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Levels and risks of surface contamination by thirteen antineoplastic drugs in the Czech and Slovak hospitals and pharmacies

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Abstract

The consumption of hazardous antineoplastic drugs (ADs) used in anticancer chemotherapies is steadily increasing representing thus risks to both human health and the environment. Hospitals may serve as a contamination source, and pharmacists preparing the antineoplastic drugs (ADs) as well as nurses administering chemotherapy and caring for oncology patients are among the healthcare professionals being highly exposed. Here, we present the results of systematic monitoring (2018–2020) of surface contamination by 13 ADs in the pharmacies and hospitals in the Czech Republic (CZ; large-scale monitoring, 20 workplaces) and Slovak Republic (SK; pilot study at 4 workplaces). The study evaluated contamination by three commonly monitored ADs, i.e., 5-fluorouracil (FU), cyclophosphamide (CP), and platinum (total Pt representing cis-, carbo-, and oxaliplatin) together with ten less explored ADs, i.e., gemcitabine (GEM), ifosfamide (IF), paclitaxel (PX), irinotecan (IRI), docetaxel (DOC), methotrexate (MET), etoposide (ETOP), capecitabine (CAP), imatinib (IMAT), and doxorubicin (DOX). Floors and desktop surfaces in hospitals (chemotherapy application rooms, nurse working areas) were found to be more contaminated, namely with CP and Pt, in both countries when compared to pharmacies. Comparison between the countries showed that hospital surfaces in SK are generally more contaminated (e.g., CP median was 20 times higher in SK), while some pharmacy areas in the CZ were more contamined in comparison with SK. The newly studied ADs were detected at lower concentrations in comparison to FU, CP, and Pt, but some markers (GEM, IF, PX, and IRI) were frequently observed, and adding these compounds to routine monitoring is recommended.

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Data availability

Data are provided in the Supplementary materials. Further details can be obtained upon email request to the corresponding author (ludek.blaha@recetox.muni.cz).

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Acknowledgements

We are grateful to all partners from participating hospitals and pharmacies. Support of the B. Braun Company is greatly acknowledged.

Funding

The research has been supported by the Czech Health Research Council project (NV18-09–00188) and the research infrastructure projects from the Czech Ministry of Education (LM2018121; CZ.02.1.01/0.0/0.0/17_043/0009632).

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Authors and Affiliations

  1. Masaryk Memorial Cancer Institute, Žlutý kopec 7, 65653, Brno, Czech Republic

    Lenka Doležalová

  2. Faculty of Pharmacy, Masaryk University, Palackeho 1946/1, 61200, Brno, Czech Republic

    Lenka Doležalová

  3. Faculty of Science, Masaryk University, RECETOX, Kamenice 753/5, Building D29, 62500, Brno, Czech Republic

    Lucie Bláhová, Jan Kuta, Tereza Hojdarová & Luděk Bláha

  4. University Hospital Brno, Jihlavská 20, 62500, Brno, Czech Republic

    Šárka Kozáková

Authors
  1. Lenka Doležalová
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  2. Lucie Bláhová
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  3. Jan Kuta
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  4. Tereza Hojdarová
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  5. Šárka Kozáková
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  6. Luděk Bláha
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Contributions

LD contributed to the design of the study, contributed to sampling, processed data, and drafted the manuscript; LucB contributed to the study design, validated methods and performed analyses, evaluated results, and contributed to manuscript writing; JK developed methods and analyzed Pt in studied samples and contributed to manuscript writing; SK contributed to the design of the study and contributed to the interpretation of the results; TH processed the samples and contributed to manuscript writing; LudB designed the study and contributed to development of methods and interpretation, and manuscript writing.

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Correspondence to Luděk Bláha.

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Doležalová, L., Bláhová, L., Kuta, J. et al. Levels and risks of surface contamination by thirteen antineoplastic drugs in the Czech and Slovak hospitals and pharmacies. Environ Sci Pollut Res 29, 26810–26819 (2022). https://doi.org/10.1007/s11356-021-17607-y

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