Antineoplastic Drug Contamination in the Urine of Canadian Workers

Hon C-Y, Teschke K, Shen H, Demers PA, Venners S.  Antineoplastic Drug Contamination in the Urine of Canadian Workers.  International Archives of Occupupational and Environmental Health 2015 Oct;88(7):933-41.

PURPOSE: The purpose of this study was to quantify the urine concentration of non-metabolized cyclophosphamide (CP), a commonly administered antineoplastic drug, among potentially exposed Canadian healthcare workers and to identify factors associated with the drug concentration levels.

RESULTS: We collected 201 urine samples, and 55 % (n = 111) had detectable levels of CP. All eight job categories evaluated had some samples with detectable levels of CP, with unit clerks having the highest average level. Workers who worked in the drug administration unit, but were not responsible for administering the drugs to patients, i.e., volunteers, oncologists, ward aides, and dieticians, had the largest proportion of samples exceeding the LOD. Two factors were found to be significantly associated with urinary CP concentration: (1) Workers who had a duty to handle antineoplastic drugs had higher concentration levels, and (2) workers who had not received safe drug handling training had higher levels of CP in their urine compared with those who had.

CONCLUSIONS: The presence of non-metabolized CP in urine confirms that, despite the existence of control measures, a broad range of healthcare workers are at risk of exposure to antineoplastic drugs.