LAUSR

The Pharmacopeial Convention and the National Institute for Occupational Safety and Health in the US have recommended that health care workers should wear disposable personal protective equipment (PPE) when admixing antineoplastic drugs and should be protected from exposure to these drugs. However, the insufficient number of PPE during the Coronavirus disease 2019 (COVID-19) pandemic has become an issue of serious concern worldwide. In addition, because the COVID-19 pandemic is likely to continue for several years, effective use of limited resources may unavoidably be recommended. Here, we surveyed PPE consumption before and after the COVID-19 pandemic while admixing antineoplastic drugs. Data on the number of PPE and the number of patients requiring admixing of antineoplastic drugs from January to March of 2019 and 2020, defined as before and after the COVID-19 pandemic, were retrospectively requested from hospitals in the Niigata Prefecture, Japan for the period 9 April 2020–30 April 2020. In Japan, class II biological safety cabinets are generally used. Typically, a surgical mask, two pairs of gloves, a head cap, and gowns are used when admixing antineoplastic drugs; N95 respirator and shoe covers are not used. Niigata Prefecture has a population of approximately 2,200,000, and there are six hospitals with a central role in cancer therapy. Only 81 patients were confirmed with COVID-19 on 10 May 2020. No pandemic has occurred in the Niigata Prefecture previously; however, numerous medical resources are insufficient owing to the COVID-19 pandemic worldwide. Based on statistics, the number of PPE used during admixing antineoplastic drugs and the number of patients who received antineoplastic drugs mixed in the pharmacy before and after the COVID-19 pandemic were compared using the Wilcoxon signedrank test. All analyses were performed using R 3.4.1 (R Foundation for Statistical Computing, Vienna, Austria). A P-value <0.05 was considered statistically significant. This study was approved by the Ethics Committee of Kaetsu Hospital (approval number: 2020-002). Data were collected from 18 hospitals, including 4 of the 6 hospitals that played a central role in cancer therapy in Niigata. Class III biological safety cabinets were used in one hospital for a part of admixing during the study period. Table 1 shows a comparison of the number of PPE used between 2019 and 2020. Although there were no significant differences in the number of patients who received antineoplastic drugs mixed in the pharmacy (P1⁄4 0.92) and the use of gloves (P1⁄4 0.73), there was a significant decrease in the use of surgical masks (P< 0.01) and gowns (P1⁄4 0.02) from 2019 to 2020. Furthermore, the use of head caps tended to decrease from 2019 to 2020. The same results