Development and validation of a method for accurate collection and analysis of select antineoplastic contaminants, both in air and on surfaces, and implications for exposure assessment

To conduct exposure assessment of antineoplastic contaminants in pharmacy and clinical use areas, an analytical method along with surface and air monitoring methods was developed and validated. Five antineoplastic agents were selected for this method based on their frequency of use and potential risk to human health. The agents selected were cyclophosphamide, ifosfamide, 5-fluorouracil, doxorubicin-HCl, and paclitaxel. Cyclophosphamide was the agent of most interest because it is listed by the International Agency for Research on Cancer (IARC) as a known human carcinogen. An analytical method developed was able to simultaneously analyze for all five agents of interest. For the surface monitoring method, Millipore #42, 55-mm filter circles were used for surfaces sample collection, and samples were desorbed in the same solvent blend determined to be optimal for use in wiping.{09}The minimum concentration of detection for these agents was typically 2.0 ng/mm2 or less for each of the five agents. The method for air monitoring was developed using a solid sorbent. Previous air monitoring had been done by use of TEFLON or glass fiber filters but with very questionable results. Information was provided at an international conference in Sweden that cyclophosphamide may actually sublimate or otherwise evaporate from high efficiency particulate air (HEPA) filters, which would indicate use of filters for monitoring may provide inaccurate results. Therefore, various solid sorbents were reviewed and tested for monitoring antineoplastics in air. Anasorb 708 (methyl acrylate polymer) tubes were found to be most acceptable for collection and desorbing of the all five agents of interest. The lowest concentration for detection in air of these agents was typically 0.5 μ/m3 or less for each of the agents of interest when monitoring at 2.0 L/minute for 20 hours or more. The surface and air monitoring methods were tested at a hospital oncology pharmacy area and at a cancer treatment clinic and were found able to detect contaminants such as cyclophosphamide on surfaces at concentrations less than 1.0 ng/cm 2 and in the air at concentrations less than 1.0 μ/m3. The ability to detect these agents at concentrations less than 1.0 μ/m 3 for assuring controls used to protect health care workers was adequate.