Abstract 4231: Significant reduction in workplace contamination of antineoplastic hazardous drugs in 13 U.S. hospitals following utilization of a new closed-system drug transfer device
Authors: Tyler Timothy , Power Luci 
Published: July 2017

Background: Adverse effects of worker exposure to antineoplastic hazardous drugs (AHD) have been well documented with dermal absorption from contaminated surfaces in the work environment being one of the most well researched sources of exposure. Multiple studies have documented decreased surface contamination when using CSTDs for AHD handling. Decreased surface contamination should result in decreased worker exposure and decreased risk of adverse effects.

Purpose: The purpose of this study was to determine the effectiveness of a new CSTD in reducing surface contamination of marker AHDs cyclophosphamide (CP) and 5-fluorouracil (5FU) during compounding and administration in multiple cancer centers, using surface wipe-sampling methodology. The results of the wipe sampling were compared to existing contamination in the sites and to similar studies in peer-reviewed literature to determine relative effectiveness.

Methods: Wipe samples of six predetermined surfaces were collected in designated compounding and infusion areas of 13 cancer centers to establish the preexisting level of surface contamination with two marker AHDs. Stainless steel templates of approximately 500 cm2 were placed over previously sampled surfaces, and a specific protocol of set doses of the AHDs were compounded and infused, using all of the components of the new CSTD system, over the templates. Wipe samples of the templates were collected following the completion of tasks and analyzed for both marker AHDs.

Results: A total of 312 wipe samples were collected from the 13 centers, 156 at baseline and 156 with the CSTD. All samples were reported as ng/cm2 with the analytical limit of detection (LOD) for each drug being 0.002 ng/500 cm2. In the aggregate results of 13 sites sampled for existing contamination, 67% of wipe samples had detectable levels of the AHDs with a range of LOD to 19.880 ng/cm2 of 5FU and 0.648 ng/cm2 of CP. With the new CSTD the contaminated samples were reduced to 5.8% with a range LOD to 0.004ng/cm2 of 5FU and 2.60ng/cm2 of CP.

Conclusions: The new CSTD significantly reduced surface contamination by the marker AHDs during both compounding and administration. Compared to published results of two multi-site studies of another CSTD for compounding, the new CSTD is superior in reducing surface contamination with marker AHDs, as determined by wipe sampling of similar surfaces.

Research reported in this study was supported by the National Cancer Institute (NCI) of the National Institutes of Health (NIH) under award number 5R44CA153636.

Citation Format: Timothy Tyler, Luci Power. Significant reduction in workplace contamination of antineoplastic hazardous drugs in 13 U.S. hospitals following utilization of a new closed-system drug transfer device [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4231. doi:10.1158/1538-7445.AM2017-4231