Evaluation of Current Hazardous Drug Exposure Control in Community Pharmacy. (June 2022)

• Record Type: Journal Article
• Authors: Papastergiou, John; Smiley, Tom
• Is Part Of: Journal of pharmacy technology. Volume 38:Number 3(2022)
• Page Start: 155
• Page End: 158
• Publication Date: 2022-06
• Subjects: hazardous drug detection -- decontamination -- community pharmacy; Pharmacy -- Periodicals; Pharmaceutical technology -- Periodicals; Chemotherapy -- Periodicals; 615.105
• DOI: 10.1177/87551225211072743
• Languages: English
• ISSNs: 8755-1225

Abstract

Purpose : To evaluate effectiveness of current hazardous drug exposure control practices in community pharmacies through identification of commonly contaminated surfaces. We also assessed the decontamination effectiveness of 5 different cleaning agents.Methods : This study was prospective and nonrandomized and conducted in 2 phases. In phase 1, 15 common areas used in the dispensing process were tested at each of 4 pharmacies in Toronto Ontario, Canada. Testing was conducted using the BD ® HD Check System, a rapid, point-of-care, hazardous drug detection system that is able to identify contamination with methotrexate (MTX) and cyclophosphamide (CYP) and doxorubicin. In phase 2, 5 different cleaning agents (70% isopropyl alcohol, Lysol ® spray, Ecolab ® retail multiquat sanitizer, Ecolab retail multisurface and glass cleaner with peroxide, and Ecolab QSR heavy-duty degreaser) were tested for their ability to eliminate contamination.Results : All 4 pharmacies tested positive for contamination with MTX (25.8% of surfaces). Contamination with CYP was less frequent, with only 3 sites and 18.2% of surfaces testing positive. Of the 5 cleaning agents tested, only Ecolab QSR heavy-duty degreaser was able to eliminate contamination with MTX. None of the agents were successful against CYP.Conclusions: The results illustrate an unacceptable prevalence of hazardous drug contamination in community pharmacy settings. The BD HD Check System can serve to rapidly detect common high-risk areas for surface contamination. Decontamination protocols against MTX may include Ecolab QSR heavy-duty degreaser. Novel agents must be identified to remove contamination caused by CYP.