International Journal of Cancer Management

Published by: Kowsar

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

Mansour Azari 1 , Davod Panahi 2 , * , Mohammad Esmaeil Akbari 3 , Hamid Reza Mirzaei 4 , Hamid Reza Rezvani 5 , Rezvan Zendehdel 2 , Yadollah Mehrabi 2 and Majid Bayatian 2
Authors Information
1 Safety Promotion and Prevent of Injuries Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Cancer Research Center, Shohadae Tajrish Hospital, Department of Radiation Oncology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5 Department of Hematology and Oncology, Taleghani General Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Article information
  • Iranian Journal of Cancer Prevention: January 2017, 10 (1); e7229
  • Published Online: December 7, 2016
  • Article Type: Research Article
  • Received: May 27, 2016
  • Revised: June 28, 2016
  • Accepted: December 3, 2016
  • DOI: 10.17795/ijcp-7229

To Cite: Azari M, Panahi D, Akbari M E, Mirzaei H R, Rezvani H R, et al. Environmental Monitoring of Occupational Exposure to Cyclophosphamide Drug in Two Iranian Hospitals, Int J Cancer Manag. 2017 ; 10(1):e7229. doi: 10.17795/ijcp-7229.

Copyright © 2016, Iranian Journal of Cancer Prevention. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Methods
4. Results
5. Discussion
  • 1. Black DJ, Livingston RB. Antineoplastic drugs in 1990. A review (Part II). Drugs. 1990; 39(5): 652-73[PubMed]
  • 2. Otto T, Rubben H. [Prevention of bladder cancer]. Urologe A. 2004; 43(5): 562-4[DOI][PubMed]
  • 3. Connor TH, Anderson RW, Sessink PJ, Broadfield L, Power LA. Surface contamination with antineoplastic agents in six cancer treatment centers in Canada and the United States. Am J Health Syst Pharm. 1999; 56(14): 1427-32[PubMed]
  • 4. Sorsa M, Anderson D. Monitoring of occupational exposure to cytostatic anticancer agents. Mutat Res. 1996; 355(1-2): 253-61[PubMed]
  • 5. Moretti M, Bonfiglioli R, Feretti D, Pavanello S, Mussi F, Grollino MG, et al. A study protocol for the evaluation of occupational mutagenic/carcinogenic risks in subjects exposed to antineoplastic drugs: a multicentric project. BMC Public Health. 2011; 11: 195[DOI][PubMed]
  • 6. NIOSH. . Preventing occupational exposures to antineoplastic and other hazardous drugs in healthcare settings. 2004;
  • 7. Pharmacists ASoH-S. . ASHP guidelines on handling hazardous drugs. . Am J Health-Syst Pharm. 2006; 63(1): 1172-93
  • 8. Connor TH, Anderson RW, Sessink PJ, Spivey SM. Effectiveness of a closed-system device in containing surface contamination with cyclophosphamide and ifosfamide in an i.v. admixture area. Am J Health Syst Pharm. 2002; 59(1): 68-72[PubMed]
  • 9. Harrison BR, Peters BG, Bing MR. Comparison of surface contamination with cyclophosphamide and fluorouracil using a closed-system drug transfer device versus standard preparation techniques. Am J Health Syst Pharm. 2006; 63(18): 1736-44[DOI][PubMed]
  • 10. Sessink PJ, Rolf M-A, Ryden NS. Evaluation of the PhaSeal hazardous drug containment system. Hospital Pharmacy. 1999; 34(11): 1311-7
  • 11. Zock MD, Soefje S, Rickabaugh K. Evaluation of surface contamination with cyclophosphamide following simulated hazardous drug preparation activities using two closed-system products. J Oncol Pharm Pract. 2011; 17(1): 49-54[DOI][PubMed]
  • 12. Wrigley PFM. Cancer chemotherapy handbook. J Royal Soc Med. 1980; 73(10): 758
  • 13. Overall evaluations of carcinogenicity: an updating of IARC Monographs volumes 1 to 42. IARC Monogr Eval Carcinog Risks Hum Suppl. 1987; 7: 1-440[PubMed]
  • 14. Crauste-Manciet S, Sessink PJ, Ferrari S, Jomier JY, Brossard D. Environmental contamination with cytotoxic drugs in healthcare using positive air pressure isolators. Ann Occup Hyg. 2005; 49(7): 619-28[DOI][PubMed]
  • 15. Sessink PJ, Anzion RB, Van den Broek PH, Bos RP. Detection of contamination with antineoplastic agents in a hospital pharmacy department. Pharm Weekbl Sci. 1992; 14(1): 16-22[PubMed]
  • 16. Hon CY, Astrakianakis G, Danyluk Q, Chu W. Pilot Evaluation of Dermal Contamination by Antineoplastic Drugs among Hospital Pharmacy Personnel. Can J Hosp Pharm. 2011; 64(5): 327-32[PubMed]
  • 17. Hedmer M, Jonsson BA, Nygren O. Development and validation of methods for environmental monitoring of cyclophosphamide in workplaces. J Environ Monit. 2004; 6(12): 979-84[DOI][PubMed]
  • 18. Larson RR, Khazaeli MB, Dillon HK. Monitoring method for surface contamination caused by selected antineoplastic agents. Am J Health Syst Pharm. 2002; 59(3): 270-7[PubMed]
  • 19. Connor TH, DeBord DG, Pretty JR, Oliver MS, Roth TS, Lees PS, et al. Evaluation of antineoplastic drug exposure of health care workers at three university-based US cancer centers. J Occup Environ Med. 2010; 52(10): 1019-27[DOI][PubMed]
  • 20. Sugiura S, Asano M, Kinoshita K, Tanimura M, Nabeshima T. Risks to health professionals from hazardous drugs in Japan: a pilot study of environmental and biological monitoring of occupational exposure to cyclophosphamide. J Oncol Pharm Pract. 2011; 17(1): 14-9[DOI][PubMed]
  • 21. Chu WC, Hon CY, Danyluk Q, Chua PP, Astrakianakis G. Pilot assessment of the antineoplastic drug contamination levels in British Columbian hospitals pre- and post-cleaning. J Oncol Pharm Pract. 2012; 18(1): 46-51[DOI][PubMed]
  • 22. Kennedy ER, Fischbach TJ, Song R, Eller PM, Shulman SA. Guidelines for air sampling and analytical method development and evaluation. 1994;
  • 23. Sabatini L, Barbieri A, Tosi M, Violante FS. A new high-performance liquid chromatographic/electrospray ionization tandem mass spectrometric method for the simultaneous determination of cyclophosphamide, methotrexate and 5-fluorouracil as markers of surface contamination for occupational exposure monitoring. J Mass Spectrom. 2005; 40(5): 669-74[DOI]
  • 24. Sessink PJ, Scholtes MM, Anzion RB, Bos RP. Determination of cyclophosphamide in urine by gas chromatography-mass spectrometry. J Chromatogr. 1993; 616(2): 333-7[PubMed]
  • 25. Ensslin AS, Stoll Y, Pethran A, Pfaller A, Rommelt H, Fruhmann G. Biological monitoring of cyclophosphamide and ifosfamide in urine of hospital personnel occupationally exposed to cytostatic drugs. Occup Environ Med. 1994; 51(4): 229-33[PubMed]
  • 26. Turci R, Sottani C, Spagnoli G, Minoia C. Biological and environmental monitoring of hospital personnel exposed to antineoplastic agents: a review of analytical methods. J Chromatogr B Analyt Technol Biomed Life Sci. 2003; 789(2): 169-209[PubMed]
  • 27. Panahi D, Azari M, Akbari ME, Zendehdel R, Mirzaei HR, Hatami H, et al. Development of a new method for sampling and monitoring oncology staff exposed to cyclophosphamide drug. Environ Monit Assess. 2016; 188(4): 238[DOI][PubMed]
  • 28. Feyerherm F, Westland J, Marvin C. Quantitation and confirmation of blood ethanol content using a new GC/FID/MS blood alcohol analyzer. Agilent technologies. 2014;
  • 29. Martins I, Rosa HVD, Apostoli P. Cyclophosphamide identification in wipe test by GC-MS and solid phase extraction. Revista Brasileira de Ciencias Farmaceuticas. 2004; 40(1): 67-73
  • 30. Schmaus G, Schierl R, Funck S. Monitoring surface contamination by antineoplastic drugs using gas chromatography-mass spectrometry and voltammetry. Am J Health Syst Pharm. 2002; 59(10): 956-61[PubMed]
  • 31. Acampora A, Castiglia L, Miraglia N, Pieri M, Soave C, Liotti F, et al. A case study: surface contamination of cyclophosphamide due to working practices and cleaning procedures in two Italian hospitals. Ann Occup Hyg. 2005; 49(7): 611-8[DOI][PubMed]
  • 32. Castiglia L, Miraglia N, Pieri M, Simonelli A, Basilicata P, Genovese G, et al. Evaluation of occupational exposure to antiblastic drugs in an Italian hospital oncological department. J Occup Health. 2008; 50(1): 48-56[PubMed]
  • 33. Fransman W, Vermeulen R, Kromhout H. Dermal exposure to cyclophosphamide in hospitals during preparation, nursing and cleaning activities. Int Arch Occup Environ Health. 2005; 78(5): 403-12[DOI][PubMed]
  • 34. Sessink PJ, Leclercq GM, Wouters DM, Halbardier L, Hammad C, Kassoul N. Environmental contamination, product contamination and workers exposure using a robotic system for antineoplastic drug preparation. J Oncol Pharm Pract. 2015; 21(2): 118-27[DOI][PubMed]
  • 35. Connor TH, Zock MD, Snow AH. Surface wipe sampling for antineoplastic (chemotherapy) and other hazardous drug residue in healthcare settings: Methodology and recommendations. J Occup Environ Hyg. 2016; : 1-33
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