The efficiency of antineoplastic drug contamination removal by widely used disinfectants-laboratory and hospital studies
Jazyk angličtina Země Německo Médium print-electronic
Typ dokumentu časopisecké články
Grantová podpora
NV18-09-00188
Agentura Pro Zdravotnický Výzkum České Republiky
LM2018121
Ministerstvo Školství, Mládeže a Tělovýchovy
PubMed
33738516
DOI
10.1007/s00420-021-01671-5
PII: 10.1007/s00420-021-01671-5
Knihovny.cz E-zdroje
- Klíčová slova
- Antineoplastic drugs, Disinfectants, Hazardous drugs, Occupational exposure, Surface contamination,
- MeSH
- dekontaminace metody MeSH
- detergenty MeSH
- dezinficiencia * MeSH
- diaminy MeSH
- glutaraldehyd MeSH
- kontaminace zdravotnického vybavení MeSH
- kvartérní amoniové sloučeniny MeSH
- kyselina peroctová MeSH
- laboratoře MeSH
- nemocnice MeSH
- nerezavějící ocel MeSH
- peroxid vodíku MeSH
- podlahy a podlahové krytiny MeSH
- protinádorové látky * MeSH
- pyrrolidinony MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- detergenty MeSH
- dezinficiencia * MeSH
- diaminy MeSH
- glucoprotamine MeSH Prohlížeč
- glutaraldehyd MeSH
- kvartérní amoniové sloučeniny MeSH
- kyselina peroctová MeSH
- nerezavějící ocel MeSH
- peroxid vodíku MeSH
- protinádorové látky * MeSH
- pyrrolidinony MeSH
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.
Faculty of Science Masaryk University RECETOX Kamenice 753 5 Building D29 62500 Brno Czech Republic
Masaryk Memorial Cancer Institute Žlutý kopec 7 65653 Brno Czech Republic
University Hospital Brno Jihlavská 20 62500 Brno Czech Republic
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