Cancer Clinical Trial
Official title:
Evaluation of a Safe Infusion Device in Reducing Occupational Exposure of Nurses to Antineoplastic Drugs: a Comparative Prospective Study. CONTAMOINS-1
Monocentric comparative before / after study to evaluate the efficacy of Safe Infusion Devices (SIDs) in reducing drug exposure to nurses compared to usual perfusion practices.
Despite the decreasing of environmental contamination throughout the anticancer drug circuit,
the administration of chemotherapies remains at risk of occupational exposure for nurses.
Many medical devices aim at securing administration, but none have been scientifically
evaluated to verify the actual improvement.
A monocentric comparative before / after study was carried out in an oncology day hospital in
order to evaluate the efficacy of Safe Infusion Devices in reducing drug exposure compared to
usual perfusion practices (neutral solvent-purged infusers). The rate of nurses' gloves
contamination was estimated. The eligible protocols must contain at least one disconnection
step and one of the 10 drugs screened. To avoid false negatives, each sample of gloves was
contaminated with a drop of topotecan. Association between contamination and other variables
was investigated using a multivariate regression analysis.
The usual practice leaded to a rate of 58.3% of contaminated samples while Safe Infusion
Devices to a rate of 15%: Safe Infusion Devices reduced the risk of gloves contamination by
84% in multivariate analysis (Odds ratio=0.16; 95% confidence interval=0.05-0.47; p<0.001).
Topotecan was identified within 100% of the samples. Only one case of cross-contamination has
occurred.
Despite the current practice of using neutral solvent-purged infusers, the occupational
exposure remains high for nurses and Safe Infusion Devices significantly reduced this risk of
exposure. However, glove contamination is only a surrogate endpoint. The results confirmed
that the disconnection of empty bags resulted in occupational exposure. Except a
contamination due to the leakage of a bag, no cross-contamination was detected. This
validated the environmental quality of the cytotoxic drug circuit. Safe Infusion Devices were
highly effective but did not completely eliminate exposure.
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