Ambient monitoring of cyclophosphamide in manufacture and hospitals

Cyclophosphamide (CP), one of the most commonly used cytostatic drugs, is known to be a human carcinogen. In this study, CP represents a model compound for the identification of potential exposure situations in the various phases of its manufacture and hospital use. Ambient air samples were taken in the various phases and analyzed for CP. A low detection limit (0.05 micrograms/m3 for a 1 m3 sample volume) was obtained for CP using the mass spectrometry method (MS) developed for this study. The detection limit was 1 microgram/m3 with the high performance liquid chromatography (HPLC) method. The correlation between the two methods was good. The highest potential exposure situations were found to occur during specific operations at the end of the process. During these operations the airborne CP concentrations may rise as high as several hundred micrograms/m3, and the workers must use supplied-air respirators, gloves and protective clothing. For the measurements in hospital use, air samples were taken from flow hoods. During normal working practices, no measurable amounts of CP could be observed. A filter from a flow hood, however, contained CP in measurable quantities, showing that occasional spilling may occur.