Health care worker exposure to aerosolized ribavirin: biological and air monitoring.

Aerosolized ribavirin is administered frequently to treat severe respiratory syncytial virus infections. The drug's potential reproductive effects in occupationally exposed workers remains a concern among health care workers. In this evaluation, we measured urinary ribavirin concentrations in occupationally exposed health care workers. Ribavirin was detected in 16 of 26 (62%) post-work-shift urine samples that had been provided by nurses, and in five of 22 (23%) post-work-shift urine samples that had been provided by respiratory therapists (range, < 0.01 to 0.22 mumol/L). We also measured airborne ribavirin concentrations in the personal breathing zones of nurses. Ventilators and other administration units that were enclosed by an aerosol containment tent produced significantly lower airborne ribavirin exposures than administration units without a containment tent did (range, < 2.5 to 78 micrograms/m3). On the basis of this and other evaluations of airborne ribavirin concentrations, we recommend using aerosol containment systems with all types of ribavirin administration units except mechanical ventilators.