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Evaluation of antineoplastic drug exposure of health care workers at three university-based US cancer centers.
J Occup Environ Med. 2010 Oct; 52(10):1019-27
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21 Oct 2010
Youcheng Liu
F1000 Public Health & Epidemiology
University of North Texas Health Science Center,
Fort Worth, TX, USA.
F1000 Public Health & Epidemiology
University of North Texas Health Science Center,
Fort Worth, TX, USA.
Dorathy Lachman
F1000 Public Health & Epidemiology
University of Kentucky College of Medicine,
Lexington, KY, USA.
F1000 Public Health & Epidemiology
University of Kentucky College of Medicine,
Lexington, KY, USA.
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DOI: 10.3410/f.5627956.5633054
I found this article interesting because it addresses a serious occupational exposure to healthcare workers. Most of these exposures are primarily musculoskeletal (such as lifting patients) or infectious (such as hepatitis/HIV) in nature. However, this article reveals another important occupational...Continue reading
I found this article interesting because it addresses a serious occupational exposure to healthcare workers. Most of these exposures are primarily musculoskeletal (such as lifting patients) or infectious (such as hepatitis/HIV) in nature. However, this article reveals another important occupational hazard in the healthcare industry: the exposure to antineoplastic drugs.
The authors selected three cancer centers across the United States and used comprehensive strategies to assess exposures: history of exposure, use of personal protective equipment (PPE), frequency of drug handling, surface contamination, air sampling, drug measurement in the urine of workers, and identification of genetic damage using a biomarker. The authors found that, despite following safe handling practices and engineering controls, contamination still occurred. Furthermore, not only were those directly handling the medication at risk (including nurses and pharmacists) but also those who were in close proximity to the location where the drug was prepared. This study was consistent with previous findings but evaluated more exposure factors than had previously been considered. This article calls for specific attention to and better management of the risk of preparing, checking and administering the drug. Comprehensive safety protocols and procedures should be strictly followed when handling antineoplastic drugs.
The authors selected three cancer centers across the United States and used comprehensive strategies to assess exposures: history of exposure, use of personal protective equipment (PPE), frequency of drug handling, surface contamination, air sampling, drug measurement in the urine of workers, and identification of genetic damage using a biomarker. The authors found that, despite following safe handling practices and engineering controls, contamination still occurred. Furthermore, not only were those directly handling the medication at risk (including nurses and pharmacists) but also those who were in close proximity to the location where the drug was prepared. This study was consistent with previous findings but evaluated more exposure factors than had previously been considered. This article calls for specific attention to and better management of the risk of preparing, checking and administering the drug. Comprehensive safety protocols and procedures should be strictly followed when handling antineoplastic drugs.
Disclosures
None declared
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Liu Y and Lachman D: F1000Prime Recommendation of [Connor TH et al., J Occup Environ Med 2010, 52(10):1019-27]. In F1000Prime, 21 Oct 2010; DOI: 10.3410/f.5627956.5633054. F1000Prime.com/5627956#eval5633054
F1000Prime Recommendations, Dissents and Comments for [Connor TH et al., J Occup Environ Med 2010, 52(10):1019-27]. In F1000Prime, 21 May 2013; F1000Prime.com/5627956
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This study evaluated health care worker exposure to antineoplastic drugs.A cross-sectional study examined environmental samples from pharmacy and nursing areas. A 6-week diary documented tasks involving those drugs. Urine was analyzed for two specific drugs, and blood samples were analyzed by the comet assay.Sixty-eight exposed and 53 nonexposed workers were studied. Exposed workers recorded 10,000 drug-handling events during the 6-week period. Sixty percent of wipe samples were positive for at least one of the five drugs measured. Cyclophosphamide was most commonly detected, followed by 5-fluorouracil. Three of the 68 urine samples were positive for one drug. No genetic damage was detected in exposed workers using the comet assay.Despite following recommended safe-handling practices, workplace contamination with antineoplastic drugs in pharmacy and nursing areas continues at these locations.
DOI: 10.1097/JOM.0b013e3181f72b63
PMID: 20881620
