Canadian monitoring program of the surface contamination with 11 antineoplastic drugs in 131 centres

IntroductionHandling hazardous drugs contributes to surface contamination in healthcare centres. Their decontamination has proven difficult. Surface monitoring can estimate workers exposure and raise awareness. This program aimed to describe contamination with 11 antineoplastic drugs measured on surfaces of Canadian healthcare centres and their practices, such as the use of dedicated equipment and the communication of results.MethodsEach centre sampled six standardized sites in oncology pharmacies and six in outpatient clinics. Ultra-performance liquid chromatography-tandem mass spectrometry quantified cyclophosphamide, docetaxel, doxorubicine, etoposide, 5-fluorouracil, gemcitabine, irinotecan, methotrexate, paclitaxel and vinorelbine. Platinum-based soluble drugs were analysed by inductively coupled plasma mass spectrometry. Centres completed a questionnaire about their practices.Results131 Canadian hospitals participated in the program. Forty percent (615/1524) of surfaces were contaminated with at least one drug: cyclophosphamide (396/1,524, 26%), gemcitabine (291/1,524, 19%) and platinum (72/805, 9%) were the most frequent. The 90^th percentile of surface concentration was 0.0086 ng/cm² for cyclophosphamide and 0.0028 ng/cm² for gemcitabine. The most contaminated sites were the front grille inside the biological safety cabinet (97/129, 75% contaminated with at least one drug) and the armrest of the treatment chair (92/124, 74%). Both sites were dedicated to hazardous drugs in the majority of centres (114/119, 96% and 91/93, 98%). Most centres (90/116, 78%) had communicated their monitoring results locally.ConclusionsSome surfaces were frequently contaminated with low concentration of antineoplastic drugs. Centres should strive to disseminate monitoring results more widely to multidisciplinary teams. These practices can help minimize contamination and ensure a safer working environment.