Abstract：OBJECTIVE To explore the hygienic guidance values (HGVs) of environmental exposure of antineoplastic drugs in Chinese PIVAS, which provide a basis data for the rapid identification of the environmental exposure level of ADs and the implementation of scientific prevention and control. METHODS The monitoring wipe samples were obtained from PIVAS from ten Chinese medical institutions, and the concentrations of cyclophosphamide (CP) and cytarabine (CAR) in the wipe samples were determined by UPLC-MS/MS. RESULTS A total of 417 monitoring samples were collected, and the detection rate of CP and CAR was as high as 84.65% and 88.73%, and the exposure level of each hospital was significantly different, with the median value of CP ranging from 0 to 6.90 ng·cm-2 and the median value of CAR ranging from 0.04 to 1.92 ng·cm-2. The detection rate and exposure of ADs in each region of PIVAS were high, and the maximum detection amount existed in the general control area. If the environmental monitoring warning HGVs in our country was set according to the 90th percentil concentration recommended by foreign countries, the HGVs of CP was 20.75 ng·cm-2, which was far higher than that reported by other countries. CONCLUSION The environmental exposure of ADs in Chinese PIVAS seemed to be more serious than that in other countries. The introduction of HGVs provides a scientific basis for medical institutions to quickly identify the level of ADs exposure and implement classified prevention and control. Based on the current situation of exposure in China, it is suggested to set up two warning lines for the prevention and control of ADs occupational exposure in China with the concentration of 75th and 90th percentiles.
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