Surface contamination of chemotherapy drug vials was evaluated in two studies reported in the March 1st, 2005 issue of the American Journal of Health-System Pharmacy. A third study evaluated new vial-cleaning techniques. The first study evaluated the external contamination of drug vials with cyclophosphamide and ifosfamide in a pharmacy. Contamination levels varied widely but were noted for both drugs, especially cyclophosphamide. The second study evaluated surface contamination for drug vials with cyclophosphamide and fluorouracil in three pharmacies. Cyclophosphamide contamination was again widespread, with fluorouracil found on only 7% of the samples. The third study compared standard decontamination procedures with improved procedures and the use of protective sleeves. These measures reduced surface contamination by 90%.
Given the mounting evidence for contamination of vials from the manufacturer, current practices for handling chemotherapy should include requiring employees who receive and handle chemotherapy to wear gloves. Employees of drug wholesalers should also be made aware of the potential contamination when handling exterior cartons or repacking vials for their pharmacy customers. Manufacturers are being encouraged to review their decontamination procedures and consider improved processes. Connor, T, et. al., Surface contamination of chemotherapy drug vials and evaluation of new vial-cleaning techniques: Results of three studies. AJHP, Volume 62, Number 5 pp. 475-484.
Hospitals for a Healthy Environment (H2E) is hosting a teleconference entitled Regulatory Entanglements: Disposal of Chemotherapeutic Wastes – What to Know and What to Find Out on Friday, March 11th at 1 PM EST. The speakers will be John Gorman, Chief, Compliance Assistance Section, EPA Region 2, Charlotte Smith, President, PharmEcology Associates, LLC, and Eydie Pines, Special Projects and Pharmaceutical Grant Coordinator, H2E. This is a great opportunity to hear directly from the EPA and to explore with us the details of chemotherapeutic waste segregation and management. Visit the H2E website to register and download the PowerPoint presentations. You do not have to be an H2E Partner or Champion to participate.
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