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Occupational exposure to antineoplastic drugs has been documented to result in various adverse health effects. Despite the implementation of control measures to minimize exposure, detectable levels of drug residual are still found on hospital work surfaces. Cleaning these surfaces is considered as one means to minimize the exposure potential. However, there are no consistent guiding principles related to cleaning of contaminated surfaces resulting in hospitals to adopt varying practices. As such, this pilot study sought to evaluate current cleaning protocols and identify those factors that were most effective in reducing contamination on drug preparation surfaces. Three cleaning variables were examined: (1) type of cleaning agent (CaviCide®, Phenokil II™, bleach and chlorhexidine), (2) application method of cleaning agent (directly onto surface or indirectly onto a wipe) and (3) use of isopropyl alcohol after cleaning agent application. Known concentrations of antineoplastic drugs (either methotrexate or cyclophosphamide) were placed on a stainless steel swatch and then, systematically, each of the three cleaning variables was tested. Surface wipes were collected and quantified using high-performance liquid chromatography–tandem mass spectrometry to determine the percent residual of drug remaining (with 100% being complete elimination of the drug). No one single cleaning agent proved to be effective in completely eliminating all drug contamination. The method of application had minimal effect on the amount of drug residual. In general, application of isopropyl alcohol after the use of cleaning agent further reduced the level of drug contamination although measureable levels of drug were still found in some cases. [ABSTRACT FROM PUBLISHER]

Objective. We undertook a pilot study involving six British Columbian hospital pharmacies to determine if antineoplastic drug contamination of surfaces exists and whether residual drugs remain on these surfaces despite being cleaned.Methods. At each site, the pharmacy technician responsible for preparing the antineoplastic drugs was observed to determine which surfaces were contacted and to ascertain the frequency of contact. Surfaces observed to be most frequently contacted were subsequently wiped after drug preparation pre- and post-clean. The wipe samples were then analyzed by liquid chromatography tandem mass spectrometry to determine the amount of contamination. Cyclophosphamide (CP) and methotrexate (MTX) were used as representative markers to reflect overall antineoplastic drug contamination levels.Results. Fourteen of the 23 surfaces sampled pre-clean (61%) were contaminated with either MTX or CP. The pre-clean wipe samples had a geometric mean concentration of 0.0135 ng/cm2 for MTX (range

The purpose of this study was to assess determinants of healthcare worker (HCW) self-reported compliance with infection control procedures. A survey was conducted of HCWs in 16 healthcare facilities. A strong correlation was found between both environmental and organizational factors and self-reported compliance. No relationship was found with individual factors. Only 5% of respondents rated their training in infection control as excellent, and 30% felt they were not offered the necessary training. We concluded that compliance with infection control procedures is tied to environmental factors and organizational characteristics, suggesting that efforts to improve availability of equipment and promote a safety culture are key. Training should be offered to high-risk HCWs, demonstrating an organizational commitment to their safety.