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      Study protocol for the assessment of nurses internal contamination by antineoplastic drugs in hospital centres: a cross-sectional multicentre descriptive study

      protocol

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          Abstract

          Introduction

          Antineoplastic drugs (AD) are potentially carcinogenic and/or reprotoxic molecules. Healthcare professionals are increasingly exposed to these drugs and can be potentially contaminated by them. Internal contamination of professionals is a key concern for occupational physicians in the assessment and management of occupational risks in healthcare settings. Objectives of this study are to report AD internal contamination rate in nursing staff and to identify factors associated with internal contamination.

          Methods and analysis

          This trial will be conducted in two French hospital centres: University Hospital of Bordeaux and IUCT-Oncopole of Toulouse. The target population is nurses practicing in one of the fifteen selected care departments where at least one of the five studied AD is handled (5-fluorouracil, cyclophosphamide, doxorubicin, ifosfamide, methotrexate). The trial will be conducted with the following steps: (1) development of analytical methods to quantify AD urine biomarkers, (2) study of the workplace and organization around AD in each care department (transport and handling, professional practices, personal and collective protection equipments available) (3) development of a self-questionnaire detailing professional activities during the day of inclusion, (4) nurses inclusion (urine samples and self-questionnaire collection), (5) urine assays, (6) data analysis.

          Ethics and dissemination

          The study protocol has been approved by the French Advisory Committee on the Treatment of Information in Health Research (CCTIRS) and by the French Data Protection Authority (CNIL). Following the opinion of the Regional Committee for the Protection of Persons, this study is outside the scope of the provisions governing biomedical research and routine care (n°2014/87). The results will be submitted to peer-reviewed journals and reported at suitable national and international meetings.

          Trial registration number

          NCT03137641.

          Related collections

          Most cited references55

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          Analysis of anticancer drugs: a review.

          In the last decades, the number of patients receiving chemotherapy has considerably increased. Given the toxicity of cytotoxic agents to humans (not only for patients but also for healthcare professionals), the development of reliable analytical methods to analyse these compounds became necessary. From the discovery of new substances to patient administration, all pharmaceutical fields are concerned with the analysis of cytotoxic drugs. In this review, the use of methods to analyse cytotoxic agents in various matrices, such as pharmaceutical formulations and biological and environmental samples, is discussed. Thus, an overview of reported analytical methods for the determination of the most commonly used anticancer drugs is given. Copyright © 2011 Elsevier B.V. All rights reserved.
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            Evaluation of antineoplastic drug exposure of health care workers at three university-based US cancer centers.

            This study evaluated health care worker exposure to antineoplastic drugs. A cross-sectional study examined environmental samples from pharmacy and nursing areas. A 6-week diary documented tasks involving those drugs. Urine was analyzed for two specific drugs, and blood samples were analyzed by the comet assay. Sixty-eight exposed and 53 nonexposed workers were studied. Exposed workers recorded 10,000 drug-handling events during the 6-week period. Sixty percent of wipe samples were positive for at least one of the five drugs measured. Cyclophosphamide was most commonly detected, followed by 5-fluorouracil. Three of the 68 urine samples were positive for one drug. No genetic damage was detected in exposed workers using the comet assay. Despite following recommended safe-handling practices, workplace contamination with antineoplastic drugs in pharmacy and nursing areas continues at these locations.
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              • Record: found
              • Abstract: found
              • Article: not found

              Occupational exposures among nurses and risk of spontaneous abortion.

              We investigated self-reported occupational exposure to antineoplastic drugs, anesthetic gases, antiviral drugs, sterilizing agents (disinfectants), and X-rays and the risk of spontaneous abortion in US nurses.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2019
                10 November 2019
                : 9
                : 11
                : e033040
                Affiliations
                [1 ] departmentInserm U1219, Bordeaux Population Health , Université de Bordeaux , Bordeaux, France
                [2 ] departmentConsultation de Pathologie Professionnelle et de I'environnement, CHU Timone , AP-HM , Marseille, France
                [3 ] Univ. of Bordeaux , Bordeaux, France
                [4 ] departmentLaboratoire de Pharmacologie Clinique et Toxicologie , CHU de Bordeaux , Bordeaux, France
                [5 ] departmentBordeaux PharmacoEpi (BPE, CIC 1401) , Université de Bordeaux , Talence, France
                [6 ] departmentGH Pellegrin, Pôle de Santé Publique, Service de Médecine du Travail et Pathologies professionnelles , CHU de Bordeaux , Bordeaux, France
                Author notes
                [Correspondence to ] Dr Mireille Canal-Raffin; mireille.canal-raffin@ 123456u-bordeaux.fr
                Author information
                http://orcid.org/0000-0003-4140-1639
                Article
                bmjopen-2019-033040
                10.1136/bmjopen-2019-033040
                6858204
                31712349
                93c135af-d475-43c6-8c29-4a360517058e
                © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 17 July 2019
                : 18 September 2019
                : 07 October 2019
                Funding
                Funded by: French Ministry of Health;
                Award ID: grant reference number PHRC-I n°13-077
                Categories
                Occupational and Environmental Medicine
                Protocol
                1506
                1716
                Custom metadata
                unlocked

                Medicine
                occupational & industrial medicine,antineoplastic drugs,urine,occupational exposure,biomonitoring,nurses

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