John Libbey Eurotext

Bulletin du Cancer


Urinary cyclophosphamide excretion of pharmacy technicians handling antineoplastic drugs Volume 90, issue 10, Octobre 2003

Service pharmacie, Centre régional de lutte contre le cancer Léon‐Bérard, 28, rue Laennec, 69008 Lyon Ingénieur de recherche, CRNHL, Faculté Laennec, 8, rue G.‐Paradin, 69372 Lyon Cedex 08

The first study in which amounts of cyclophosphamide were found in the urine of nurses handling cytototoxic drugs using gas chromatography was published in 1984. We carried out a similar investigation on six pharmacy technicians involved in the preparation of antineoplastic agents (25 000 doses per year) but the analysis was performed with a more sensitive method : gas chromatography‐mass spectrometry (LOQ ∓ 0,1 ng\ml). Cyclophosphamide was found in two urine samples (out of 104) from two different workers. The rates detected were just above the limit of quantification. No correlation was found between the amounts of cyclophosphamide handled and the urinary excretion. The mean urinary levels measured in this study are lower than those reported by other investigators. In addition, only 1.9% of the collected samples are positive to cyclophosphamide. The drug was detected for two different technicians during two different sampling periods, suggesting that pollution is not repeated. No relationship could be seen between urinary detection of cyclophosphamide and individual or general work in the cytotoxic preparation unit. As supported by recent datas, transdermal resorption seems to be the most important way of incorporation. Further investigations are necessary to prove this hypothesis if we want to prevent occupational exposure of people handling these drugs. ▴