Occupational Exposure Assessment to Antineoplastic Drugs in Nine Italian Hospital Centers over a 5-Year Survey Program

Cristina Sottani, Elena Grignani, Marco Cornacchia, Sara Negri, Francesco Saverio Robustelli della Cuna, Danilo Cottica, Dario Bruzzese, Paolo Severi, Daniele Strocchi, Giovanni Verna, Veruscka Leso and Ivo Iavicoli
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Cristina Sottani: Environmental Research Center, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
Elena Grignani: Environmental Research Center, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
Marco Cornacchia: Deparment of Drug Science, University of Pavia, 27100 Pavia, Italy
Sara Negri: Environmental Research Center, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
Francesco Saverio Robustelli della Cuna: Environmental Research Center, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
Danilo Cottica: Environmental Research Center, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
Dario Bruzzese: Department of Public Health, Section of Medical Statistics, University of Naples Federico II, 80131 Naples, Italy
Paolo Severi: Prevention and Protention Service, Azienda Unità, Sanitaria Locale della Romagna Ospedali degli ambiti territoriali di Ravenna e Rimini dell’AUSL della Romagna, 47521 Cesena, Italy
Daniele Strocchi: Prevention and Protention Service, Azienda Unità, Sanitaria Locale della Romagna Ospedali degli ambiti territoriali di Ravenna e Rimini dell’AUSL della Romagna, 47521 Cesena, Italy
Giovanni Verna: Prevention and Protention Service, Azienda Unità, Sanitaria Locale della Romagna Ospedali degli ambiti territoriali di Ravenna e Rimini dell’AUSL della Romagna, 47521 Cesena, Italy
Veruscka Leso: Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, 80131 Naples, Italy
Ivo Iavicoli: Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, 80131 Naples, Italy

IJERPH, 2022, vol. 19, issue 14, 1-17

Abstract: In the present study, surface contamination where antineoplastic drugs (ADs) are present was investigated, as occupational exposure risk is still an open debate. Despite recommendations and safety standard procedures being in place in health care settings, quantifiable levels of ADs are being reported in the recent literature. Thus, a survey monitoring program was conducted over five years (2016–2021) in nine Italian hospitals. The repeated surveys produced 8288 data points that have been grouped according to the main hospital settings, such as pharmacy areas and patient care units. Based on the most often prepared ADs, the investigated drugs were cyclophosphamide (CP), gemcitabine (GEM), 5-fluorouracil (5–FU), and platinum compounds (Pt). Patient care units had a frequency of positive wipe samples (59%) higher than pharmacies (44%). Conversely, pharmacies had a frequency of positive pad samples higher (24%) than patient care units (10%). Moreover, by statistical analysis, pad samples had a significantly higher risk of contamination in pharmacy areas than in patient care units. In this study, the 75th and the 90th percentiles of the contamination levels were obtained. The 90th percentile was chosen to describe a suitable benchmark that compares results obtained by the present research with those previously reported in the literature. Based upon surface contamination loads, our data showed that 5–FU had the highest concentration values, but the lowest frequency of positive samples. In pharmacy areas, the 90th percentile of 5–FU data distribution was less than 0.346 ng/cm 2 and less than 0.443 ng/cm 2 in patient care units. AD levels are higher than those reported for health care settings in other European countries yet trends of contamination in Italy have shown to decrease over time.

Keywords: chemotherapeutic drugs; frequency of positive samples; percentiles of data distribution; temporal trends; threshold exposure limits (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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