Environmental Monitoring of Occupational Exposure to Cyclophosphamide Drug in Two Iranian Hospitals

Background: Most cytotoxic drugs are unable to discriminate normal cells from cancer cells and they interfere with cell division and could lead to harmful effects such as carcinogenicity, genetic mutation, and teratogenicity. In order to assess dermal occupational exposure to cytotoxic drugs, surface sampling was used to determine the residual drugs on the working surfaces, as well as the effectiveness of the procedures for cleaning the treatment area. Objectives: This study was designed with the aim to investigate the contamination of surfaces and hand skin of the oncology staff with cyclophosphamide drug. Methods: Environmental and personal monitoring were performed by collecting wipe and dermal samples over the span of a month at two different times of handling of cytotoxic drugs or other work like cleaning and patient admission. Samples were taken from exposed oncology staff after administering cyclophosphamide to patient. Results: The method of sampling and analysis of cyclophosphamide over a linear range surface density of 30 - 180 ng/cm2 was validated. Cyclophosphamide was detected on some wipe samples at two hospitals. Results of this study demonstrated that some staff had dermal exposure to cyclophosphamide and it was also revealed that working surfaces were also contaminated with this drug. Conclusions: Health workers with present work practice are at risk with cytotoxic drugs. Therefore, adequate training and control measures are justified.