The surface contamination of hazardous drugs in different working places of healthcare facilities in shaanxi, China

Introduction Surface contamination from chemotherapy drugs poses occupational risks to healthcare workers, yet data from China are limited. This study assessed such contamination in healthcare facilities in Shaanxi Province. Methods A cross-sectional study was conducted in 16 institutions. Surface wipe samples were collected from Pharmacy Intravenous Admixture Services (PIVAS) and drug preparation rooms in wards (DPRWs) over three days, before and after cleaning. Concentrations of cyclophosphamide (CP) and gemcitabine (Gem) were measured using HPLC-MS/MS. Statistical analyses evaluated contamination differences across environments and cleaning effects. Results A total of 659 samples were analyzed. In PIVAS, median Gem and CP levels ranged from 0.00–1.44 ng/cm² and 0.0011–1.10 ng/cm², respectively. In DPRWs, levels ranged from 0.01–3.53 ng/cm² (Gem) and 0.47–36.61 ng/cm² (CP), with CP consistently higher. Contamination concentrated on biological safety cabinet (BSC) surfaces in PIVAS and cabinet windows or preparation tables in DPRWs. Cleaning significantly reduced contamination, which correlated with drug preparation volume. While DPRWs had higher median contamination, the overall difference with PIVAS was not significant. However, DPRWs equipped with BSC had notably lower contamination. Conclusions Hazardous drug contamination remains a concern, especially in DPRWs without BSC. Enhanced cleaning protocols and stricter safety regulations are needed to protect healthcare workers in Chinese medical settings.