Source avec lien : Toxicology Letters, 298, 12/1/2018. 10.1016/j.toxlet.2018.05.031
L’utilisation de médicaments cytotoxiques pose un risque professionnel pour le personnel de la salle d’opération. Cette étude a examiné l’exposition potentielle du personnel médical par des mesures de biosurveillance et de contamination de surface, au cours d’une procédure de chimiothérapie hyperthermique intrapéritonéale (HIPEC) et d’une procédure de chimiothérapie aérosol intrapéritonéale sous pression (PIPAC) sous pression. Il semble y avoir peu de risque d’exposition aux médicaments à base de platine au cours des négociations HIPEC et PIPAC, à condition que les mesures de sécurité adéquates soient mises en œuvre.
BACKGROUND: Hyperthermic intraperitoneal chemotherapy (HIPEC) has been introduced over the last decade for the treatment of peritoneal carcinomatosis. In this procedure, heated cytotoxic drugs are administered directly into the abdominal cavity, ensuring cancer cells to be exposed while reducing systemic toxicity. More recently, pressurized intraperitoneal aerosol chemotherapy (PIPAC), where the chemotherapeutic drug is injected into the peritoneal cavity as an aerosol under pressure, has been proposed to patients in palliative situation, as a new approach. The amount of drug used is up to 10 fold lower than in HIPEC. The use of cytotoxic drugs poses an occupational risk for the operating room personnel. This study investigated the potential exposure of the medical staff by biomonitoring and surface contamination measurements, during a HIPEC procedure and a PIPAC procedure. METHOD: Wipe samples were collected from various locations in operating rooms including gloves, hands, devices and floor. Urines samples were collected from 10 volunteers of the medical staff and from a control group. The platinum analysis was performed by inductively coupled plasma mass spectrometry. RESULTS: Significant contaminations were observed on the floor, gloves, shoes and devices. However, urinary platinum was below the limit of quantification (<10 ng/L) for more than 50% of samples from the healthcare workers performing HIPEC and PIPAC. Concentrations did not differ significantly from those reported for the control group. CONCLUSION: There appears to be little risk of exposure to platinum drugs during HIPEC and PIPAC providing the adequate safety measures are implemented.
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