šárka KOZÁKOVÁ, Tereza HOJDAROVÁ a Luděk BLÁHA. The efficiency of antineoplastic drug contamination removal by widely used disinfectants-laboratory and hospital studies. \textit{International Archives of Occupational and Environmental Health}. New York: Springer, 2021, roč.~94, č.~7, s.~1687-1702. ISSN~0340-0131. Dostupné z: https://dx.doi.org/10.1007/s00420-021-01671-5.

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