Hazardous drugs levels in compounding area surfaces of Hospital Pharmacies Services: multicentric study

Abstract Objective: Hazardous drugs presence at Hospital Pharmacies has been demonstrated in numerous studies. This study aims to analyze the presence and levels of hazardous drugs at Spanish Hospital Pharmacies and the influence of different aspects on them. Method: We developed a cross test at Hospital Pharmacies hazardous drugs compounding surfaces of ten Spanish hospitals. An independent laboratory determined cyclophosphamide, iphosphamide and 5-fluorouracile levels in samples recovered. Annual number of hazardous drugs compounded, as well as the number of preparations developed the testing day was registered. We also registered cleaning and decontamination processes and the drug transfer device used at each hospital. Results: 204 samples were analyzed. Hazardous drugs presence was confirmed in all participant hospitals. We observed a 49%, 23% and 10% of positive samples for cyclophosphamide, iphosphamide and 5-fluorouracile. Median levels (first-third quartile) of cyclophosphamide, iphosphamide and 5-fluorouracile were 0.05 ng/cm2 (0.03-0.23), 0.03 ng/cm2 (0.03-0.06) y 0.31 ng/cm2 (0.3-0.59) respectively. Conclusions: Present study confirms hazardous drugs presence on compounding areas at Spanish Hospital Pharmacies departments. We observed a significant variability between participant hospitals, as well as between tested locations. Samples with more positive results were cabine airfoils and floors in front of them. The number of preparations had no influence on results observed. Variability observed points outs the need to standardized compounding hazardous drugs processes.