LAUSR

Objective: Hazardous drugs presence at Hospital Pharmacies has been demonstrated in numerous studies. This study aims to analyze the  presence and levels of hazardous drugs at Spanish Hospital Pharmacies and the influence of different aspects on them. Method: We developed a cross test at Hospital Pharmacies hazardous drugs  compounding surfaces of ten Spanish hospitals. An independent laboratory  determined cyclophosphamide, iphosphamide and 5-fluorouracile levels in  samples recovered. Annual number of hazardous drugs compounded, as well as  the number of preparations developed the testing day was registered. We also  registered cleaning and decontamination processes and the drug transfer device  used at each hospital. Results: 204 samples were analyzed. Hazardous drugs presence was confirmed  in all participant hospitals. We observed a 49%, 23% and 10% of positive  samples for cyclophosphamide, iphosphamide and 5-fluorouracile. Median levels  (first-third quartile) of cyclophosphamide, iphosphamide and 5-fluorouracile  were 0.05 ng/cm2 (0.03-0.23), 0.03 ng/cm2 (0.03- 0.06) y 0.31 ng/cm2 (0.3- 0.59) respectively. Conclusions: Present study confirms hazardous drugs presence at Spanish Hospital Pharmacies departments. We observed a significant variability between participant hospitals, as well as between tested locations. Samples with more positive results were cabine airfoils and floors in front of  them. The number of preparations had no influence on results observed. Variability observed points outs the need to standardized compounding hazardous drugs processes.