Efforts to Ensure Safety of Hospital Pharmacy Personnel Occupationally Exposed to Antineoplastic Drugs during a Preparation Task

Abstract

Purpose Antineoplastic drugs are often detected in the plasma and urine of medical staff, despite the adoption of safety measures. This study involves ambulatory chemotherapy, which was prepared on a rotating schedule at the Department of Pharmacy. The first objective of this study was to evaluate occupational exposure by measuring epirubicin in the urine and plasma and sister chromatid exchanges (SCE) in the peripheral lymphocytes of the involved pharmacists. The second, to improve a previously reported method for ease of occupational exposure evaluation. The third, to determine environmental contamination. Methods Pharmacists were categorized into three groups based on three patterns, depending on the other tasks they performed. They were alternately responsible for the preparation in each group with the recommended protections. Samples were collected at the end of each work day. High-performance liquid chromatography (HPLC) analysis along with fluorescence detection was performed at a flow rate of 200 mcL/min using 0.1% formic acid, methanol, and acetonitrile (75:5:20). Epirubicin in the samples was extracted by solid-phase extraction. Chromosomes were prepared according to a standard protocol. Results A final concentration of 2 ng/mL was the lower quantification limit. Epirubicin was not detected in the urine and plasma, and the SCE levels were within the normal limits for all the subjects. However, epirubicin was detected in samples collected from the preparation gloves. Conclusions For personnel safety, it is important to periodically evaluate protective measures. Pharmacists on a rotating schedule who work less than 6 hours per week on preparatory tasks were not unduly exposed to antineoplastics.