Pilot Evaluation of Dermal Contamination by Antineoplastic Drugs among Hospital Pharmacy Personnel
Bibliographic record
Abstract
Background: It is believed that health care workers are exposed to antineoplastic drugs primarily via dermal contact. However, levels of occupational dermal contamination in Canada have not been formally investigated.Objective: To determine the potential dermal exposure to antineoplastic drugs among hospital pharmacy personnel in a metropolitan area in British Columbia.Methods: Six hospital pharmacies in the Vancouver area participated in this pilot study. Three pharmacy workers (a technician responsible for preparing drugs, a pharmacist responsible for checking drugs before administration, and a technician not responsible for preparing drugs but working in the pharmacy department) were selected from each site, for a total of 18 participants. Each worker’s hands were wiped with a premoistened tissue (one wipe per person), and the wipes were subsequently analyzed by high-performance liquid chromatography tandem mass spectrometry to determine levels of both cyclophosphamide and methotrexate (total of 36 analyses).Results: At 3 of the 6 sites, at least one hand-wipe sample was above the analytical detection limit. Of the 18 analyses from the 3 “positive” sites, 5 (28%) had measurable levels of cyclophosphamide and methotrexate. Cyclophosphamide was detected in 3 samples (geometric mean 0.98 ng, geometric standard deviation 2.72 ng, range from below limit of detection to 3.96 ng) and methotrexate in 2 samples (geometric mean 0.27 ng, geometric standard deviation 2.57 ng, range from below limit of detection to 0.27 ng).Conclusions: The results of this pilot study suggest that hospital pharmacy workers in Metro Vancouver are probably exposed to antineoplastic drugs, given that detectable levels of drug were found on the hands of some personnel. Further studies are recommended to confirm these findings.RÉSUMÉContexte : D’aucuns croient que les travailleurs de la santé sont exposés aux agents anticancéreux principalement par voie cutanée. Cependant, les taux de contamination professionnelle par voie cutanée au Canada n’ont pas fait l’objet d’études officielles.Objectif : Déterminer l’exposition cutanée potentielle aux agents anticancéreux du personnel des pharmacies d’hôpitaux dans une région métropolitaine de Colombie-Britannique.Méthodes : Six pharmacies d’hôpitaux de la région de Vancouver ont participé à cette étude pilote. Trois membres du personnel de la pharmacie (un technicien responsable de la préparation des médicaments; un pharmacien responsable de la vérification des médicaments avant leur administration; et un technicien non responsable de la préparation des médicaments, mais travaillant dans le service de pharmacie) ont été choisis dans chaque centre, pour un total de 18 sujets. Les mains de chaque sujet ont été essuyées au moyen d’une lingette (une par sujet), puis les lingettes ont été analysées par chromatographie liquide haute performance couplée à la spectrométrie de masse en tandem afin de déterminer les concentrations de cyclophosphamide et de méthotrexate, pour un total de 36 analyses.Résultats : Dans trois centres, au moins un échantillon de lingette présentait une concentration supérieure à la limite de détection analytique. Des 18 analyses provenant de ces trois centres, cinq (28 %) ont révélé des concentrations mesurables de cyclophosphamide ou de méthotrexate. On a détecté de la cyclophosphamide dans trois échantillons (moyenne géométrique de 0,98 ng, écart-type géométrique de 2,72, plage allant d’une valeur sous la limite de détection à 3,96 ng) et du méthotrexate dans deux échantillons (moyenne géométrique de 0,27 ng, écart-type géométrique de 2,57, plage allant d’une valeur sous la limite de détection à 0,27 ng).Conclusions : Les résultats de cette étude pilote suggèrent que les membres du personnel des pharmacies d’hôpitaux de Metro Vancouver sont probablement exposés à des agents anticancéreux, étant donné les concentrations détectables de médicaments trouvées sur les mains de certains employés. D’autres études sont recommandées afin de confirmer ces résultats.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".