[Survey of Preventing Exposure Regarding Sweat in Patients Receiving Antineoplastic Agents at Base Hospitals for Promoting Hematopoietic Stem Cell].

This survey aimed to reveal the actual preventing exposure for handling of clothing and sweat of patients treated with anticancer drugs, following the publication of "Guideline for Preventing Occupational Exposure in Cancer Chemotherapy Drugs, 2019 Edition" (Guideline 2019). A survey was conducted among nurses working at 95 hematopoietic stem cell transplantation promotion base hospitals from September 1, 2023 to October 31, 2023. The response rate was 84.2% (80 facilities). Of the respondents, 45% wore gloves when touching patients' skin to administer anticancer drugs. Almost the nurses identified "urine" and "feces" as fluids on contaminated linen, while 14.1% also identified "sweat." For new staff, the results for preventing exposure education on "if touching the patients' skin" and "if handling clothing and linen" were 23.8% and 34.9%, respectively. This survey shows that nurses may not be following the Guideline 2019 for use of personal protective equipment and handling of clothes. Medical institutions handling anticancer drugs need to educate their staff for preventing occupational exposure.

The Effectiveness of Washing Clothing Contaminated With Cyclophosphamide: A Pilot Study.

BACKGROUND: Measures to prevent exposure to anticancer drugs mitigate health hazards for caregivers, family members, and healthcare workers caring for patients with cancer. Previous studies have reported that anticancer drugs were detected on the linens of patients receiving chemotherapy. OBJECTIVES: This pilot study investigated the effectiveness of the washing methods recommended by Japanese guidelines for linens contaminated with cyclophosphamide (CTX). METHODS: This study used 15 shirts contaminated with 10 mg of CTX divided into three study groups washed with or without detergent, with or without an additional clean shirt. The CTX level on each shirt was measured after washing. Residual CTX levels on the shirts were compared to the measurable level of 1 ng/cm2 as a criterion for evaluating efficacy. FINDINGS: Washing a garment twice, as recommended in the Japanese guidelines, is effective in removing CTX contamination from clothing with or without detergent. However, contaminated garments should be washed separately from uncontaminated clothing.

Duration of sweat cyclophosphamide excretion in patients undergoing a conditioning regimen of high-dose cyclophosphamide for hematopoietic stem-cell transplantation.

PURPOSE: To investigate the duration of cyclophosphamide (CPA) excretion in the sweat after administration when receiving high-dose CPA therapy as a conditioning regimen for hematopoietic stem-cell transplantation (HSCT). METHODS: Shirts and pillowcases samples (changed once a day) from 12 patients, categorized as groups 1 (n = 6), 2 (n = 4), and 3 (n = 2), receiving high-dose CPA therapy were collected, sealed, stored at 4°C, and mailed to an analytical facility for CPA estimation using LC-MS/MS. CPA was administered intravenously at a dose of 60 mg/kg on days 1, 2 (closed-system delivery for group 3), and samples were collected during days 1-4 (groups 1,3) or days 1-9 (group 2). RESULTS: CPA was detected in all 126 shirts and pillowcases. In 9 patients, excluding 1 patient who had fever during the study period and group 3 patients, the mean (range) rate of CPA excretion in sweat was 0.03% (0.01-0.12%). The mean CPA excretion in 9 patients adjusted for body weight was 19.9 µg/kg on day 1 and 0.3 µg/kg on day 4. CONCLUSIONS: This study showed that CPA was excreted for an extended duration in the patient's sweat, receiving a high-dose CPA therapy as a conditioning regimen against HSCT.