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Health hazard evaluation report: chemotherapy drug evaluation at a veterinary teaching hospital - Michigan.

Couch-J; Gibbins-J; Connor-T
Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, HETA 2010-0068-3156, 2013 Apr; :1-23
In February 2010, NIOSH received a confidential employee HHE request concerning exposure to chemotherapy drugs at a university veterinary teaching hospital (veterinary hospital) in Michigan. Employees were concerned that exposure to chemotherapy drugs may cause adverse health effects such as reproductive problems and hair loss. We visited the veterinary hospital in September 2010 and observed work practices and workplace conditions. We talked with employees about their health and workplace concerns related to chemotherapy drugs. We collected surface wipe and air samples for the chemotherapy drugs cyclophosphamide, ifosfamide, and doxorubicin. We gave a presentation on the occupational risks associated with chemotherapy and other hazardous drugs to the employer, employees, and students. We also met with university officials responsible for the veterinary hospital's occupational health and safety program. Cyclophosphamide was detected in 4 of 44 surface wipe samples, ranging from ND (< 5 ng/100 cm2) to 240 ng/100 cm2. All detectable levels of cyclophosphamide were found in the chemotherapy drug preparation room and administration area. Ifosfamide was detected in 2 of 44 surface wipe samples, ranging from ND (< 2 ng/100 cm2) to 37 ng/100 cm2. We detected neither cyclophosphamide nor ifosfamide in the air samples. Doxorubicin was not detected (LOD = 7 ng/sample) in any of the surface wipe or air samples, but we believe the recovery of doxorubicin from these samples may have been poor because of the length of time the samples were stored frozen before analysis. Most employees we talked with were not satisfied with the health and safety program, particularly in the areas of training, supervisor communication, and required re-use of disposable PPE. A few employees reported that they did not always wear appropriate PPE when administering chemotherapy drugs. Three employees reported health effects (headache, nausea, and abnormal menstruation) that have been associated with chemotherapy exposure in prior studies, but that also have a variety of other etiologies. No employees reported hair loss at the time of our evaluation. We were unable to determine if the health effects reported by employees were work related. However, similar effects have been reported with occupational exposure to chemotherapy drugs in other studies. We have provided recommendations that may reduce chemotherapy drug exposure, address employee concerns about their workplace health and safety program, and lead to more consistent work practices and personal protective equipment use.
Region-5; Veterinarians; Veterinary-medicine; Chemotherapy; Antineoplastic-agents; Drugs; Drug-therapy; Health-surveys; Air-sampling; Personal-protective-equipment; Oncogenic-agents; Work-practices; Worker-health; Employee-exposure; Reproductive-effects; Reproductive-hazards; Animals; Author Keywords: Veterinary services; chemotherapy; oncology; anti-neoplastic; hazardous drugs; veterinary; cyclophosphamide; ifosfamide; doxorubicin; surface wipe samples; air samples
50-18-0; 3778-73-2; 23214-92-8
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Field Studies; Hazard Evaluation and Technical Assistance
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Healthcare and Social Assistance
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National Institute for Occupational Safety and Health
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division