Pilot Evaluation of Dermal Contamination by Antineoplastic Drugs among Hospital Pharmacy Personnel

ABSTRACTBackground: It is believed that health care workers are exposed to antineoplastic drugs primarily via dermal contact. However, levels of occupational dermal contamination in Canada have not been formally investigated.Objective: To determine the potential dermal exposure to antineoplastic drugs among hospital pharmacy personnel in a metropolitan area in British Columbia.Methods: Six hospital pharmacies in the Vancouver area participated in this pilot study. Three pharmacy workers (a technician responsible for preparing drugs, a pharmacist responsible for checking drugs before administration, and a technician not responsible for preparing drugs but working in the pharmacy department) were selected from each site, for a total of 18 participants. Each worker’s hands were wiped with a premoistened tissue (one wipe per person), and the wipes were subsequently analyzed by high-performance liquid chromatography tandem mass spectrometry to determine levels of both cyclophosphamide and methotrexate (total of 36 analyses).Results: At 3 of the 6 sites, at least one hand-wipe sample was above the analytical detection limit. Of the 18 analyses from the 3 “positive” sites, 5 (28%) had measurable levels of cyclophosphamide and methotrexate. Cyclophosphamide was detected in 3 samples (geometric mean 0.98 ng, geometric standard deviation 2.72 ng, range from below limit of detection to 3.96 ng) and methotrexate in 2 samples (geometric mean 0.27 ng, geometric standard deviation 2.57 ng, range from below limit of detection to 0.27 ng).Conclusions: The results of this pilot study suggest that hospital pharmacy workers in Metro Vancouver are probably exposed to antineoplastic drugs, given that detectable levels of drug were found on the hands of some personnel. Further studies are recommended to confirm these findings.RÉSUMÉContexte : D’aucuns croient que les travailleurs de la santé sont exposés aux agents anticancéreux principalement par voie cutanée. Cependant, les taux de contamination professionnelle par voie cutanée au Canada n’ont pas fait l’objet d’études officielles.Objectif : Déterminer l’exposition cutanée potentielle aux agents anticancéreux du personnel des pharmacies d’hôpitaux dans une région métropolitaine de Colombie-Britannique.Méthodes : Six pharmacies d’hôpitaux de la région de Vancouver ont participé à cette étude pilote. Trois membres du personnel de la pharmacie (un technicien responsable de la préparation des médicaments; un pharmacien responsable de la vérification des médicaments avant leur administration; et un technicien non responsable de la préparation des médicaments, mais travaillant dans le service de pharmacie) ont été choisis dans chaque centre, pour un total de 18 sujets. Les mains de chaque sujet ont été essuyées au moyen d’une lingette (une par sujet), puis les lingettes ont été analysées par chromatographie liquide haute performance couplée à la spectrométrie de masse en tandem afin de déterminer les concentrations de cyclophosphamide et de méthotrexate, pour un total de 36 analyses.Résultats : Dans trois centres, au moins un échantillon de lingette présentait une concentration supérieure à la limite de détection analytique. Des 18 analyses provenant de ces trois centres, cinq (28 %) ont révélé des concentrations mesurables de cyclophosphamide ou de méthotrexate. On a détecté de la cyclophosphamide dans trois échantillons (moyenne géométrique de 0,98 ng, écart-type géométrique de 2,72, plage allant d’une valeur sous la limite de détection à 3,96 ng) et du méthotrexate dans deux échantillons (moyenne géométrique de 0,27 ng, écart-type géométrique de 2,57, plage allant d’une valeur sous la limite de détection à 0,27 ng).Conclusions : Les résultats de cette étude pilote suggèrent que les membres du personnel des pharmacies d’hôpitaux de Metro Vancouver sont probablement exposés à des agents anticancéreux, étant donné les concentrations détectables de médicaments trouvées sur les mains de certains employés. D’autres études sont recommandées afin de confirmer ces résultats

Tribooxidational effects on friction and wear behavior of silicon nitride/tool steel and silicon nitride/gray cast iron contacts

Unlubricated pin-on-disk wear tests of SiJN4 against tool steel and gray cast iron were performed at 5 N of normal load, 0.5 m/s of sliding speed, and environmental temperature in the range 22°-600°C. The friction oefficient of SiJN4 sliding against tool steel and gray cast iron had maximum values of 0.88-0.98 for tests at 100°C. The friction coefficient of SiJN4 sliding against gray cast iron couples had minimum values of 0.48-0.57 at 400°C. Because of the increased third-body protection, the wear coefficient of the SiJN4 pins of the SiJN4/gray cast iron couples decreased by 1 order of magnitude from 1.6 x 10-5 mmJ/(N.m) at room temperature to 1.3 x 10-6 mmJ/(N.m) at 600°C. Fe20J and FeJO4 resulting from Tribooxidation of the metallic disks were the main constituents of the wear debris and adherent tribolayers. Activation energy values (6.3-13. 7 kJ/mol) were comparable to those of oxidation wear of steel (7.3- 11.8 kJ/mol) but were much lower than the activation energy for oxidation of iron alloys in static conditions. Calculations of the activation energy of the oxidation wear corroborate the morphological observations of a sacrificial action of the metallic surface protecting the ceramic material

Protecting the faces of health care workers: knowledge gaps and research priorities for effective protection against occupationally-acquired respiratory infectious diseases

The report, funded by the Change Foundation in Ontario, identifies several priorities that require further attention to ensure the safety of healthcare workers and how best to implement the necessary changes.Environmental Health (SOEH), School ofOccupational and Environmental Hygiene, School ofMedicine, Faculty ofPopulation and Public Health (SPPH), School ofUnreviewedFacultyOthe