Investigating antineoplastic drug surface contamination in veterinary settings and on canine patients.

Abstract

Antineoplastic drugs can persist on surfaces in human and veterinary oncology clinics where they are administered, resulting in potentially hazardous exposures for healthcare workers and cancer patient caregivers. To assess potential surface contamination in occupational settings, a new liquid chromatography-selected reaction monitoring-mass spectrometry (LC-SRM-MS/MS) method was developed to simultaneously detect six commonly used antineoplastic drugs. A surface wipe and desorption method was optimized for cyclophosphamide, doxorubicin, methotrexate, etoposide, paclitaxel, and 5-fluorouracil with drug desorption recoveries ranging from 49% to 79%. The limit of detection (LOD) and limit of quantitation (LOQ) ranged from 0.01 to 0.12 ng/ml and 0.01 to 1.33 ng/ml, respectively. This method was used to quantify cyclophosphamide and doxorubicin surface contamination from wipe samples collected at a veterinary clinic following drug administration to canine-patients. Specific areas in the oncology treatment room identified as frequently contacted were sampled to determine the antineoplastic drug surface contamination that could lead to worker exposure through dermal contact, with cyclophosphamide and doxorubicin levels ranging from 6.68 to 17.4 pg cm-2 and 13.5 to 40.3 pg cm-2. Additionally, cyclophosphamide and doxorubicin wipe samples (n = 50) were obtained from two kennel surfaces and 10 canine-patients after chemotherapy. Samples were collected from the patients' coats before leaving the clinic and day after in the home environment to investigate the potential for dogs to be a source of household contamination. Cyclophosphamide was identified in samples collected at home in 4/5 canine-patients at levels ranging from 2.61 to 368 ng/sample, while doxorubicin was identified on kennel surfaces wiped post-treatment at levels ranging from 3.53 to 1655 pg cm-2. These findings support the ability of this method to detect contamination of these drugs in both occupational clinics and homes. The results set the stage for investigating contamination levels in various settings, such as human and veterinary clinics and home environments, as well as evaluating the effectiveness of decontamination products and protocols toward reducing workplace and environmental exposures.