Comparative Study of Syringe Contamination by Hazardous Drugs

Aim e purpose of this study was to compare surface contamination resulting from standard syringe plungers and cylinders compared to using the EQUASHIELD® Syringe Unit. Method e contamination level of standard syringes was compared to that of EQUASHIELD® Syringe Units, after repeated pharmaceutical manipulations using an antineoplastic (Cyclophosphamide) drug. Results Signi cant levels of up to 0.5 milligrams contamination were found on all sampled standard syringe plungers and cylinders. Signi cantly lower contamination levels were found on EQUASHIELD's fully enclosed Syringe Units. Since the late 1970s numerous studies have documented the potential health risks associated with exposure to hazardous drugs in healthcare settings. Evidence has indicated that exposure to these dangerous substances can lead to acute and long term health complications such as infertility, miscarriage, birth defects, leukemia and other types of cancer. It has been clearly demonstrated that workers are in danger of exposure to these drugs at all contact stages, including drug manufacture, transport, distribution, receipt, storage, preparation, administration, waste handling, and equipment repair and maintenance (ASHP, 2006). Identifying and quantifying possible sources of contamination is of great importance, as it can contribute to a better understanding of the issues involved in the safe handling of hazardous drugs, as well as to constant improvement of drug handling methods, the development of more e ective protective equipment, and the establishment of better pharmacy and bedside compounding and administration safety policies and regulations. e National Institute for Occupational Safety and Health (NIOSH, 2004) has recommended the use of an e ective closed-system drug transfer device (CSTD) in order to facilitate safe, enclosed drug transfers and minimize the exposure to hazardous drugs and their adverse e ects. When examining surface contamination, studies using CSTDs have shown a signi cant reduction in contamination levels, yet detectable levels of hazardous substances were still found, suggesting that the systems are not entirely safe and that environmental contamination still places healthcare workers at risk of exposure. In 2005, a study using a surface monitoring technique further explored environmental contamination, when it speci cally examined the possibility of syringe plunger contamination during routine drug preparations at hospital pharmacies. Contamination by Cyclophosphamide was con rmed, quanti ed, and localized on a standard syringe plunger, in order to determine what quantity of the Cytotoxic agents come into contact with the operators' gloves (Favier, Gilles, Latour, Desage and Giammarile, 2005). us, results revealed a previously undetected route of exposure whereby drug residuals on the syringe plunger contaminate gloves and the work environment, and most alarmingly, place unprotected hospital sta who handle the syringe outside of the safety cabinet, at great danger.