Pentamidine aerosols and environmental contamination: health-care workers at risk

In our hospital safety guidelines are available for the handling of pentamidine in the day-care department, but no safety ventilation cabin is used because only one patient a day has been treated, The number of patients to be treated, however, is growing, resulting in the need to treat more than one patient a day. To determine the environmental contamination and exposure of health-care workers during and after aerosolised pentamidine treatment of more than one patient with the acquired immunodeficiency syndrome a day a high-performance liquid chromatographic method is used for the detection and quantification of pentamidine. High volume air samples were taken before, immediately after and the day after a treatment session of up to three patients. Also, sediment samples and personal air samples close to the mouth of the health-care workers were taken. Immediately after a treatment session the air in the room contains 1.0-99.7 micrograms pentamidine per m3 of air. Before and the morning after treatment no pentamidine could be detected in the air. Sediment samples vary in detectable amounts of pentamidine from < 5 to 1165 micrograms. pentamidine/cm2. The personal air samples also show a large variation in quantities of pentamidine: < 5-170 ng a filter. When large amounts of pentamidine in the high volume air samples are found high amounts of pentamidine on the sediment samples and the personal air samples are found as well. This means that the patients treated should be instructed well on how to use the nebulizer correctly and be monitored during treatment. Additional safety measures (for example the use of a safety ventilation cabin) should be taken when more than one patient is treated a day.