A Study On The Determination Of Urinary Drug Concentration In People At Risk Of Occupational Exposure And Hand Protection During The Preparation Of Four Cytotoxic Drugs

Objective(s):Studies on the penetration of methotrexate,epirubicin,cyclophosphamide and etoposide in gloves made of different materials.To establish a highly sensitive method for the determination of the concentration of human urine samples,and to determine the drug content in the urine of people who are prone to occupational exposure to cytotoxic drugs in medical institutions,in order to evaluate the occupational protection risk of cytotoxic drugs in medical institutions and provide laboratory basis for the research on occupational exposure prevention.Methods:(1)To establish the experimental model of CD penetration gloves,and a highly sensitive method for simultaneously determining the content of four drugs was established by applying LC-MS/MS analysis technology,so as to study the penetration ability of four CD concentrations on LDPE gloves and rubber gloves.(2)LC-MS/MS analysis technology and SPE method were applied to establish the detection methodology of four kinds of CD in human urine samples,to study the drug content of four kinds of CD in the urine samples of patients and people prone to occupational exposure in medical institutions,and to preliminarily evaluate the occupational exposure of four kinds of CD.Results:(1)The method established for the determination of the four cytotoxic drugs in the filter paper has strong specificity,highly sensitivity,highly precision and highly accuracy,and the methodological indexes meet the determination requirements of the samples.The penetration of cyclophosphamide and etoposide to both gloves was detectable,and the penetration of methotrexate and epirubicin to both gloves was not detected.The quantity of drug detected is related to the loading concentration of drug.(2)The established method has strong specificity,high sensitivity,high precision and high accuracy in the determination of four CD in urine samples,and the methodological indexes meet the determination requirements of biological samples.The method was applied to test the urine samples of 7 patients who had used the above CD,and the results were all positive,and the urine drug concentration could be detected even after the sensitivity reached 5 ti/2.The results showed that the specificity and sensitivity of the method were consistent with the studies on occupational exposure.This method was used to study the staff in the PIVAS and the oncology department.The results showed that drugs were detected in both groups,and CTX was detected most frequently.CD was detected in the bodies of pharmacists and workers in only a few cases,while CTX was detected in the bodies of oncology nurses.Conclusions:In this study,the established detection methods of hand protection and four kinds of CD in urine samples are applicable to environmental and human occupational exposure respectively.The penetration of the drug to the glove is related to the drug and the properties of the glove itself,and the organic solvent will increase the penetration of the drug.PIVAS has strong occupational protection ability,while clinical departments are more likely to have occupational exposure.The risk of occupational exposure of PIVAS is more related to individual operation.Oncology nurses are high-risk population of occupational exposure,and their nursing mode and drug disposal process need to be improved.