EXPOSURE OF PHARMACY TECHNICIANS TO ANTINEOPLASTIC AGENTS - REEVALUATION AFTER ADDITIONAL PROTECTIVE MEASURES

In the past, special guidelines and protective measures have been intr oduced to protect hospital workers during the handling of antineoplast ic agents; nevertheless, it was found that they did not prevent the up take of these toxic compounds. In response, additional protective meas ures were introduced, including adaptations of the laminar downflow ho od, use of special masks, use of double pairs of gloves, and replaceme nt of ampules with vials. In the current study, the authors compared t he effects in these additional measures with results of a previous stu dy. Cyclophosphamide, 5-fluorouracil, and methotrexate constituted 81% of the antineoplastic agents prepared; therefore, the investigators m onitored these compounds again by personal air sampling and by determi ning the levels of contamination on masks and gloves. Cyclophosphamide in the urine of workers was also measured. During preparation, invest igators concluded that there were lower concentrations of cyclophospha mide in the air than had occurred in the previous study. Replacement o f ampules with vials (i.e., 5-fluorouracil) resulted in a significantl y diminished contamination of latex gloves. Cyclophosphamide was detec ted in urine samples provided by six of nine technicians; the maximum amount excreted over 5 d was 2.6 mu g. The mean cyclophosphamide excre tion/d was not significantly lower than that found in the previous stu dy (0.16 mu g and 1.44 mu g, respectively). Despite an intensified hyg ienic regimen, exposure to antineoplastic agents cannot be reduced if the reasons for exposure remain unknown.