In external oncology units, it is common for the arms of chairs used by patients to be contaminated by medications which can pose a risk to the health of patients and nursing staff. This contamination often occurs when removing the needle used to inject this type of medication.
According to a study carried out in 2022 in 124 Canadian hospitals, 81% of samples taken from chair arms contained traces of contaminants. And in 74% of cases, it involved traces of cyclophosphamide, an agent commonly used in chemotherapy that contains molecules that cling to surfaces, requiring specific cleaning protocols.
This problem is at the heart of the surveillance program in which Professor Jean-François Bussières, from the Faculty of Pharmacy of the University of Montreal, participates, who, with Cynthia Tanguay, from his research unit in pharmaceutical practice, and his students Mathilde Dupré and Manon Marc, led a research project aimed at evaluating the effectiveness of six decontamination scenarios and the results of which were published in The Canadian Journal of Hospital Pharmacy.
Six decontamination simulations
Jean-François Bussières
Credit: Courtesy
The experiment involved 59 samples of silicone fabric, similar to that of medical chairs. The researchers intentionally contaminated 56 of these samples with a precise dose of cyclophosphamide (10 micrograms) to determine the effectiveness of different cleaning solutions.
Decontamination products tested included quaternary ammonium, 0.5% hydrogen peroxide, 0.005% detergent, and 0.5% sodium hypochlorite. All were poured onto microfiber wipes with which three successive cleanings were carried out. Subsequently, residual contamination was measured using a liquid chromatography system and tandem spectrometry.
The average agent efficiency was greater than or equal to 99.79%. And regardless of the agent used, the effectiveness was 99.3% after the first cleaning, 99.9% after the second, and 99.95% after the third.
“Our simulations confirm that several decontamination solutions work, including sodium hypochlorite, that is to say the famous bleach,” indicates Jean-François Bussières. The other products also gave good results and this is why we recommend alternating antiseptic and disinfectant solutions in order to prevent bioresistance in external oncology units.”
“Although injection chairs are cleaned between each patient, traces of dangerous medications can sometimes remain on the arms of the chairs and our results will help pharmacists, nurses and technicians reduce their risk of exposure, which will also be less for patients,” assures the professor, who was head of the pharmacy department at CHU Sainte-Justine for 26 years.
A unique monitoring program
This study is part of a unique monitoring program implemented in 2010 at CHU Sainte-Justine. This program aims to measure and reduce the exposure of healthcare personnel to dangerous drugs such as those used in chemotherapy.
“Every year, we publish the results of our work and we manage to reduce the risks of contamination through various interventions, guidelines, webinars and targeted strategies to protect healthcare workers,” rejoices Jean-François Bussières.
This program also inspired the development of a Canadian program now applied in more than 130 hospitals across the country.
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