静脉药物配置中心作业环境中5-氟尿嘧啶的污染情况

目的 评价医院静脉药物配置中心(PIV AS)作业环境中5-氟尿嘧啶(5-Fu)的污染情况,发现抗癌药物的污染环节.方法 采集不同区域表面、物品的样品,经洗脱后,用紫外-可见光分光光度法测定5-Fu浓度.结果 空气样品中未检出5-Fu.生物安全柜内操作台表面、左侧、右侧、内侧和前窗表面5-Fu浓度分别为(22.00±6.35)、(13.99±2.46)、(14.13±0.72)、(7.25±1.19)、(9.87±1.23) ng/cm2,明显高于非使用区域的相应位置[分别为(3.14±0.04)、(5.43±0.65)、(2.26±0.17)、(2.26±0.17)、(3.63±0.46) ng/cm2,差异均有统计学意义(P<0.05).操作台下方地板、距安全柜正面1 m处地板、准备间地板、阳台地板、更衣室垃圾桶旁边地板上5-Fu浓度分别为(18.19±5.22)、(10.25±2.57)、(11.64±2.53)、(99.89±14.06)、(24.54±0.23)ng/cm2,明显高于非使用区域地板上的5-Fu浓度[(3.36±0.11)ng/cm2],差异均有统计学意义(P<0.05或P<0.01).配置间桌面、准备间桌面5-Fu浓度[分别为(7.22±1.04)、(11.81±1.18)ng/cm]明显高于非使用区域[(5.56±0.14)ng/cm2],差异均有统计学意义(P<0.05或P<0.01).物流进窗口、出窗口和配置间门内把手擦拭物5-Fu浓度明显高于非使用区域相应表面,差异有统计学意义(P<0.05或P<0.01),而配置间门边地板、配置间门外把手与非使用区域相应表面相比,差异无统计学意义(P>0.05).药袋、药筐表面5-Fu浓度与相应表面对照比较,差异有统计学意义(P<0.05).配置人员外层口罩、内层口罩与相应对照比较,差异无统计学意义(P>0.05).配置人员双手外层和左手内层手套、核对人员手套的5-Fu浓度明显高于相应对照,差异有统计学意义(P<0.05或P<0.01).结论 抗癌药物配置、核对和医疗垃圾处理是抗癌药物污染的重要环节.

Investigation on occupational exposure to 5-fluorouracil in pharmacy intravenous admixture service of a hospital

Objective To investigate the level of occupational exposure to 5-fluorouracil (5-Fu) in the pharmacy intravenous admixture service (PIVAS) of a hospital, and identify the sources of 5-Fu contami-nation. Methods The 5-Fu concentrations in air, on the surface of different areas in PIVAS and personal pro-tective equipments were detected using UV-vis spectrophotometry. Results The 5-Fu in air could not be de-tected. The 5-Fu concentrations on five different surfaces of biological safety cabinets were (22.00±6.35), (13.99±2.46), (14.13±0.72), (7.25±1.19) and (9.87±1.23) ng/cm2, respectively, which were significantly higher than those [(3.14±0.04),(5.43±0.65),(2.26±0.17),(2.26±0.17) and (3.63±0.46) ng/cm2] of corre-sponding controls (P<0.05orP<0.01).The5-Fu concentrations of the floor under cabinets [(18.19±5.22) ng/cm2], the floor in front of cabinets [(10.25±2.57)ng/cm2], the office floor [(11.64±2.53) ng/cm2], the terrace floor [(99.89±14.06 )ng/cm2], the floor beside trash can in dressing room [(24.54±0.23) ng/cm2] were significantly higher than those of control [ (3.36±0.11) ng/cm2] (P<0.05 or P<0.01). The 5-Fu concentrations of the tables in preparation room [(7.22±1.04)ng/cm2] and the tables in office [(11.81±1.18) ng/cm2] were significantly higher than those of control [(5.56±0.14) ng/cm2] (P<0.05 or P<0.01). The 5-Fu concentrations of the indoor handle in preparation room were significantly higher than those of controls (P<0.05 or P<0.01). 5-Fu concen-trations on the surfaces of outdoor handle and floor beside door in preparation room were not significantly in-creased compared with controls (P>0.05). The 5-Fu concentrations on the surfaces of infusion bags, transfer box, transfer trays were significantly higher than those of controls (P<0.05). The differences of 5-Fu concentrations between outer and inner masks and controls were not significant (P>0.05). The 5-Fu concentrations of gloves of preparing and checking staffs were significantly higher than those of controls (P<0.05 or P<0.01). Conclusion The preparing and checking process of 5-Fu and the treatment of medical wastes are major sources of 5-Fu contamination.