Abstract: Objective: To assess the residue of antineoplastic drugs (ADs) in the working environment and the occupational exposure
of staff in four pharmacy intravenous admixture service (PIVAS) in Dali Bai Autonomous Prefecture. Methods: Paclitaxel and cisplatin
were selected as indicators, and samples of PIVAS environment and personal protective equipment wiping from 4 hospitals were col⁃
lected for environmental monitoring. Forty staff members who were exposed to ADs were selected as the exposure group, while 40 nonexposed
individuals were selected as the non-exposure group. Blood samples were collected for blood routine test and five-item im⁃
mune panel tests. Results: The detection rates of paclitaxel and cisplatin in environmental samples were 3.57% and 28.57% respec⁃
tively, and the maximum residues were 3.08 ng/mL and 56.62 ng/mL respectively. The detection rates on the surfaces of protective
equipment were 6.25% and 62.50% respectively, and the maximum residues were 5.22 ng/mL and 527.70 ng/mL respectively. Biologi⁃
cal monitoring showed that only the monocyte count in the blood routine of the two groups was marginally significant (P=0.050), and af⁃
ter adjusting for confounding factors, occupational exposure only had a significant effect on the monocyte count (P<0.05). There were no
statistically significant differences in the five immune indicators between the two groups (P>0.05). Conclusion: Residual ADs were de⁃
tected on surfaces in the PIVAS working environment and protective equipment. Changes in the number of monocytes among the ex⁃
posed staff indicate a potential impact on immune function associated with long-term or high-level exposure. Enhanced PIVAS envi⁃
ronmental cleaning, strict personal protection, regular environmental and biological monitoring are recommended to mitigate the risk of
occupational exposure.

Key words: pharmacy intravenous admixture service, antineoplastic drugs, occupational exposure, environmental monitoring, biologi?
cal monitoring