Abstract
Purpose
Despite the decreasing of environmental contamination throughout the anticancer drug circuit, the administration of chemotherapies remains at risk of occupational exposure for nurses. Many medical devices aim at securing administration, but none have been scientifically evaluated to verify the actual improvement.
Methods
A monocentric comparative before/after study was carried out in an oncology day hospital to evaluate the efficacy of Safe Infusion Devices in reducing drug exposure compared to usual infusion practices. The rate of nurses’ gloves contamination was estimated. To avoid false negatives and to ensure sampling reproducibility, each sample of gloves was contaminated with a drop of topotecan. Association between contamination and other variables was investigated using a multivariate logistic regression analysis.
Results
The usual practice led to a rate of 58.3% of contaminated samples while Safe Infusion Devices to a rate of 15%: Safe Infusion Devices reduced the risk of gloves contamination by 85% in multivariate analysis (Odds ratio = 0.15; 95% confidence interval = 0.05–0.46; p < 0.001). Topotecan was identified in 100% of the samples. Only one case of cross-contamination has occurred.
Conclusion
Despite the current practice of using neutral solvent-purged infusers, the occupational exposure remains high for nurses and Safe Infusion Devices significantly reduced this risk of exposure. However, glove contamination is only a surrogate endpoint. The results confirmed that the disconnection of empty bags resulted in occupational exposure. Except a contamination due to the leakage of a bag, no cross-contamination was detected. Safe Infusion Devices were highly effective but did not completely eliminate exposure.
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Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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FF: Conception and design, interpretation of data, draft, final approval; EB, CM: Conception and design, article revising, final approval; Bastien Raymond: Sample collection, article revising, final approval; SM, AM, MH, WB, XS: Interpretation of data, article revising, final approval; FT: Statistical analysis, interpretation of data, article revising, final approval; JG: Samples analysis, interpretation of data, article revising, final approval.
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Forges, F., Blanc, E., Raymond, B. et al. Evaluation of a safe infusion device on reducing occupational exposure of nurses to antineoplastic drugs: a comparative prospective study. Contamoins-1. Int Arch Occup Environ Health 94, 1317–1325 (2021). https://doi.org/10.1007/s00420-021-01679-x
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DOI: https://doi.org/10.1007/s00420-021-01679-x