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Annals of Occupational Hygiene Advance Access originally published online on August 26, 2005
Annals of Occupational Hygiene 2005 49(7):619-628; doi:10.1093/annhyg/mei045
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© 2005 British Occupational Hygiene Society Published by Oxford University Press


Original Article

Environmental Contamination with Cytotoxic Drugs in Healthcare Using Positive Air Pressure Isolators

S. CRAUSTE-MANCIET1,2,5,*, P. J. M. SESSINK3, S. FERRARI4,5, J.-Y. JOMIER4,5 and D. BROSSARD1,2,5

1 University of Pharmacy Paris 5 René Descartes, Pharmacie Galénique, 4 avenue de l'Observatoire 75006 Paris, France; 2 CHI Saint Germain-en-Laye, Pharmacy department, 20, rue Armagis, 78105 Saint Germain-en-Laye, France; 3 Exposure Control B.V., P.O. Box 467, 6600, AL Wijchen, The Netherlands; 4 CH Pau, Pharmacy department, 4 bd Hauterive, 64000, Pau, France; 5 GERPAC (Group of Evaluation and Research for Protection in Controlled Area), ZI de saux, 6 rue Ampère, 65100 Lourdes, France

* Author to whom correspondence should be addressed. Tel: +33 (0)1 39 27 42 71; fax: +33 (0)1 39 27 44 70; e-mail: sylvie.crauste-manciet{at}univ-paris5.fr

Occupational exposure to cytotoxic drugs of hospital personnel involved in their preparation and administration is a major issue: ever since the introduction of protective measures in recent decades, the handling of these drugs has always been referred to as an occupational health hazard. Isolator technology was one of the protective equipments aimed at providing safe handling, but it has not yet been studied regarding contamination. The present study evaluates surface contamination with four cytotoxic drugs [cyclophosphamide (CP), ifosfamide (IF), 5 fluorouracil (5FU) and methotrexate (MTX)] by wipe sampling in two hospital pharmacies. Wipe samples were taken from work surfaces both located inside and outside the isolators. In addition, working gloves, the surface of infusion bags filled with 5FU or CP, and gloves used in simulation of drug administration were analyzed. Contamination was routinely found inside the isolators but rarely outside the isolators, indicating that the isolator technology is offering good protection of the cytotoxic drug handlers as well as the environment during preparation. On the other hand, contamination was found on the surfaces of infusion bags and gloves in contact with infusion bags filled with cytotoxic drugs. Consequently, personal protective equipment is still recommended during the manipulation and administration of the drugs because of potentially contaminated drug vials and final products.

Keywords: antineoplastic drugs • cytotoxic drugs • surface contamination


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