Abstract
At the present time, the method of choice to determine surface contamination of the workplace with antineoplastic and other hazardous drugs is surface wipe sampling and subsequent sample analysis with a variety of analytical techniques. The purpose of this article is to review current methodology for determining the level of surface contamination with hazardous drugs in healthcare settings and to discuss recent advances in this area. In addition it will provide some guidance for conducting surface wipe sampling and sample analysis for these drugs in healthcare settings. Published studies on the use of wipe sampling to measure hazardous drugs on surfaces in healthcare settings drugs were reviewed. These studies include the use of well-documented chromatographic techniques for sample analysis in addition to newly evolving technology that provides rapid analysis of specific antineoplastic. Methodology for the analysis of surface wipe samples for hazardous drugs are reviewed, including the purposes, technical factors, sampling strategy, materials required, and limitations. The use of lateral flow immunoassay (LFIA) and fluorescence covalent microbead immunosorbent assay (FCMIA) for surface wipe sample evaluation is also discussed. Current recommendations are that all healthcare settings where antineoplastic and other hazardous drugs are handled include surface wipe sampling as part of a comprehensive hazardous drug-safe handling program. Surface wipe sampling may be used as a method to characterize potential occupational dermal exposure risk and to evaluate the effectiveness of implemented controls and the overall safety program. New technology, although currently limited in scope, may make wipe sampling for hazardous drugs more routine, less costly, and provide a shorter response time than classical analytical techniques now in use.
Highlights
Occupational exposure to antineoplastic and other hazardous drugs is a concern for healthcare facilities in the U.S and worldwide
Current recommendations are that all healthcare settings where antineoplastic and other hazardous drugs are handled include surface wipe sampling as part of a comprehensive hazardous drug-safe handling program
Surface wipe sampling may be used as a method to characterize potential occupational dermal exposure risk and to evaluate the effectiveness of implemented controls and the overall safety program
Summary
Occupational exposure to antineoplastic and other hazardous drugs is a concern for healthcare facilities in the U.S and worldwide. Surface wipe sampling is used to determine the level of workplace contamination in healthcare settings where antineoplastic and other hazardous drugs are present (Connor et al 2016). Dermal uptake is considered the most likely route of occupational exposure to most hazardous drugs, especially low-molecular-weight antineoplastic drugs. Their study documented surface contamination with cyclophosphamide, ifosfamide, and 5-fluorouracil in the pharmacy and patient treatment areas, and in areas adjacent to the pharmacy Since publication of these initial studies, world-wide reports have been published, demonstrating a universal issue with workplace surface contamination with antineoplastic drugs and uptake of the drugs by healthcare workers. This article reviews methodology currently being used for surface wipe sampling for hazardous drugs and discusses new applications of available technology that can be employed to make wipe sampling less expensive and to provide near real-time results for wipe sampling
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