Safe Handling of Cytotoxic Drugs and Risks of Occupational Exposure to Nursing Staffs
-
Somayeh Hanafi
,
Hassan Torkamandi
,
Sahar Bagheri
,
Maria Tavakoli
,
Naser Hadav
,
Mohammadreza Javadi
Abstract
Background: Inherent toxicity of cytotoxic drugs is the basis for their potential adverse risks from occupational exposure to the nursing staff. In Iran, chemotherapy regimens are prescribed and administered according to the world updated protocols. But little is done regarding the protective standards in this field.
Methods: An observational cross-sectional survey was conducted among nurses who work in three tertiary care teaching hospitals in Tehran, Iran in 2012. All participants worked in one of the hospital wards handling cytotoxic drugs (preparation and administration). A questionnaire was used for interviewing all subjects, and observing them preparing and administering the drugs. We examined all adverse effects associated with handling of antineoplastic drugs.
Results: Totally 270 adverse reactions were reported. The most frequently reported adverse effects included headache and vertigo (40 cases), hair loss (36 cases), skin rashes and itching (31 cases), and burning sensation in eyes (31 cases). In all hospital wards, the standards were met in not more than 50% of the items.
Conclusion: Monitoring the personnel who are directly involved in handling of cytotoxic drugs is of great importance. Furthermore, educating the personnel in the field of standards of cytotoxic drugs handling could increase the nursing staff’s knowledge regarding these drugs’ adverse reactions.
Handling cytotoxic drugs in the workplace. WorkSafe Victoria. 2003.
Types of chemotherapy drugs. 2010. Available at: URL:http://www. newearthbiomed.org/145/chemo-article. (Accessed June 28, 2012).
Occupational exposure to antineoplastic agents (Effects of Occupational Exposure). 2011. Available at:URL: http://www.cdc.gov/niosh/topics/ antineoplastic/effects.html. (Accessed April 15, 2012).
Eisenberg S. Safe handling and administration of antineoplastic chemotherapy. J infus Nurs 2009; 32 (1): 23-32.
Power L A, Polovich M. Safe Handling Of Hazardous Drugs: Reviewing Standards for Worker Protection. Pharmacy Practice News 2009; 1-9.
Valanis B, Vollmer W, Labuhn K, Glass A. Occupational exposure to antineoplastic agents and self-reported infertility among nurses and pharmacists. J Occup Environ Med 1997; 39:574–80.
Selevan S, Lindbohm M, Hornung R, Hemminki K. A study of occupational exposure to antineoplastic drugs and fetal loss in nurses. N Engl J Med 1985; 313:1173–8.
Stucker I, Caillard J, Collin R, Poyen D, Hemon D. Risk of spontaneous abortion among nurses handling antineoplastic drugs. Scand J Work Environ Health 1990; 17:133–138.
Hemminki E, Kyyronen P, Lindblom M. Spontaneous abortions and malformations in the offspring of nurses exposed to anesthetic gases, cytostatic drugs and other hazards in hospitals, based on registered information of outcome. J Epidemiol Community Health 1985; 39:141–7.
Hengstler JG, Fuchs J, Oesch F. DNA strand breaks and DNA cross links in peripheral mononuclear blood cells of ovarian cancer patients during chemotherapy with cyclophosphamide/carboplatin. Cancer Res 1992;52:5622–6.
Martin S, Beach L. The adverse health effects of occupational exposure to hazardous drugs. Community Oncology 2005; 2(5): 397–400.
ASHP guidelines on handling hazardous drugs. Am J Health-Syst Pharm.2006; 63: 1172-93.
Ishii N, Dakeishi M. Safety awareness of anticancer drug handling among Japanese nurses. Nippon Koshu Eisei Zasshiu 2005;52(8):727-35.
Polovich M. Developing a hazardous drug safe handling program.Community Oncology 2005; 2(5): 403-5.
Martin S, Larson E. Chemotherapy–handling practice of out patient and office based oncology nursing. Oncol Nurse Forum 2003; 30(4):575-81.
Ben-Ami S, Shaham J. The influence of nurses’ knowledge, attitudes and health beliefs on their safe behaviour with cytotoxic drugs in Israel. Cancer Nurs 2001; 24(3):192-200.
Turk M, Davas A. Knowledge, attitude and safe behaviour of nurses handling cytotoxic anticancer drugs in Ege University Hospital. Asian Pac J Cancer Prev 2004; 5(2):164-8.
Kyprianou M, Kapsou M, Raftopoulos V, Soteriades ES. Knowledge, attitudes and beliefs of Cypriot nurses on the handling of antineoplastic agents. Eur J Oncol Nurs 2010; 14: 278-82.
Polovich M. Safe handling of hazardous drugs. Online Journal of Issues in Nursing 2004; 9(3).
Chaudhary R, Karn BK. Chemotherapy-knowledge and handling practice of nurses working in a medical university of Nepal. Journal of Cancer Therapy 2012; 3:110-14.
Monjamed Z, Parsayekta Z. Evaluation of the quality care presented to cancer patients in chemotherapy centers affiliated to Universities of Medical Sciences of M.O.H in Iran. Tehran Univ; 2000.
Sismondi P, Ferrero A, Goffredo F, Marchese R. Safety of cytotoxic drug handling, preparation, storage, etc: the role of the pharmacists and nurses. CME Journal of Gynecologic Oncology 2001; 6:153-6.
| Files | ||
| Issue | Vol 3, No 1-2 (Spring 2015) | |
| Section | Original Article(s) | |
| Keywords | ||
| Nurses Chemotherapy Occupational Exposure | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
