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Chemical Decontamination of Hazardous Drugs: A Comparison of Solution Performances.

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Title: Chemical Decontamination of Hazardous Drugs: A Comparison of Solution Performances.
Authors: Simon, Nicolas1,2 nicolas.simon@univ-lille.fr, Odou, Pascal2, Decaudin, Bertrand2, Bonnabry, Pascal1, Fleury-Souverain, Sandrine1
Source: Annals of Work Exposures & Health. Mar2020, Vol. 64 Issue 2, p114-124. 11p. 2 Diagrams, 1 Chart.
Subjects: Environmental exposure prevention, Antineoplastic agents, Asepsis & antisepsis, Decontamination (From gases, chemicals, etc.), Mutagenicity testing, Safety, Solution (Chemistry), Surveys, Systematic reviews, Occupational hazards, User-centered system design
Abstract: Objectives Over the past 40 years, numerous actions have been undertaken to decrease the contamination of hospital facilities by intravenous conventional antineoplastic drugs (ICADs) such as centralizing compounding in pharmacies, using personal protective equipment, specific compounding, or infusion devices. As recently proposed in the monograph, an additional specific decontamination step must be envisaged. A recent literature review analysed and discussed the different solutions tested in terms of decontamination efficacy. This article aims to discuss the performance of these solutions in the framework of aseptic compounding. Methods The same dataset used in the previous literature review was reanalysed according to other parameters so as to select decontamination solutions: overall decontamination efficiency (EffQ), tested contaminants, and the risks of use in daily practice. Results Using an EffQ threshold of 90% resulted in discarding 26 out of the 59 solutions. Solutions were tested differently: 8 on 1 contaminant, 11 on 2 contaminants, and 14 solutions on between 3 and 11 contaminants. Three risks were identified to help make choices in routine practice: the mutagenicity of degradation products, the safety of operators and facilities, and respect for the aseptic environment. Conclusions From the results, performance is discussed according to specific situations: a one-time incident or the basic chemical contamination due to daily practice. Accordingly, the decontamination solution selected then required a risk analysis and an evaluation before implementing it in the daily practice of a compounding unit. [ABSTRACT FROM AUTHOR]
Copyright of Annals of Work Exposures & Health is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Chemical Decontamination of Hazardous Drugs: A Comparison of Solution Performances.
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  Data: <searchLink fieldCode="AR" term="%22Simon%2C+Nicolas%22">Simon, Nicolas</searchLink><relatesTo>1,2</relatesTo><i> nicolas.simon@univ-lille.fr</i><br /><searchLink fieldCode="AR" term="%22Odou%2C+Pascal%22">Odou, Pascal</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Decaudin%2C+Bertrand%22">Decaudin, Bertrand</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Bonnabry%2C+Pascal%22">Bonnabry, Pascal</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Fleury-Souverain%2C+Sandrine%22">Fleury-Souverain, Sandrine</searchLink><relatesTo>1</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Annals+of+Work+Exposures+%26+Health%22">Annals of Work Exposures & Health</searchLink>. Mar2020, Vol. 64 Issue 2, p114-124. 11p. 2 Diagrams, 1 Chart.
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  Data: <searchLink fieldCode="DE" term="%22Environmental+exposure+prevention%22">Environmental exposure prevention</searchLink><br /><searchLink fieldCode="DE" term="%22Antineoplastic+agents%22">Antineoplastic agents</searchLink><br /><searchLink fieldCode="DE" term="%22Asepsis+%26+antisepsis%22">Asepsis & antisepsis</searchLink><br /><searchLink fieldCode="DE" term="%22Decontamination+%28From+gases%2C+chemicals%2C+etc%2E%29%22">Decontamination (From gases, chemicals, etc.)</searchLink><br /><searchLink fieldCode="DE" term="%22Mutagenicity+testing%22">Mutagenicity testing</searchLink><br /><searchLink fieldCode="DE" term="%22Safety%22">Safety</searchLink><br /><searchLink fieldCode="DE" term="%22Solution+%28Chemistry%29%22">Solution (Chemistry)</searchLink><br /><searchLink fieldCode="DE" term="%22Surveys%22">Surveys</searchLink><br /><searchLink fieldCode="DE" term="%22Systematic+reviews%22">Systematic reviews</searchLink><br /><searchLink fieldCode="DE" term="%22Occupational+hazards%22">Occupational hazards</searchLink><br /><searchLink fieldCode="DE" term="%22User-centered+system+design%22">User-centered system design</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objectives Over the past 40 years, numerous actions have been undertaken to decrease the contamination of hospital facilities by intravenous conventional antineoplastic drugs (ICADs) such as centralizing compounding in pharmacies, using personal protective equipment, specific compounding, or infusion devices. As recently proposed in the <USP800> monograph, an additional specific decontamination step must be envisaged. A recent literature review analysed and discussed the different solutions tested in terms of decontamination efficacy. This article aims to discuss the performance of these solutions in the framework of aseptic compounding. Methods The same dataset used in the previous literature review was reanalysed according to other parameters so as to select decontamination solutions: overall decontamination efficiency (EffQ), tested contaminants, and the risks of use in daily practice. Results Using an EffQ threshold of 90% resulted in discarding 26 out of the 59 solutions. Solutions were tested differently: 8 on 1 contaminant, 11 on 2 contaminants, and 14 solutions on between 3 and 11 contaminants. Three risks were identified to help make choices in routine practice: the mutagenicity of degradation products, the safety of operators and facilities, and respect for the aseptic environment. Conclusions From the results, performance is discussed according to specific situations: a one-time incident or the basic chemical contamination due to daily practice. Accordingly, the decontamination solution selected then required a risk analysis and an evaluation before implementing it in the daily practice of a compounding unit. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Annals of Work Exposures & Health is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1093/annweh/wxz093
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      – Code: eng
        Text: English
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      Pagination:
        PageCount: 11
        StartPage: 114
    Subjects:
      – SubjectFull: Environmental exposure prevention
        Type: general
      – SubjectFull: Antineoplastic agents
        Type: general
      – SubjectFull: Asepsis & antisepsis
        Type: general
      – SubjectFull: Decontamination (From gases, chemicals, etc.)
        Type: general
      – SubjectFull: Mutagenicity testing
        Type: general
      – SubjectFull: Safety
        Type: general
      – SubjectFull: Solution (Chemistry)
        Type: general
      – SubjectFull: Surveys
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      – SubjectFull: Systematic reviews
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      – SubjectFull: Occupational hazards
        Type: general
      – SubjectFull: User-centered system design
        Type: general
    Titles:
      – TitleFull: Chemical Decontamination of Hazardous Drugs: A Comparison of Solution Performances.
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            NameFull: Simon, Nicolas
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              M: 03
              Text: Mar2020
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              Y: 2020
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