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Environmental contamination with methotrexate in Canadian community pharmacies.
Delphine Merger1, Cynthia Tanguay, Éric Langlois
1Pharmacy Practice Research Unit, CHU Sainte-Justine, Montréal, Canada.
Methotrexate contamination was found in 60% of Quebec community pharmacies, while cyclophosphamide and ifosfamide were undetected. Hazardous drug handling practices require improvement to reduce staff exposure.
Area of Science:
- Environmental Science
- Occupational Health
- Pharmaceutical Sciences
Background:
- Hazardous drugs are increasingly used in community pharmacies.
- Assessing environmental contamination and handling practices is crucial for staff safety.
Purpose of the Study:
- To evaluate environmental contamination with methotrexate, cyclophosphamide, and ifosfamide in Quebec community pharmacies.
- To describe hazardous drug handling practices in these pharmacies.
Main Methods:
- Samples from 20 community pharmacies were analyzed for hazardous drugs using high-performance liquid chromatography tandem mass spectrometry.
- Nine working practices related to hazardous drug handling were assessed.
Main Results:
- Methotrexate was detected in 60% of pharmacies; cyclophosphamide and ifosfamide were not detected.
- While all pharmacies had dedicated tablet counters for hazardous drugs, only 40% had dedicated storage, and none had dedicated preparation areas for methotrexate tablets.
- No pharmacies reported cutting or crushing methotrexate tablets.
Conclusions:
- Environmental contamination with methotrexate is a concern in Quebec community pharmacies.
- Enhanced awareness and adherence to personal protection measures are necessary to minimize occupational exposure to hazardous drugs.
- The increasing prevalence of hazardous drugs presents challenges for community pharmacy safety protocols.
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