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J Occup Health year 2008 volume 50 number 1 page 48 - 56
Classification Originals 
Title Evaluation of Occupational Exposure to Antiblastic Drugs in an Italian Hospital Oncological Department
Author Loredana CASTIGLIA1, Nadia MIRAGLIA1, 2, Maria PIERI1, 2, Angela SIMONELLI2, Pascale BASILICATA2, Giuliana GENOVESE2, Rossella GUADAGNI2, Antonio ACAMPORA1, Nicola SANNOLO2 and Maria Virginia SCAFARTO3
Organization 1Department of Public Medicine and Social Health, University of Naples gFederico IIh, 2Department of Experimental Medicine-Labour, Hygiene and Industrial Toxicology Section, Second University of Naples and 3University of Naples gFederico IIh-Sanitary Direction, Italy
Keywords Occupational exposure , Cyclophosphamide, Ifosfamide, 5-fluorouracil, Statistical evaluation
Correspondence M. Pieri, Department of Experimental Medicine-Labour, Hygiene and Industrial Toxicology Section, Second University of Naples, Via L. De Crecchio, 80138, Naples, Italy (e-mail address: maria.pieri@unina2.it)
Abstract Evaluation of Occupational Exposure to Antiblastic Drugs in an Italian Hospital Oncological Department: Loredana CASTIGLIA, et al. Department of Public Medicine and Social Health, University of Naples gFederico IIh, Italy-The determination of the current antiblastic drug contamination levels in an Italian hospital oncology ward was carried out. Statistical evaluation of data aiming to identify potential exposure causes was performed. Cyclophosphamide (CP), ifosfamide (IF) and 5-fluorouracil (5-FU) were determined by wipe tests, extracted with diatomaceous earths and quantified by GC/MSMS or HPLC/UV. Data were analysed with respect to the potential contamination levels of sampled surfaces, and various amounts of handled analyte. x2 tests and Spearman correlation coefficients were calculated. Median concentration levels of 0.086, 0.071, 2.363 g/dm2 were obtained, (CP, IF, 5-FU, respectively). 3.8 and 13.5% of investigated surfaces showed CP and IF concentrations higher than 1 g/dm2 (up to 26.96 g/ dm2) and 13.4% of samples contained 5-FU concentrations in the range 20-208.9 g/dm2. Analytesf concentration levels were dependent on sampling sites, with significant correlations showing a progressive contamination decrement going from workbenches, floor, hood planes and other surfaces. A diffuse contamination (traces of all the three analytes) was found on all investigated surfaces, even when analytes had not been used during the sampling days. A significant correlation (s=0.303, p=0.001) between the measured analyte concentration and the analyte handled amount was found only in the case of IF. The risk management strategy should be improved, as suggested by the measured and widespread levels of contamination. Since contamination also depends on other factors attributable to working modalities and cleaning procedures, the obtained results suggest that performance of specific training courses as well as scheduling environmental monitoring plans to achieve an actual decrement of the observed contamination levels should be implemented.