Exposure to anti-cancer drugs during preparation and administration. Investigations of an open and a closed system.

Systems for the preparation and administration of drugs are designed to ensure that the drug is not contaminated. They do not necessarily consider the work environment for the medical staff and new techniques are therefore desirable. The aim of this work is to compare a new closed system for the preparation and administration of drugs with the traditional technique with regard to airborne emission and surface spillage of drugs. Platinum, determined using adsorptive voltammetry, was used as the tracer for airborne emission. Air samples were collected during the preparation and administration, and the collected platinum on the filters was determined by adsorptive voltammetry. For determination of spills and leakage onto surfaces the radioisotope 99m-technetium was used as a tracer. The radiation from the isotope was determined on protective gloves and bench covers after preparation and administration. The mean airborne emission was 6 ng m(-3) with the closed system and 15 ng m(-3) with the traditional pump technique. The average surface spillage using the closed technique was 0.005 microL. This is significantly smaller than with the traditional technique, which resulted in an average spillage of 64 microL. Our results also show that the dominant part of the leakage is surface spillage. Inexperienced nurses could also adequately handle the closed system.