RESUMO
UNLABELLED: The study was plan to assess platinum (Pt) contamination in the operating room and its exposure to health workers during heated intraperitoneal perioperative chemotherapy (HIPEC) using oxaliplatin. MATERIALS AND METHODS: Pt was measured in urinary and environmental (air and surfaces) samples via inductively coupled plasma mass spectrometry (ICP-MS). Urinary samples were obtained from 11 members of the staff before and after the procedure and from 6 controls. Samples from 15 surfaces and from 3 filters from the air extractors were also analyzed for Pt contamination. RESULTS: Before HIPEC, Pt levels in urinary samples were similar in both the exposed and control groups; concentrations were below the limit of detection (i.e., 1.5 ng/L). No elevation was observed in the exposed group at the end of the procedure. Surgeon gloves were heavily contaminated. On other analyzed surfaces, lesser amounts of Pt were measured, ranging from 2 ng on the surgeon's hands to 183 ng on the forceps. All three air filters tested negative. CONCLUSION: No contamination of healthcare workers or of the air in the operating room was detected. However, the heavy contamination of the surgeon's gloves demonstrates why doubling of specialized gloves for the surgeon should be mandatory.
Assuntos
Antineoplásicos/administração & dosagem , Hipertermia Induzida/métodos , Corpo Clínico Hospitalar , Exposição Ocupacional/análise , Compostos Organoplatínicos/administração & dosagem , Platina/análise , Poluentes Ocupacionais do Ar/análise , Carcinoma/tratamento farmacológico , Carcinoma/cirurgia , Terapia Combinada/métodos , Monitoramento Ambiental/métodos , Luvas Cirúrgicas , Humanos , Infusões Parenterais , Exposição por Inalação , Salas Cirúrgicas , Oxaliplatina , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/cirurgia , Platina/urinaRESUMO
The aim of this study was to evaluate air and surface contaminations, and internal contamination of healthcare workers during open-abdomen HIPEC using oxaliplatin. Platinum (Pt) was measured in urine of exposed workers and in multiple air and surface samples. Three successive HIPEC procedures were investigated in each of the two hospitals participating in the study. Analysis of air samples did not detect any oxaliplatin contamination. Heavy contamination of the operating table, the floor at the surgeon's feet, and the surgeon's overshoes were observed. Hand contamination was observed in surgeons using double gloves for intra-abdominal chemotherapy administration, but not in those using three sets of gloves. Pt was not detected in urine samples obtained after HIPEC (<5 ng/L). The main risk of HIPEC is related to direct or indirect skin exposure and can be prevented by correct use of adapted protective equipment.