Abstract
BackgroundCertain amount of anticancer drugs is excreted in the urine of patients receiving anticancer drugs, and urinary scattering including anticancer drugs at excretion has become a route of anticancer drug contamination. Therefore, we developed an active carbon sheet (HD safe sheet-U) that prevented diffusion by adsorbing anticancer drugs including that excreted in urine. The present study conducted a performance evaluation of this sheet.MethodsThe adsorption performance of active carbon to anticancer drug in the urine was evaluated by determining concentration changes in the active carbon suspension (5 mg/mL) of 14 kinds of anticancer drugs (cyclophosphamide, ifosfamide, carboplatin, cisplatin, methotrexate, 5-fluorouracil, cytarabine, gemcitabine, doxorubicin, epirubicin, paclitaxel, docetaxel, etoposide, and irinotecan) diluted with artificial urine. Adhesion of the anticancer drug dropping on the sheet to a slipper sole was evaluated because urine including anticancer drugs is scattered on the floor, which can spread by adhering to shoe soles of patients and healthcare workers. The performance of the active carbon sheet was compared with two other types of medical adsorption sheets used as control sheets. Anticancer drugs diluted with artificial urine (1 mL) were dropped on the active carbon sheet and the two control sheets. The sheets were trod with slippers made by polyvinyl chloride. The adhered anticancer drug was wiped off and its quantity was determined.ResultsA remarkable decrease in anticancer drug concentrations, except for cisplatin, was detected by mixture of active carbon in the artificial urine (0–79.6%). The quantity of anticancer drug adhesion to slipper soles from the active carbon sheet was significantly lower compared with that observed for the two control sheets for eight kinds of anticancer drugs (cyclophosphamide, ifosfamide, carboplatin, methotrexate, cytarabine, gemcitabine, doxorubicin, and docetaxel). There was no adhesion in cyclophosphamide and docetaxel. Furthermore, the quantities of adhesion in cytarabine, gemcitabine, doxorubicin, paclitaxel, and irinotecan were lower than determination limit.ConclusionActive carbon might be effective in adsorbing urinary anticancer drugs. The active carbon sheet adsorbed urinary excreted anticancer drugs, and use of such sheets might prevent diffusion of contamination due to urinary excreted anticancer drugs.
Highlights
Certain amount of anticancer drugs is excreted in the urine of patients receiving anticancer drugs, and urinary scattering including anticancer drugs at excretion has become a route of anticancer drug contamination
The use of tools such as biological safety cabinet (BSC), closed system, and personal protection equipment (PPE) such as masks, gloves, and gowns are effective in protecting against exposure during the preparation and administration
CPA was detected at 17–252 ng per member in the urine in five members from 10 patient families. These findings suggested that healthcare workers and family members were more likely to be exposed to anticancer drugs owing to contact with patients’ body fluids including urine
Summary
Certain amount of anticancer drugs is excreted in the urine of patients receiving anticancer drugs, and urinary scattering including anticancer drugs at excretion has become a route of anticancer drug contamination. The use of tools such as biological safety cabinet (BSC), closed system, and personal protection equipment (PPE) such as masks, gloves, and gowns are effective in protecting against exposure during the preparation and administration Another contamination process is scattering of anticancer drugs through patients’ excrement. A wipe cleaning method using sodium hydroxide, sodium hypochlorite, and ozone waters is used for the preparation or administration environment, such as inside BSCs or hospital rooms where anticancer agent contamination occurs routinely [14–16] This may lead to other problem such as damage to tiles, toilet stool, or other metal equipment, need for neutralization, and other uncertain degradation effects associated with the use of these inactivating agents in the lavatory. A new method to prevent scattering of urinary anticancer drugs is warranted
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