Abstract
Purpose
The aim of this pilot study was to evaluate surface contamination by platinum drugs in the environment of patients in ICUs and wards treated by hyperthermic intraperitoneal chemotherapy (HIPEC).
Methods
The monitoring included 12 HIPEC treatments from four hospitals during the following 3 days after perfusion. A total of 33 urine and 33 drainage fluids from HIPEC patients and 160 wipe samples from several surfaces (urine/drainage bags, floors, gloves) were taken during the study period.
Results
In urine, the highest platinum concentrations were measured on the first day after perfusion. Median platinum concentrations were 1260 ng/ml for patients after cisplatin perfusion and 11,000 ng/ml for oxaliplatin treatment. Concentrations decreased until day three to 413 ng/ml cisplatin and 529 ng/ml oxaliplatin, respectively. In drainage liquids, platinum concentrations were generally lower. Platinum concentrations from surfaces of bags and floors ranged from 0.01 to 439 pg/cm2 (median: urine bag 2.77 pg/cm2, drainage bag 0.22 pg/cm2, floor left 0.14 pg/cm2, floor right 0.24 pg/cm2), with the highest contamination found on the outer surface of the urine bags. Samples from nurses’ protective gloves ranged between 0.03 and 12 pg/cm2 (median: 0.2 pg/cm2).
Conclusions
High platinum-drug concentrations in urine and drainage liquids are the main source of contamination. Therefore, safe handling of these liquids is the best way to avoid cross-contamination on surfaces in wards and ICUs. Our results show that it is possible to take care of HIPEC patients without high contaminations during the first 3 days.
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Acknowledgments
We thank Mr. Christopher Plechinger and Nadja Blumschein (Kardialgut Germany) for great support. Thanks also to all physicians, surgeons, perfusionists and nurses of the participating hospitals. The platinum analyses were performed by Stefan Gröbmair, Gisela Gümperlein and Isak Qoroli. We want to thank Trish van der Beke (Chicago, Illinois) for improving our English wording. Data published here are part of the doctoral thesis of KS.
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Schenk, KE., Schierl, R., Angele, M. et al. Cisplatin and oxaliplatin surface contamination in intensive care units (ICUs) and hospital wards during attendance of HIPEC patients. Int Arch Occup Environ Health 89, 991–996 (2016). https://doi.org/10.1007/s00420-016-1137-3
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DOI: https://doi.org/10.1007/s00420-016-1137-3