Open Access

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

Stefano Dugheri
Stefano Dugheri
, 
Donato Squillaci
Donato Squillaci
, 
Giovanni Cappelli
Giovanni Cappelli
, 
Valentina Saccomando
Valentina Saccomando
, 
Niccolò Fanfani
Niccolò Fanfani
, 
Jacopo Ceccarelli
Jacopo Ceccarelli
, 
Nicola Mucci
Nicola Mucci
 and 
Giulio Arcangeli
Giulio Arcangeli
   | Sep 30, 2023
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Article Category: Original article
Published Online: Sep 30, 2023
Page range: 187 - 197
Received: Apr 01, 2023
Accepted: Jul 01, 2023
DOI: https://doi.org/10.2478/aiht-2023-74-3734
© 2023 Stefano Dugheri et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

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

Figure 2

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)
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)

Figure 3

Prevalence of positive tests to antineoplastic drugs on collected nitrile gloves
Prevalence of positive tests to antineoplastic drugs on collected nitrile gloves

Figure 4

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)
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)

Figure 5

Comparison of carmustine permeation curves between nitrile gloves of different thickness
Comparison of carmustine permeation curves between nitrile gloves of different thickness

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 70th percentile (pg/cm2) <LOQ 150
AGV-T (95th percentile) (pg/cm2) 123 3422

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) 90th percentile (pg/cm2) AGV Adm (95th 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

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) 90th percentile (pg/cm2) AGVPrep (95th 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
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