Addition of a Novel Qualitative Technique to Standard Quantitative Practices for Evaluation of Hazardous Drug Exposure in a Canadian Hospital Setting.

Background: Current recommendations from regulatory authorities suggest quantitative surface sampling for detection of hazardous drugs at least once every 6 months. A more frequent and efficient process for hazardous drug testing might reduce the safety risks associated with exposure to these agents. Objectives: The primary objective was to assess the findings of surface testing based on traditional quantitative sampling methods relative to the findings of qualitative surface sample testing with the BD HD Check system. The secondary objectives included assessment of the ease of integrating qualitative sampling into pharmacy protocols and identification of opportunities to enhance patient and staff education and safety. Methods: Samples from 23 unique surfaces were tested concurrently once a month for 5 months using a quantitative surface sampling method and the qualitative BD HD Check system on adjacent 12 inch × 12 inch (30.5 cm × 30.5 cm) surface areas. The presence or absence of cyclophosphamide, methotrexate, and/or doxorubicin contamination was assessed by each of the 2 testing methods. The BD HD Check system was also assessed for ease of use and efficiency. Results: Ten areas of contamination were identified over the 5-month period. Nine were detected by the BD HD Check system and one by the quantitative system. The BD HD Check system was easy to use, with results available in less than 10 minutes per area tested. Conclusions: The BD HD Check system allows for more timely identification of surface contamination with hazardous drugs than the standard sampling protocol. The discrepancy in results between the 2 methods of hazardous drug surface sampling requires further investigation.

Contexte: Les recommandations actuelles des autorités de réglementation suggèrent de procéder à un échantillonnage de surface quantitatif pour la détection de médicaments dangereux au moins une fois tous les 6 mois. Un processus de test des médicaments dangereux plus fréquent et plus efficace pourrait réduire les risques de sécurité associés à l'exposition à ces agents. Objectifs: L'objectif principal visait à évaluer les résultats de l'échantillonnage de surface basé sur les méthodes d'échantillonnage quantitatives traditionnelles par rapport aux résultats des tests qualitatifs d'échantillons de surface effectués avec le système de détection des médicaments dangereux BD HD Check. Les objectifs secondaires comprenaient l'évaluation de la facilité d'intégration de l'échantillonnage qualitatif dans les protocoles pharmaceutiques et l'identification des occasions d'améliorer l'éducation et la sécurité des patients et du personnel. Méthodologie: Des échantillons provenant de 23 surfaces uniques ont été testés simultanément une fois par mois pendant 5 mois à l'aide d'une méthode d'échantillonnage de surface quantitative et du système BD HD Check sur des surfaces adjacentes de 12 pouces × 12 pouces (30,5 cm × 30,5 cm). La présence ou l'absence de contamination par le cyclophosphamide, le méthotrexate et/ou la doxorubicine a été évaluée à l'aide de chacune des 2 méthodes de test. La facilité d'utilisation et l'efficacité du système BD HD Check ont également fait l'objet d'une évaluation. Résultats: Dix zones de contamination ont été identifiées sur la période de 5 mois. Neuf ont été détectées par le système BD HD Check et une par le système quantitatif. Le système BD HD Check était facile à utiliser et les résultats étaient prêts en moins de 10 minutes par zone testée. Conclusions: Le système BD HD Check permet d'identifier plus rapidement la contamination de surface par médicaments dangereux que le protocole d'échantillonnage standard. L'écart dans les résultats entre les 2 méthodes d'échantillonnage de surface des médicaments dangereux nécessite une étude plus approfondie.

Personal Protective Equipment Use and Surface Contamination With Antineoplastic Drugs: The Impact of the COVID-19 Pandemic.

BACKGROUND: Surface contamination with antineoplastic drugs (ADs) is persistent. The use of personal protective equipment (PPE) is recommended to reduce exposure to ADs. OBJECTIVES: This study explored the impact of the COVID-19 pandemic on nurses' PPE use and surface contamination with ADs. METHODS: Demographic characteristics, PPE use, and associated factors were assessed on two inpatient oncology units where etoposide and cyclophosphamide were administered before (N = 26) and during the COVID-19 pandemic (N = 31). FINDINGS: PPE use when handling contaminated excreta was significantly higher during the pandemic. Perceived risk of chemotherapy exposure was significantly associated with greater PPE use when handling AD-contaminated excreta, and conflict of interest was related to less PPE use during AD administration and handling of AD-contaminated excreta. During the pandemic, surface contamination with etoposide increased in shared areas and decreased in patient rooms.

Development and validation of a quantitative wipe sampling method to determine platinum contamination from antineoplastic drugs on surfaces in workplaces at Swedish hospitals.

INTRODUCTION: Antineoplastic drugs (ADs) are frequently used pharmaceuticals in the healthcare, and healthcare workers can be occupationally exposed to ADs. Monitoring of surface contamination is a common way to assess occupational exposure to ADs. The objective was to develop and validate a sensitive and quantitative monitoring method to determine surface contaminations of Pt as a marker for Pt-containing ADs. The surface contaminations of Pt-containing ADs were monitored at four Swedish hospital workplaces. METHODS: An analytical method was developed based on inductively coupled plasma mass spectrometry. The wipe sampling procedure was validated regarding different surface materials. The stability of collected wipe samples was investigated. Workplace surfaces were monitored by wipe sampling to determine contaminations of Pt-containing ADs. RESULTS: A wipe sampling and analytical method with a limit of detection of 0.1 pg Pt/cm2 was developed. Pt was detected in 67% of the wipe samples collected from four workplaces, and the concentrations ranged from <0.10 to 21100 pg/cm2. In 4% of samples, the detected surface contaminations of Pt in three hospital wards were above proposed hygienic guidance value (HGV) of Pt. In the hospital pharmacy, 9% of the detected surface contaminations of Pt were above lowest proposed HGV. CONCLUSIONS: A user-friendly, specific, and sensitive method for determination of surface contaminations of Pt from ADs in work environments was developed and validated. A large variation of contaminations was observed between detected surface contaminations of Pt in samples collected in wards, and it likely reflects differences in amounts handled and work practices between the wards.

Decay pattern of SARS-CoV-2 RNA surface contamination in real residences.

The COVID-19 pandemic has provided valuable lessons that deserve deep thought to prepare for the future. The decay pattern of surface contamination by SARS-CoV-2 RNA in the residences of COVID-19 patients is important but still unknown. We collected 2,233 surface samples from 21 categories of objects in 141 residences of COVID-19 patients in Shanghai when attacked by the omicron variant in spring 2022. Several characteristics of the patients and their residences were investigated to identify relevant associations. The decay of contamination was explored to determine the persistence. Approximately 8.7% of the surface samples were tested positive for SARS-CoV-2 RNA. The basin, water tap, and sewer inlet had the highest positive rates, all exceeding 20%. Only time was significantly associated with the level of surface contamination with SARS-CoV-2, showing a negative association. The decrease fit a first-order decay model with a decay rate of 0.77 ± 0.07 day-1, suggesting a 90% reduction in three days. Positive associations between the cumulative number of newly diagnosed patients in the same building and the positive rate of SARS-CoV-2 RNA in the public corridor were significant during the three days. Our results, in conjunction with the likely lower infectivity or viability, demonstrate that fomite transmission played a limited role in COVID-19 spread. The time determined SARS-CoV-2 RNA contamination, which was reduced by three days. This study is the first to show the decay patterns of SARS-CoV-2 contamination in real residential environments, providing insight into the patterns of transmission, as well as community-based prevention and control of similar threats.

Strategies to detect trace methamphetamine contamination on hard surfaces: Assessing realistic performance of commercially available presumptive tests and a laboratory-based LC-MS/MS method.

Recreational methamphetamine production and heavy use can result in dwelling contamination that is difficult to detect. First responders and public health officials may use commercially available trace methamphetamine detection (presumptive) test kits to understand apparent and hidden dangers in impacted dwellings. Here, we assessed the limit of detection (LOD) of several commercially available presumptive test kits using simulated contaminated hard surfaces. Pyrex petri dishes were spiked with aliquots of methanolic methamphetamine solutions to reach desired simulated contamination levels. Commercially available presumptive tests were conducted according to manufacturer instructions and using included sample preparation materials, when available. Additionally, a laboratory-based liquid chromatography-triple quadrupole mass spectrometer (LC-MS/MS) trace methamphetamine quantification method was developed and validated using the EZSTATSG2 tool. For the LC-MS/MS method, samples were collected using 2-ply alcohol prep pads and methamphetamine was extracted using a 1:1 (v:v) methanol: water solution. Most presumptive tests considered were able to detect trace levels of methamphetamine extracted from hard surfaces, with LOD ranging from 0.10-15.00 µg/sample. Comparatively, the laboratory-based LC-MS/MS LOD was 0.05 µg/sample and limit of quantitation was 0.10 µg/sample. The LC-MS/MS method may be useful when the presence of dust or other contaminants interferes with presumptive test interpretation or reliability. Costs of presumptive tests varied from several dollars to tens of dollars, which is included alongside LOD results to aid stakeholders in identifying which test(s) are the best fit for purpose. Therefore, first responders, public health officials, and other stakeholders have several options for assessing trace methamphetamine contamination.

Theoretical design of a solid scintillation detector for tritium surface contamination measurement based on CaF2(Eu) sheet and self-coincidence technology of MCP-PMT.

Measurement of tritium surface contamination is important for tritium related facilities, especially for fusion devices. A novel detector has been designed for tritium surface contamination measurements based on CaF2(Eu) sheet and Microchannel plate photomultiplier tube (MCP-PMT). Self-coincidence technology has been introduced to obtain lower detection limit by diminishing the background noise caused by γ-rays and hot electrons. Performance of the detector was optimized by specifying the key parameters including the distance of the scintillator and sample, the thickness of light guide, the number of annular electrodes et al., using Monte Carlo method. Results indicate that detection efficiency of 49.4 % and the response deviations at different positions less than 0.5 % could be achieved. The detection limit of tritium under the simulation conditions is 0.09 Bq/cm2 and 0.03 Bq/cm2 when the counting time is 10 s and 60 s, respectively.

Environmental surface surveillance during a COVID-19 outbreak in a school community: implications for controlling indirect transmission.

Environmental surface surveillance is a valuable tool for detecting and controlling infectious diseases. During the COVID-19 pandemic, concerns have been raised regarding the potential for indirect transmission of SARS-CoV-2 via contaminated surfaces. However, few studies have evaluated environmental contamination in non-clinical settings during outbreaks. We conducted a study in a school community during a major outbreak, collecting 35 surface samples from high-traffic areas and testing them for SARS-CoV-2 RNA using RT-qPCR. Our results showed that 31.4% of samples were positive, including high-touch surfaces such as drinking fountains and washbasins. These findings emphasize the importance of environmental monitoring to identify and address specific areas for attention, and implementing such strategies can help prevent the indirect transmission of COVID-19 in various settings.

Longitudinal evaluation of environmental contamination with hazardous drugs by surface wipe sampling.

INTRODUCTION: Exposure of healthcare workers to hazardous drugs can lead to adverse health effects supporting the importance of a continuous monitoring program, for example, by taking surface wipe samples. The objective was to describe the results of repeated monitoring of contamination with hazardous drugs on multiple surfaces in a hospital pharmacy and at two wards using standardized preparation techniques and cleaning procedures. METHODS: Twelve surfaces in the hospital pharmacy and at two wards were sampled and analyzed for contamination with the hazardous drugs cyclophosphamide, doxorubicin, 5-fluorouracil, gemcitabine, methotrexate, and paclitaxel. The drugs were prepared with a closed-system drug transfer device (CSTD). Sampling of the drugs was performed in four trials during eight months. Liquid chromatography tandem mass spectrometry was used for the analysis of the drugs. RESULTS: During the four trials, contamination with five of the six hazardous drugs was found on half of the surfaces in the pharmacy and in a ward. Seventeen out of 288 possible outcomes were positive (6%), with the biological safety cabinet grate (n = 6) and scanner (n = 5) most frequently contaminated. The highest level of contamination was observed on the pass-thru window (cyclophosphamide: 2.90 ng/cm2) and the touch screen of the Diana device (5-fluorouracil: 2.38 ng/cm2). Both levels were below the action level of 10 ng/cm2. CONCLUSIONS: The long-term use of a CSTD in combination with appropriate cleaning has proven effective in achieving low levels of surface contamination with hazardous drugs.

Efficacy of Violet-Blue (405 nm) LED Lamps for Disinfection of High-Environmental-Contact Surfaces in Healthcare Facilities: Leading to the Inactivation of Microorganisms and Reduction of MRSA Contamination.

Effective disinfection procedures in healthcare facilities are essential to prevent transmission. Chemical disinfectants, hydrogen peroxide vapour (HPV) systems and ultraviolet (UV) light are commonly used methods. An emerging method, violet-blue light at 405 nm, has shown promise for surface disinfection. Its antimicrobial properties are based on producing reactive oxygen species (ROS) that lead to the inactivation of pathogens. Studies have shown significant efficacy in reducing bacterial levels on surfaces and in the air, reducing nosocomial infections. The aim of this study was to evaluate the antimicrobial effectiveness of violet-blue (405 nm) LED lamps on high-contact surfaces in a hospital infection-control laboratory. High-contact surfaces were sampled before and after 7 days of exposure to violet-blue light. In addition, the effect of violet-blue light on MRSA-contaminated surfaces was investigated. Exposure to violet-blue light significantly reduced the number of bacteria, yeasts and moulds on the sampled surfaces. The incubator handle showed a low microbial load and no growth after irradiation. The worktable and sink showed an inconsistent reduction due to shaded areas. In the second experiment, violet-blue light significantly reduced the microbial load of MRSA on surfaces, with a greater reduction on steel surfaces than on plastic surfaces. Violet-blue light at 405 nm has proven to be an effective tool for pathogen inactivation in healthcare settings Violet-blue light shows promise as an additional and integrated tool to reduce microbial contamination in hospital environments but must be used in combination with standard cleaning practices and infection control protocols. Further research is needed to optimise the violet-blue, 405 nm disinfection method.

SARS-CoV-2 transmission via maritime cold chains: A statistical analysis of nucleic acid detection results of cold chain food imported from Fuzhou ports.

Numerous epidemic outbreaks related to cold chains have occurred since the coronavirus disease 2019 (COVID-19) outbreak, suggesting the potential danger of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission through cold chain foods (CCFs). By analyzing SARS-CoV-2 RNA contamination of CCFs imported from Fuzhou ports, this study evaluated the contamination and transmission of SARS-CoV-2 RNA via maritime cold chains, with the aim of provide suggestions for CCFs supervision and public health management. The statistical analysis included 131,385 samples. The majority of the CCFs imported into Fuzhou ports was aquatic raw food that originated in Southeast Asia (57.08 %), South America (19.87 %), and South Asia (11.22 %). South Asia had the highest positivity rate of 0.37 %, followed by Southeast Asia (0.21 %) and South America (0.08 %). The positivity rate showed that the outer packaging of CCFs was the most easily contaminated, accounting for 81.33 % of all positive samples. This suggested that CCFs storage and loading processes were the weak links vulnerable to SARS-CoV-2 contamination. The positivity rates in outer packaging, inner packaging, and content of raw food were 0.48 %, 0.08 %, and 0.05 %, respectively, which were obviously higher than those of processed and refined food. This indicated that increasing the mechanization of factories and implementing sensible worker management practices may decrease viral contamination. The monthly positivity rates varied widely from 0 % (March 2021) to 0.40 % (January 2021), with an average of 0.19 %. The positivity rates in outer packaging, inner packaging and content of crustaceans from Southeast Asia were 2.47 %, 0.41 %, and 0.69 %, which were approximately 5-14 times higher than those of fish and cephalopods. Meanwhile, the monthly detection number show that SARS-CoV-2 epidemic prevention strategies affected the trade of imported CCFs.

Proposals of guidance values for surface contamination by antineoplastic drugs based on long term monitoring in Czech and Slovak hospitals and pharmacies.

Introduction: The exposures to hazardous antineoplastic drugs (AD) represent serious risks for health care personnel but the exposure limits are not commonly established because of the no-threshold effects (genotoxic action, carcinogenicity) of many ADs. In this study, we discussed and derived practically applicable technical guidance values (TGV) suitable for management of AD risks. Methods: The long-term monitoring of surface contamination by eight ADs was performed in pharmacies and hospitals in the Czech Republic and Slovak Republic in 2008-2021; in total 2,223 unique samples were collected repeatedly in 48 facilities. AD contamination was studied by LC-MS/MS for cyclophosphamide, ifosfamide, methotrexate, irinotecan, paclitaxel, 5-fluorouracil and gemcitabine and by ICP-MS for total Pt as a marker of platinum-based ADs. Results: The study highlighted importance of exposure biomarkers like 5-fluorouracil and especially carcinogenic and persistent cyclophosphamide, which should be by default included in monitoring along with other ADs. Highly contaminated spots like interiors of laminar biological safety cabinets represent a specific issue, where monitoring of contamination does not bring much added value, and prevention of staff and separated cleaning procedures should be priority. Rooms and surfaces in health care facilities that should be virtually free of ADs (e.g., offices, kitchenettes, daily rooms) were contaminated with lower frequency and concentrations but any contamination in these areas should be carefully examined. Discussion and conclusions: For all other working places, i.e., majority of areas in pharmacies and hospitals, where ADs are being prepared, packaged, stored, transported, or administered to patients, the study proposes a generic TGV of 100 pg/cm2. The analysis of long-term monitoring data of multiple ADs showed that the exceedance of one TGV can serve as an indicator and trigger for improvement of working practices contributing thus to minimizing of unintended exposures and creating a safe work environment.

Further development and application of a method for assessing radionuclide surface activity distribution and source location based on measurements of ambient dose equivalent rate.

A method has been developed for solving the Fredholm equation in the barrier geometry for reconstructing the surface activity density (SAD) from the results of measuring the ambient dose equivalent rate (ADER). Inclusion of the barrier geometry means that the method takes into account the shielding effect of buildings and structures on the contaminated site. The method was based on the representation of the industrial site, buildings and radiation fields in the form of a raster and the use of the visibility matrix (VM) of raster cells to describe the barrier geometry. The developed method was applied to a hypothetical industrial site with a size of 200 × 200 conventional units for four types of SAD distribution over the surface of the industrial site: 'fragmentation', 'diffuse', 'uniform' and 'random'. The method of Lorentz curves was applied to estimate the compactness of the distributions of SAD and the ADER for the considered radiation sources. It was shown that the difference between the Lorentz curve for SAD and ADER means that the determination of the spatial distribution of SAD over the industrial site by solving the integral equation is essentially useful for determining the location of radiation source locations on the industrial site. The accuracy of SAD reconstruction depends on the following parameters: resolution (fragmentation) of the raster, the height of the radiation detector above the scanned surface, and the angular aperture of the radiation detector. The measurement of ADER is simpler and quicker than the direct measurement of SAD and its distribution. This represents a significant advantage if SAD distribution needs to be determined in areas with high radiation dose-rate during limited time. The developed method is useful for supporting radiation monitoring and optimizing the remediation of nuclear legacies, as well as during the recovery phase after a major accident.

Further development and application of a method for assessing radionuclide surface activity distribution and source location based on measurements of ambient dose equivalent rate. Examples for Andreeva Bay, Chernobyl NPP and Istiklol.

A method for reconstructing surface activity density (SAD) maps based on the solution of the Fredholm equation has been developed and applied. The construction of SAD maps was carried out for the site of the temporary storage (STS) of spent fuel and radioactive waste (RW) in Andreeva Bay using the results of measuring campaign in 2001-2002 and for the sheltering construction of the solid RW using the results of measurements in 2021. The Fredholm equation was solved in two versions: under conditions of a barrier-free environment and taking into account buildings and structures located on the industrial site of the STS Andreeva Bay. Lorenz curves were generated to assess the compactness of the distributions of SAD and ambient dose equivalent rate (ADER) for the industrial site and the sheltering construction at STS Andreeva Bay, the area of the IV stage uranium tailing site near the city of Istiklol in the Republic of Tajikistan, and for roofs of the Chernobyl nuclear power plant. The nature of impact of the resolution (fragmentation) of the raster, the value of the radius of mutual influence of points (contamination sites), the height of the radiation detector above the scanned surface and the angular aperture of the radiation detector on the accuracy of the SAD reconstruction is shown. The method developed allows more accurate planning of decontamination work when only ADER measurements data is available. The proposed method can be applied to support the process of decontamination of radioactively contaminated territories, in particular during the remediation of the STS Andreeva Bay.

Assessing floor contamination by antineoplastic agents in a Japanese medical institution specializing in cancer treatment.

INTRODUCTION: This study investigated the extent of contamination with antineoplastic agents on floor surfaces of the ward and the outpatient chemotherapy center of a Japanese cancer center to evaluate healthcare workers' risk of occupational exposure to antineoplastic agents outside of the designated drug preparation areas. METHODS: In this study conducted at Aichi Cancer Center, the amount of fluorouracil detected on various floor surfaces was measured using liquid chromatography-tandem quadrupole mass spectrometry. Areas around the toilets were cleaned with a surfactant two or three times a day, whereas other floor surfaces were cleaned only with dry and wet mops. RESULTS: Fluorouracil was detected on all surveyed floor surfaces, with particularly high amounts detected around the toilet areas in the ward. Additionally, areas with more human traffic tended to have higher fluorouracil contamination. CONCLUSIONS: This survey suggested that antineoplastic agent contamination occurring through patient excretions might spread throughout the hospital with human traffic. Therefore, controlling the spread of antineoplastic agent contamination in hospitals should include the review of measures to mitigate contamination around toilets and to implement effective cleaning methods for floor surfaces.

Negligible risk of surface transmission of SARS-CoV-2 in public transportation.

BACKGROUND: Exposure to pathogens in public transport systems is a common means of spreading infection, mainly by inhaling aerosol or droplets from infected individuals. Such particles also contaminate surfaces, creating a potential surface-transmission pathway. METHODS: A fast acoustic biosensor with an antifouling nano-coating was introduced to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on exposed surfaces in the Prague Public Transport System. Samples were measured directly without pre-treatment. Results with the sensor gave excellent agreement with parallel quantitative reverse-transcription polymerase chain reaction (qRT-PCR) measurements on 482 surface samples taken from actively used trams, buses, metro trains and platforms between 7 and 9 April 2021, in the middle of the lineage Alpha SARS-CoV-2 epidemic wave when 1 in 240 people were COVID-19 positive in Prague. RESULTS: Only ten of the 482 surface swabs produced positive results and none of them contained virus particles capable of replication, indicating that positive samples contained inactive virus particles and/or fragments. Measurements of the rate of decay of SARS-CoV-2 on frequently touched surface materials showed that the virus did not remain viable longer than 1-4 h. The rate of inactivation was the fastest on rubber handrails in metro escalators and the slowest on hard-plastic seats, window glasses and stainless-steel grab rails. As a result of this study, Prague Public Transport Systems revised their cleaning protocols and the lengths of parking times during the pandemic. CONCLUSIONS: Our findings suggest that surface transmission played no or negligible role in spreading SARS-CoV-2 in Prague. The results also demonstrate the potential of the new biosensor to serve as a complementary screening tool in epidemic monitoring and prognosis.

Evaluation of long-term data on surface contamination by antineoplastic drugs in pharmacies.

PURPOSE: The handling of antineoplastic drugs represents an occupational health risk for employees in pharmacies. To minimize exposure and to evaluate cleaning efficacy, wipe sampling was used to analyze antineoplastic drugs on surfaces. In 2009, guidance values were suggested to facilitate the interpretation of results, leading to a decrease in surface contamination. The goal of this follow-up was to evaluate the time trend of surface contamination, to identify critical antineoplastic drugs and sampling locations and to reassess guidance values. METHODS: Platinum, 5-fluorouracil, cyclophosphamide, ifosfamide, gemcitabine, methotrexate, docetaxel and paclitaxel were analyzed in more than 17,000 wipe samples from 2000 to 2021. Statistical analysis was performed to describe and interpret the data. RESULTS: Surface contaminations were generally relatively low. The median concentration for most antineoplastic drugs was below the limit of detection except for platinum (0.3 pg/cm2). Only platinum and 5-fluorouracil showed decreasing levels over time. Most exceedances of guidance values were observed for platinum (26.9%), cyclophosphamide (18.5%) and gemcitabine (16.6%). The most affected wipe sampling locations were isolators (24.4%), storage areas (17.6%) and laminar flow hoods (16.6%). However, areas with no direct contact to antineoplastic drugs were also frequently contaminated (8.9%). CONCLUSION: Overall, the surface contaminations with antineoplastic drugs continue to decrease or were generally at a low level. Therefore, we adjusted guidance values according to the available data. The identification of critical sampling locations may help pharmacies to further improve cleaning procedure and reduce the risk of occupational exposure to antineoplastic drugs.

Viable mpox virus in the environment of a patient room.

We conducted a prospective environmental surveillance study to investigate the air, surface, dust, and water contamination of a room occupied by a patient infected with mpox virus (MPXV) at various stages of the illness. The patient tested positive for MPXV from a throat swab and skin lesions. Environmental sampling was conducted in a negative pressure room with 12 unidirectional high efficiency particulate air filter (HEPA) air changes per hour and daily cleaning of the surfaces. A total of 179 environmental samples were collected on days 7, 8, 13, and 21 of illness. Among the days of sampling, air, surface, and dust contamination showed the highest contamination rates on day 7 and 8 of illness, with a gradual decline to the lowest contamination level by day 21. Viable MPXV was isolated from surfaces and dust samples and no viable virus was isolated from the air and water samples.

Side-by-Side Comparison of Methods for Environmental Monitoring for Hazardous Drug Contamination.

Background: Exposure to hazardous drugs is known to have deleterious effects on health care workers. To assess risk, environmental monitoring is conducted to ascertain drug contamination on surfaces, as dermal contact is the main route of exposure. Conventional monitoring employs wipe sampling whereby the wipe must be sent to a laboratory for analysis. This means that quantitative results are not available for some time, during which the risk remains unknown. A new device, the HD Check system, developed by BD, which uses lateral-flow immunoassay technology, allows for near real-time qualitative assessment of contamination (positive or negative); however, its sensitivity relative to the traditional method is unknown. Objective: To evaluate the ability of this novel device to detect drug contamination relative to the conventional method. Methods: Five sets of different known drug concentrations were compared between the conventional wipe sampling method and the HD Check systems for methotrexate (MTX) and cyclophosphamide (CP). Stainless steel surfaces were tested, and the drug concentrations ranged from 0 ng/cm2 to twice the limit of detection (LOD) of each HD Check system. Results: For MTX, positive results were obtained in every test trial at all drug concentrations examined with the HD Check system (LOD = 0.93 ng/cm2). For CP, test results with the HD Check system (LOD = 4.65 ng/cm2) were all positive at the LOD and twice the LOD; however, at 50% and 75% of the LOD, the result was positive in only 90% (9/10) of the trials. The conventional method was able to quantify the test drug concentrations with a high level of accuracy and reproducibility. Conclusions: These results suggest the potential utility of the novel device as a screening tool for higher levels of drug contamination with MTX and CP, but additional research is needed to determine its suitability for lower concentrations, especially of CP.

Contexte: L'exposition à des médicaments dangereux est connue pour avoir des effets délétères sur les travailleurs de la santé. Pour évaluer les risques, une surveillance environnementale est menée pour vérifier la contamination des surfaces par les médicaments, car le contact cutané est la principale voie d'exposition. La surveillance conventionnelle utilise un échantillonnage par frottis, lequel doit être envoyé à un laboratoire pour analyse. Cela signifie que les résultats quantitatifs ne sont pas disponibles pendant un certain temps ­ temps pendant lequel le risque reste inconnu. Un nouvel appareil, le système HD Check de BD, qui utilise la technologie d'immunodosage à flux latéral, permet une évaluation qualitative en temps quasi réel de la contamination (positive ou négative); cependant, sa sensibilité par rapport à la méthode traditionnelle est inconnue. Objectif: Évaluer la capacité de ce nouveau dispositif pour détecter la contamination médicamenteuse par rapport à la méthode conventionnelle. Méthodes: Cinq ensembles de différentes concentrations connues de médicaments ont été utilisés pour comparer la méthode conventionnelle d'échantillonnage par frottis et les systèmes HD Check pour la méthotrexate (MTX) et la cyclophosphamide (CP). Des surfaces en acier inoxydable ont été testées et les concentrations de médicament variaient de 0 ng/cm2 à deux fois la limite de détection (LD) de chaque système HD Check. Résultats: Pour la MTX, des résultats positifs ont été obtenus dans chaque essai à toutes les concentrations de médicament examinées avec le système HD Check (LD = 0,93 ng/cm2). Pour la CP, les résultats des tests avec le système HD Check (LD = 4,65 ng/cm2) étaient tous positifs à la LD et au double de la LD; cependant, à 50 % et 75 % de la LD, le résultat n'était positif que dans 90 % (9/10) des essais. La méthode conventionnelle a été en mesure de quantifier les concentrations de médicament à l'essai avec un niveau élevé de précision et de reproductibilité. Conclusions: Ces résultats suggèrent l'utilité potentielle du nouveau dispositif comme outil de dépistage pour des niveaux plus élevés de contamination médicamenteuse par la MTX et la CP, mais des recherches supplémentaires sont nécessaires pour déterminer son adéquation à des concentrations plus faibles, en particulier de CP.

Assessing the Cleanliness of Dental Implants Using Scanning Electron Microscopy and Energy-Dispersive X-ray Spectroscopy Analysis-A SEM and EDS In Vitro Study.

A wide variety of titanium (Ti) alloy dental implant systems are available and as a result, choosing the correct system has become a challenge. Cleanliness of the dental implant surface affects osseointegration but surface cleanliness may be jeopardized during manufacturing. The purpose of this study was to assess the cleanliness of three implant systems. Fifteen implants per system were examined with scanning electron microscopy to identify and count foreign particles. Particle chemical composition analysis was performed with energy-dispersive X-ray spectroscopy. Particles were categorized according to size and location. Particles on the outer and inner threads were quantitatively compared. A second scan was performed after exposing the implants to room air for 10 min. Carbon, among other elements, was found on the surface of all implant groups. Zimmer Biomet dental implants had higher particle numbers than other brands. Cortex and Keystone dental implants showed similar distribution patterns. The outer surface had higher particle numbers. Cortex dental implants were the cleanest. The change in particle numbers after exposure was not significant (p > 0.05). Conclusion: Most of the implants studied were contaminated. Particle distribution patterns vary with the manufacturer. The wider and outer areas of the implant have a higher probability of contamination.

Comparison of conventionally and digitally completed patient consent-anamnesis forms in terms of surface contamination.

BACKGROUND: With the development of modern technology, the use of software-based applications in the field of health has become increasingly widespread. For this reason, computer-assisted personal registration forms have been developed using software programs. OBJECTIVE: The aim of this study was to compare surface contamination during the filling of orthodontic anamnesis-consent forms, traditionally on paper and digitally on a tablet equipped with a software application, measured in confined spaces using the 3M Clean-Trace Luminometer device. METHODS: In order for the participants to complete the orthodontic anamnesis-consent forms, two separate identical cabins with standard flat surfaces were prepared. In the first cabin, the participants conventionally completed these forms on paper (conventional group), while in the second cabin, the other group used a tablet equipped with a software program for this purpose (digital group). After the form completion process, surface pollution of the predetermined areas was measured in both cabins using a 3M Clean-Trace Luminometer device. RESULTS: Surface contamination was found to be statistically significantly higher in all measurement areas in the conventional group than in the digital group. Despite a statistically significant difference between the two groups in relation to the measurements performed using the pens (conventional or electronic), this was not as strong as those found for the remaining surfaces. CONCLUSION: The completion of orthodontic anamnesis-consent forms over tablets significantly reduced surface contamination in the close environment. This study reflects the importance of digitization - which has become beneficial in many fields - in reducing the spread of infections.