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Hazardous anticancer drugs in healthcare: environmental exposure assessment.

Framing the Future in Light of the Past: Living in a Chemical World, 3rd International Scientific Conference, September 18-21, 2005, Bologna, Italy. Carpi, Italy: Collegium Ramazzini, 2005 Sep; :59-60
Exposure of health care workers to anticancer drugs became problematic in the 1970s. Shortly thereafter, studies began documenting exposure of health care workers to these drugs. Investigations employing biological markers such as urine mutagenicity, chromosomal aberrations, sister chromatid exchanges and micronuclei demonstrated associations between occupational exposures and elevated marker levels. Other analytical methods emerged to monitor workplaces where drugs were handled. These contemporary studies uncovered widespread contamination of drugs on work surfaces, trace amounts in air samples, and their presence in worker urines. Vials containing these drugs are often contaminated with the drug when they are shipped. Most workplace surfaces are contaminated with the drugs being prepared and used in that area. Other anticancer/hazardous drugs would most likely be used in these areas. 'j:he interior surfaces of biological safety cabinets and isolators, floors, countertops, carts, storage bins, waste containers, treatment areas, tabletops, chairs, linen and other items are all potential sources of exposure to anticancer drugs. Patient body fluids contain the drugs and/or metabolites, often more biologically active than the parent compounds. An exposure assessment of areas where anticancer/hazardous drugs are handled must consider every potential source and route of exposure. Data from surface contamination and inhalation studies suggest that dermal exposure is the primary route of exposure. Assessment of exposure is the first step in providing a safe work environment for these workers. However, because of the many drugs to which they are exposed, any assessment can only be an estimation of the overall exposure. The findings and conclusions in this abstract have not been formally disseminated by the National Institute for Occupational Safety and Health and should not be construed to represent any agency determination or policy.
Health-care-personnel; Health-hazards; Drug-interaction; Drug-therapy; Drugs; Antineoplastic-agents; Cancer; Exposure-assessment; Materials-handling; Materials-storage
National Institute for Occupational Safety and Health, Division of Applied Research and Technology, 4676 Columbia Parkway, Cincinnati, OH 45226
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Abstract; Conference/Symposia Proceedings
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Research Tools and Approaches: Exposure Assessment Methods
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Framing the Future in Light of the Past: Living in a Chemical World, 3rd International Scientific Conference, September 18-21, 2005, Bologna, Italy