Assessment of chemical contamination by cancer drugs during use of the RIVATM compounding robot: A pilot study.

Abstract

IntroductionMany hospitals are now investing in robotic compounding system for the preparation of cytotoxic agents. The objective of the present study was to describe contamination by cytotoxics inside and outside the RIVA^TM robot (ARxIUM, Winnipeg, Canada).Material & MethodsWe applied a risk analysis to determine which locations inside and outside the compounding robot should be monitored. Samples were collected by swabbing with a wet swab (using 0.1 mL of sterile water) before the robots was cleaned. Ten cytotoxics compounded with the robot were screened for using LC-MS/MS. We determined the percentage contamination rates inside (CR_in) and outside (CR_out) the robot and the amounts of each contaminant (in ng/cm²). If a sample was found to be positive, a corrective action was implemented.ResultsOur risk analysis highlighted 10 locations inside the robot and 7 outside. Ten sampling campaigns (10 samples per campaign) were performed. The mean CR_in (40%) was significantly higher than the mean CR_out (2%; p < 10^-4). Gemcitabine and cyclophosphamide were the main contaminants. After the implementation of corrective measures (such as daily cleaning with SDS/isopropyl alcohol), the CR_in fell from 60% to 10%.Discussion/conclusionThe frequency of contamination was lower for robotic compounding than for manual compounding in an isolator. However, robotic compounding tended to generated larger mean amounts of contaminant; this was related to incidents such as splashing when syringes were disposed of after the compounding. The implementation of corrective actions effectively reduced the CRs. Further longer-term studies are required to confirm these results.