目标:职业暴露是一个长期存在的公共卫生问题,如何有效地开展职业防护的问题近年来越来越引起人们的关注。手套被认为是细胞毒性药物最关键的保护设备。然而,关于不同材料制成的手套的防护性能以及细胞毒性剂的最佳手套组合的研究仍然很少。
方法:在这项研究中,设计了一种用于手套渗透实验的特定仪器,用各种液相色谱-串联质谱(LC-MS/MS)方法开发并验证。通过使用特定的仪器和LC-MS/MS方法,对八种选定的细胞毒性药物(氟尿嘧啶,表柔比星(EPI),多西他赛(DCT),甲氨蝶呤(MTX),环磷酰胺(CTX),依托泊苷(ETP),硫酸长春新碱(VCR),和顺铂衍生物Pt-(DDTC)3)成五种手套(橡胶(RB),丁腈(NT),氯化聚乙烯(CPE),低密度聚乙烯,和聚氯乙烯(PVC)树脂)给定不同的接触时间。然后,通过广义估计方程和Pearson相关分析对实验数据进行分析。
结果:结果表明,在短时间内(不到五分钟),ETP,CTX,氟尿嘧啶,DCT,顺铂通过了五种手套,但MTX的水平,VCR,EPI渗透很小,尽管这三种药物和手套之间的接触时间长达三个小时。此外,发现DCT和ETP的渗透与时间呈正相关。
结论:氯化聚乙烯和PVC树脂在保护大多数细胞毒性药物方面表现良好,值得临床推荐。由于防护能力差,不建议为此使用RB手套。基于各种手套在提供保护方面的性能,可以推导出两个手套的防护等级。氯化聚乙烯+PVC树脂,CPE+NT手套组合对大多数目标药物显示出良好的保护性能,可推荐用于临床实践。
OBJECTIVE: Occupational exposure is a long-standing public health concern, which has drawn more and more attention in recent years to the problem of how to carry out occupational protection effectively. Gloves are regarded as the most critical protective equipment for cytotoxic medications. However, there is still little research conducted on the protective performance of gloves made of different materials and the optimal glove combination for cytotoxic agents.
METHODS: In this research, a specific instrument intended for glove permeation experiment was designed, with various methods of liquid chromatography-tandem mass spectrometry (LC-MS/MS) developed and validated. By using the specific instrument and LC-MS/MS methods, a study was conducted on the permeation ability of eight selected cytotoxic drugs (fluorouracil, epirubicin (EPI), docetaxel (DCT), methotrexate (MTX), cyclophosphamide (CTX), etoposide (ETP), vincristine sulfate (VCR), and cisplatin derivatives Pt-(DDTC)3) into five kinds of gloves (rubber (RB), nitrile (NT), chlorinated polyethylene (CPE), low-density polyethylene, and polyvinylchloride (PVC) resin) given different contact times. Then, the experimental data were analyzed through a generalized estimation equation and Pearson correlation analysis.
RESULTS: The results show that within a short period of time (less than five minutes), ETP, CTX, fluorouracil, DCT, and cisplatin passed through five types of gloves but the level of MTX, VCR, and EPI permeation was minimal, despite the duration of contact between the three drugs and the gloves reaching as long as three hours. Furthermore, the permeation of DCT and ETP was found to be positively correlated with time.
CONCLUSIONS: Chlorinated polyethylene and PVC resin perform well in protecting against most cytotoxic drugs and are recommendable for clinical practice. Due to the poor protective ability, RB gloves are not recommended for this purpose. Based on the performance of various gloves in offering protection, the protection grade of two gloves can be deduced. Chlorinated polyethylene + PVC resin, CPE + NT glove combination shows good protective performance against most target drugs and can be recommended for clinical practice.