Evaluation of the risk of occupational exposure to antineoplastic drugs in healthcare sector: part I – medical gloves

Stefano Dugheri; Donato Squillaci; Giovanni Cappelli; Valentina Saccomando; Niccolò Fanfani; Jacopo Ceccarelli; Nicola Mucci; Giulio Arcangeli

doi:10.2478/aiht-2023-74-3734

Evaluation of the risk of occupational exposure to antineoplastic drugs in healthcare sector: part I – medical gloves

Archives of Industrial Hygiene and Toxicology

Volume 74 (2023): Issue 3 (September 2023)

By: Stefano Dugheri, Donato Squillaci, Giovanni Cappelli, Valentina Saccomando, Niccolò Fanfani, Jacopo Ceccarelli, Nicola Mucci and Giulio Arcangeli

Open Access

|Sep 2023

Figures & Tables

Nitrile glove sample collection (panels 1 & 2) and extraction procedure (panels 3 & 4)

Calculation of the cumulative permeation and area under the curve at different time points. AUC – area under the curve; b1 – cumulative permeation (t1); b2 – cumulative permeation (t); BDT – breakthrough detection time; PR1 – permeation rate (t1); PR2 – permeation rate (t)

Prevalence of positive tests to antineoplastic drugs on collected nitrile gloves

Table 1

Glove contamination and calculated alert glove values (AGVs) in AD administration units expressed as pg/cm²

Administration unit
	Positive gloves (N)	Gloves with contamination >100 pg/cm² (N)	Average contamination (pg/cm²)	Highest contamination (pg/cm²)	90^th percentile (pg/cm²)	AGV _Adm (95^th percentile) (pg/cm²)	LOQ (pg/cm²)
5-FU	5	2	784	3244	<LOQ	3.3	0.15
GEM	3	1	496	1385	<LOQ	<LOQ	0.28
IRT	0	0	0	0	<LOQ	<LOQ	0.06
CP	0	0	0	0	<LOQ	<LOQ	0.03
DXR	1	0	7	8	<LOQ	<LOQ	0.12
DC	0	0	0	0	<LOQ	<LOQ	0.04
EPI	0	0	0	0	<LOQ	<LOQ	0.11
ETP	0	0	0	0	<LOQ	<LOQ	0.21
MT	1	0	5	5	<LOQ	<LOQ	0.02
PTX	0	0	0	0	<LOQ	<LOQ	0.19
DTX	0	0	0	0	<LOQ	<LOQ	2.59
TMX	0	0	0	0	<LOQ	<LOQ	0.08
TPT	0	0	0	0	<LOQ	<LOQ	0.03
VNC	0	0	0	0	<LOQ	<LOQ	0.16
VNB	0	0	0	0	<LOQ	<LOQ	0.44
VNR	1	0	16	16	<LOQ	<LOQ	0.06
FTM	0	0	0	0	<LOQ	<LOQ	0.04
MITC	1	0	2	2	<LOQ	<LOQ	0.02
IDC	0	0	0	0	<LOQ	<LOQ	0.62
IP	4	0	23	52	<LOQ	<LOQ	0.04
CTB	0	0	0	0	<LOQ	<LOQ	0.06
MP	0	0	0	0	<LOQ	<LOQ	0.18
BSF	0	0	0	0	<LOQ	<LOQ	0.09
PMX	0	0	0	0	<LOQ	<LOQ	0.09
RTX	0	0	0	0	<LOQ	<LOQ	0.08
VND	0	0	0	0	<LOQ	<LOQ	5.71
5-AZ	0	0	0	0	<LOQ	<LOQ	0.70
CisPt	0	0	0	0	<LOQ	<LOQ	29.58
CarboPt	0	0	0	0	<LOQ	<LOQ	2.73
OxaliPt	0	0	0	0	<LOQ	<LOQ	0.35

1 LOQ – instrumental limits of quantification for each substance. 5-FU – 5-fluorouracil; BSF – busulfan; CP – cyclophosphamide; CarboPt – carboplatin; CisPt – cisplatin; OxaliPt – oxaliplatin; CTB – cytarabine; DC – dacarbazine; DNR – daunorubicin; DTX – docetaxel; DXR – doxorubicin; EPI – epirubicin; ETP – etoposide; GEM – gemcitabine; FTM – fotemustine; IDC – idarubicine; IP – iphosfamide; IRT – irinotecan; MP – melphalan; MT – methotrexate; MITC – mitomycin C; PTX – paclitaxel; PMX – pemetrexed; TMX – tamoxifen; RTX – raltitrexed; TPT – topotecan; VNB – vinblastine; VNC – vincristine; VND – vindesine; VNR – vinorelbine

Table 2

Glove contamination and calculated alert glove values (AGVs) in AD preparation units expressed as pg/cm²

Preparation unit
	Positive gloves (N)	Gloves with contamination >100 pg/cm² (N)	Average contamination (pg/cm²)	Highest contamination (pg/cm²)	90^th percentile (pg/cm²)	AGV_Prep (95^th percentile) (pg/cm²)	LOQ (pg/cm²)
5-FU	6	3	3667	20729	<LOQ	13.6	0.15
GEM	23	10	1292	12767	163.6	1985.2	0.28
IRT	1	0	36	36	<LOQ	<LOQ	0.06
CP	12	3	319	2934	13.8	40.6	0.03
DXR	1	0	39	39	<LOQ	<LOQ	0.12
DC	2	0	7	7	<LOQ	<LOQ	0.04
EPI	0	0	0	0	<LOQ	<LOQ	0.11
ETP	2	0	35	56	<LOQ	<LOQ	0.21
MT	1	0	50	50	<LOQ	<LOQ	0.02
PTX	12	5	170	487	34	97.8	0.19
DTX	0	0	0	0	<LOQ	<LOQ	2.59
TMX	0	0	0	0	<LOQ	<LOQ	0.08
TPT	0	0	0	0	<LOQ	<LOQ	0.03
VNC	1	0	46	46	<LOQ	<LOQ	0.16
VNB	0	0	0	0	<LOQ	<LOQ	0.44
VNR	0	0	0	0	<LOQ	<LOQ	0.06
FTM	0	0	0	0	<LOQ	<LOQ	0.04
MITC	0	0	0	0	<LOQ	<LOQ	0.02
IDC	0	0	0	0	<LOQ	<LOQ	0.62
IP	5	1	84	395	<LOQ	0.6	0.04
CTB	2	1	2602	5190	<LOQ	<LOQ	0.06
MP	0	0	0	0	<LOQ	<LOQ	0.18
BSF	1	0	18	18	<LOQ	<LOQ	0.09
PMX	5	4	421	1175	<LOQ	19.3	0.09
RTX	0	0	0	0	<LOQ	<LOQ	0.08
VND	0	0	0	0	<LOQ	<LOQ	5.71
5-AZ	0	0	0	0	<LOQ	<LOQ	0.70
CisPt	0	0	0	0	<LOQ	<LOQ	29.58
CarboPt	6	1	0	414	<LOQ	11.2	2.73
OxaliPt	0	0	0	0	<LOQ	<LOQ	0.35

Table 3

Cumulative AD contamination and total alert glove values (AGV-T) for administration and preparation units

	Administration (pg/cm²)	Preparation (pg/cm²)
Positive gloves (N)	15	44
Average cumulative contamination (pg/cm²)	369	1503
Highest cumulative contamination (pg/cm²)	3279	33518
Cumulative 70^th percentile (pg/cm²)	<LOQ	150
AGV-T (95^th percentile) (pg/cm²)	123	3422

Calculated cumulative permeation and area under the curve (AUC) for carboplatin, cyclophosphamide, etoposide, 5-fluorouracil, iphosphamide, and carmustine after 120 min of exposure (assuming 0.05 mm glove thickness)

Comparison of carmustine permeation curves between nitrile gloves of different thickness

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DOI: https://doi.org/10.2478/aiht-2023-74-3734 | Journal eISSN: 1848-6312 (formerly 0004-1254) | Journal ISSN: 0004-1254

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Language: English, Croatian

Page range: 187 - 197

Submitted on: Apr 1, 2023

Accepted on: Jul 1, 2023

Published on: Sep 30, 2023

Published by: Institute for Medical Research and Occupational Health

In partnership with: Paradigm Publishing Services

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Basic medical science, other

© 2023 Stefano Dugheri, Donato Squillaci, Giovanni Cappelli, Valentina Saccomando, Niccolò Fanfani, Jacopo Ceccarelli, Nicola Mucci, Giulio Arcangeli, published by Institute for Medical Research and Occupational Health
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Volume 74 (2023): Issue 3 (September 2023)

Evaluation of the risk of occupational exposure to antineoplastic drugs in healthcare sector: part I – medical gloves

Figures & Tables

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Table 1

Table 2

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