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Markowiak, Till ; Ried, Michael ; Larisch, Christopher ; Nowak, Dennis ; Hofmann, Hans-Stefan ; Rakete, Stefan

Exposure to cisplatin in the operating room during hyperthermic intrathoracic chemotherapy

Markowiak, Till , Ried, Michael , Larisch, Christopher, Nowak, Dennis, Hofmann, Hans-Stefan and Rakete, Stefan (2021) Exposure to cisplatin in the operating room during hyperthermic intrathoracic chemotherapy. International Archives of Occupational and Environmental Health 95, pp. 399-407.

Date of publication of this fulltext: 07 Jul 2021 06:38
Article
DOI to cite this document: 10.5283/epub.46289


Abstract

Purpose Hyperthermic intrathoracic chemotherapy (HITOC) is an additive, intraoperative treatment for selected malignant pleural tumors. To improve local tumor control, the thoracic cavity is perfused with a cisplatin-containing solution after surgical cytoreduction. Since cisplatin is probably carcinogenic to humans, potential contamination of surfaces and pathways of exposure should be ...

Purpose Hyperthermic intrathoracic chemotherapy (HITOC) is an additive, intraoperative treatment for selected malignant pleural tumors. To improve local tumor control, the thoracic cavity is perfused with a cisplatin-containing solution after surgical cytoreduction. Since cisplatin is probably carcinogenic to humans, potential contamination of surfaces and pathways of exposure should be systematically investigated to enable risk assessments for medical staff and thus derive specific recommendations for occupational safety. Methods Wipe sampling was performed at pre-selected locations during and after ten HITOC procedures, including on the surgeon's gloves, for the quantitation of surface contaminations with cisplatin. After extraction of the samples with hydrochloric acid, platinum was determined as a marker for cisplatin by voltammetry. Results High median concentrations of cytostatic drugs were detected on the surgeons' (1.73 pg Cis-Pt/cm(2), IQR: 9.36 pg Cis-Pt/cm(2)) and perfusionists' (0.69 pg Cis-Pt/cm(2), IQR: 1.73 pg Cis-Pt/cm(2)) gloves. The display of the perfusion device showed partially elevated levels of cisplatin up to 4.92 pg Cis-Pt/cm(2) and thus could represent an origin of cross-contamination. In contrast, cisplatin levels on the floor surfaces in the area of the surgeon and the perfusion device or in the endobronchial tube were relatively low. Conclusion With a correct use of personal protective equipment and careful handling, intraoperative HITOC appears to be safe to perform with a low risk of occupational exposure to cisplatin.



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Details

Item typeArticle
Journal or Publication TitleInternational Archives of Occupational and Environmental Health
Publisher:Springer
Open Access Type:DEAL (Springer)
Place of Publication:NEW YORK
Volume:95
Page Range:pp. 399-407
Date30 June 2021
InstitutionsMedicine > Abteilung für Thoraxchirurgie
Identification Number
ValueType
10.1007/s00420-021-01738-3DOI
KeywordsANTINEOPLASTIC DRUGS; SURFACE CONTAMINATION; HOSPITAL PERSONNEL; PHARMACY; AGENTS; MESOTHELIOMA; SURGERY; WORKERS; URINE; Hyperthermic intrathoracic chemotherapy; HITOC; Cisplatin; Surface contamination; Occupational exposure
Dewey Decimal Classification600 Technology > 610 Medical sciences Medicine
StatusPublished
RefereedYes, this version has been refereed
Created at the University of RegensburgPartially
URN of the UB Regensburgurn:nbn:de:bvb:355-epub-462890
Item ID46289

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