6 None of the other subjects had ribavirin in any plasma, erythrocyte or urine sample. The ribavirin level in erythrocytes is more than 100 times higher than that in serum. Only free ribavirin in the circulation could be expected to cross the placenta to the fetus. As with other potentially hazardous drugs, it seems reasonable to try to minimize exposure of all staff to ribavirin. A recent study has shown that turning off the small-particle aerosol generator before entering the hood or tent results in a significant decrease in ribavirin concentrations in the air.
Some authorities recommend the use of masks, gloves and gowns.
This may reduce the risk of nosocomial spread of respiratory syncytial virus, but it would not reduce inhalation of ribavirin resulting from occupational exposure. More elaborate precautions do not appear to be justified by the available data. The committee makes the following recommendations concerning aerosol therapy with ribavirin. The small-particle aerosol generator should be turned off when the hood or tent is entered for any reason. No special precautions are indicated for patients, visitors or hospital workers in the room.