Advanced search
1 file | 3.66 MB

Occupational safety of pressurized intraperitoneal aerosol chemotherapy (PIPAC)

(2017) PLEURA AND PERITONEUM. 2(3). p.121-128
Author
Organization
Abstract
Background: Pressurized intraperitoneal aerosol chemotherapy (PIPAC) has emerged as a novel method to treat extensive, small volume peritoneal metastases. The clinical use of chemotherapy containing aerosols represents a potential occupational health hazard. We report the results of toxicological analysis during the first two clinical PIPAC procedures performed at Ghent University Hospital. Methods: After extensive preparation and in vitro testing, two patients were treated with PIPAC: the first using doxorubicin (2.86 mg in 51.43 mL) and cisplatin (14.28 mg in 164.3 mL), the second using oxaliplatin (182.10 mg in 186.42 mL). A standardized safety checklist was developed and used. Aerosol delivery was combined with electrostatic precipitation (ePIPAC). The following samples were obtained at several time points and locations: environmental air, floor surface wipes, surgeon's gloves, surgeon's hand wipes, circuit filters, and fluid from the water seal collection chamber container placed along the closed aerosol waste evacuating line. Platinum concentration was measured in these samples using voltammetry. Sample collection and analysis were performed by an independent external laboratory. Results: Platinum was not detected on the four floor locations after both procedures (detection limit 0.02 ng/cm(2)). Similarly, no platinum was detected in environmental air during both PIPACs at the surgeon's or anesthesiologist's position (detection limit 4.0-27 ng/m(3)). No platinum contamination was detected on the hands, outer pair of gloves, or inner pair of gloves of the surgeon (detection limit 70 and 50 ng respectively). Platinum was not detected on the filters and in the air-seal container liquid. Conclusions: With adequate preparation and precautions, a clinical PIPAC program can be established without measurable chemotherapy exposure to the operating room environment or healthcare workers.
Keywords
carcinomatosis, occupational, PIPAC, PERITONEAL CARCINOMATOSIS, ELECTROSTATIC PRECIPITATION, CYTOREDUCTIVE SURGERY, COLORECTAL-CANCER, OXALIPLATIN, EXPOSURE, HEALTH, EPIPAC, HIPEC

Downloads

    • full text
    • |
    • UGent only
    • |
    • PDF
    • |
    • 3.66 MB

Citation

Please use this url to cite or link to this publication:

Chicago
Willaert, Wouter, Paul Sessink, and Wim Ceelen. 2017. “Occupational Safety of Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC).” Pleura and Peritoneum 2 (3): 121–128.
APA
Willaert, Wouter, Sessink, P., & Ceelen, W. (2017). Occupational safety of pressurized intraperitoneal aerosol chemotherapy (PIPAC). PLEURA AND PERITONEUM, 2(3), 121–128.
Vancouver
1.
Willaert W, Sessink P, Ceelen W. Occupational safety of pressurized intraperitoneal aerosol chemotherapy (PIPAC). PLEURA AND PERITONEUM. 2017;2(3):121–8.
MLA
Willaert, Wouter, Paul Sessink, and Wim Ceelen. “Occupational Safety of Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC).” PLEURA AND PERITONEUM 2.3 (2017): 121–128. Print.
@article{8549890,
  abstract     = {Background: Pressurized intraperitoneal aerosol chemotherapy (PIPAC) has emerged as a novel method to treat extensive, small volume peritoneal metastases. The clinical use of chemotherapy containing aerosols represents a potential occupational health hazard. We report the results of toxicological analysis during the first two clinical PIPAC procedures performed at Ghent University Hospital. 
Methods: After extensive preparation and in vitro testing, two patients were treated with PIPAC: the first using doxorubicin (2.86 mg in 51.43 mL) and cisplatin (14.28 mg in 164.3 mL), the second using oxaliplatin (182.10 mg in 186.42 mL). A standardized safety checklist was developed and used. Aerosol delivery was combined with electrostatic precipitation (ePIPAC). The following samples were obtained at several time points and locations: environmental air, floor surface wipes, surgeon's gloves, surgeon's hand wipes, circuit filters, and fluid from the water seal collection chamber container placed along the closed aerosol waste evacuating line. Platinum concentration was measured in these samples using voltammetry. Sample collection and analysis were performed by an independent external laboratory. 
Results: Platinum was not detected on the four floor locations after both procedures (detection limit 0.02 ng/cm(2)). Similarly, no platinum was detected in environmental air during both PIPACs at the surgeon's or anesthesiologist's position (detection limit 4.0-27 ng/m(3)). No platinum contamination was detected on the hands, outer pair of gloves, or inner pair of gloves of the surgeon (detection limit 70 and 50 ng respectively). Platinum was not detected on the filters and in the air-seal container liquid. 
Conclusions: With adequate preparation and precautions, a clinical PIPAC program can be established without measurable chemotherapy exposure to the operating room environment or healthcare workers.},
  author       = {Willaert, Wouter and Sessink, Paul and Ceelen, Wim},
  issn         = {2364-7671},
  journal      = {PLEURA AND PERITONEUM},
  keyword      = {carcinomatosis,occupational,PIPAC,PERITONEAL CARCINOMATOSIS,ELECTROSTATIC PRECIPITATION,CYTOREDUCTIVE SURGERY,COLORECTAL-CANCER,OXALIPLATIN,EXPOSURE,HEALTH,EPIPAC,HIPEC},
  language     = {eng},
  number       = {3},
  pages        = {121--128},
  title        = {Occupational safety of pressurized intraperitoneal aerosol chemotherapy (PIPAC)},
  url          = {http://dx.doi.org/10.1515/pp-2017-0018},
  volume       = {2},
  year         = {2017},
}

Altmetric
View in Altmetric