About Anti-cancer Drug Exposure Measurement

Provide a little more detail about anti-cancer drug exposure measurement.

  • Although the pharmacists are often preparing prescriptions inside a safety cabinet, nursing staff or a doctor may conduct this activity on a treatment table or in the hospital ward. During such activities for prescription, there is a possibility to cause aerosol (micro particles or solid particles floating in air) due to splashing or spillage of medical solution. Such phenomena are naturally difficult to observe visually. Anti-cancer drug, no matter how small amount, can have adverse impact if absorbed by human body. Therefore, it is necessary to periodically monitor the environment of the work area and ensure its safety.
  • By using the Sampling Sheet Method patented by Shionogi Pharma, you can confirm not only the situation of anti-cancer drug scattering within the current work environment, but also assess improvement with a "quantitative value" after implementing measures against exposure. Periodic exposure investigation can create an environment that protects your medical staff from the risk of anti-cancer drug exposure, and make them feel safe and focus on medical activities.

Under what conditions is the risk of exposure high?

  • When medical solution spillage or splashing occurs during prescription work
  • When inserting or pulling out a needle to or from a vial or transfusion bag
  • When cutting an ampule
  • When exchanging transfusion tube
  • When drugs are administered
  • When medical solution leaks from tube, syringe or connection
  • When cleaning the locations contaminated with medication
  • Locations where disposal process is conducted for rooms contaminated by medical material
  • When handling vomit, blood or excrement from a patient who was administered anti-cancer drugs within 48 hours
  • Restroom cleaning
  • Linens handling
  • Home nursing

There are many situations and locations such as those listed above where there are possibilities of exposure.

What are the routes to get into your body?

There are many routes, such as breathing air containing the aerosol that occurred from splashing medial solution or when solution gets directly on the body or splashed into your eyes. Even if there is no direct contact with the drug formulation, there are pathways such as when handling cancer patient stool or urine, touching linens soiled with drug formulation, or eating with hands with drug formulation. There are also cases of accidental stabbings with a needle contaminated with drug.

What symptoms are reported in academic papers regarding secondary exposure to human body?

Allergy reaction or rash, hypersensitivity of eyes to stimuli, chronic coughing or throat irritation, and immune response such as fever have been reported. Additionally, GI symptoms such as loss of appetite, nausea, vomiting, diarrhea, constipation, cardiovascular symptoms such as shortness of breath, arrhythmia, peripheral edema, chest pain and hypertension and furthermore, neurological symptoms such as headache, dizziness, insomnia or unconsciousness have been reported as acute symptoms.

About Measures against exposure

The routes to entry of anti-cancer drugs into human body are airway , skin and oral, so protection is the key point. Ensure strict wearing of gloves, mask, gown, goggle and cap that are necessary for protection. Additionally, use of safety cabinet or implementing closed system equipment have been known to be effective. Adequate training and instructions on dangers of anti-cancer drugs and their use are also necessary.

About Exposure Investigation Methods

Investigation procedure

Please check "Measurement Method" for details.

About Environmental monitoring

Please select the measurement method according to the place you want to measure and the purpose. As an example, here is an introduction of measurement using sampling sheet method.

Sampling Sheet Method

  • In general, the period for attaching adhesive sampling sheet is 1 to 5 days.
  • Even when adhesive sampling sheet is attached, there is no problem to conduct cleaning activity as usual.
  • When accumulated amount is to be measured, please peel off the sampling sheet prior to cleaning.
  • Even when a single large size sheet is cut up and the pieces are used at various locations, but they are collected as one sample, the cost is for a single sheet.

Please inquire medical formulation that can be measured.

Test Procedure (Measurement of Urine Concentration)

Urine Concentration of Cyclophosphamide (recommended method)

  1. The investigation is conducted when an amount of anti-cancer drug is handled.
  2. All urine is collected at the timing of 24 hours after the start of handling into a graduated 500ml cup, and the volume collected is recorded.
  3. Using a dropper, transfer 10ml to 11ml of the urine of step 2 into a container, and put it into a zippered bag and freeze immediately.
  4. Put the sample in a cold preserving container with dry ice and send it back to us using frozen storage delivery service.

*Underlined are to be packed together.

Achievements

In 2018, we have 167 actual cases across hospitals, universities, CRO and corporations.

Cost and Procedure for Exposure Investigation

When requesting price quotation

Please check "Order Flow" for details. We can take requests via order form or telephone.

What is the approximate price range for the cost of conducting environmental monitoring?

It varies by measurement method, number of sampling points and number of drug formulations to be measured. The cost includes complete kit, mailing fee, actual tests, and creating report. (Client is responsible for the return postage for samples.) Please inquire for details.

Tell us about the cost of urine concentration measurements

The cost includes complete kit and its mailing fee, actual tests and creating report. (Client is responsible for the return postage for samples.) Cost is listed below.

Cyclophosphamide Urine Concentration Measurement

1-29 Samples 16,100 Yen per sample
30 Samples Total 480,000 Yen
More than 31 Samples 9,000 Yen per sample
More than 40 Samples 30 Samples (480,000 Yen) + 10 samples (9,000 Yen x 10) = Total 570,000 Yen

Urine Kit

We will send you urine collection cup, dropper, sample containers and zippered bags

More than 30 Samples Free
Under 30 Samples 100Yen per set

Flow from order placement to sending complete kit

Please check "Order Process"

Required time from sending sample to receiving a report

Sampling Sheet Method

For Sampling Sheet Method, normal time is within one month from receiving samples.

Cyclophosphamide Urine Concentration Measurement

For the measurement of cyclophosphamide urine concentration, normal time is within one month for over 30 samples, but please inquire in case of less than 30 samples.

* In case of delay due to inspection of analytical equipment, we may consult with you. Also, we may need to consult with you during peak periods. Your kind patience is appreciated.