230075 Occupational exposures to antineoplastic agents in a hospital hematology-oncology department

Monday, November 8, 2010 : 10:45 AM - 11:00 AM

Derry Stover, MPH , Office of Environmental Hazards & Indoor Air, Nebraska Department of Health & Human Services, Lincoln, NE
Chandran Achutan, PhD , College of Public Health, University of Nebraska Medical Center, Omaha, NE
Background: Previous studies have documented health risks from occupational exposures to antineoplastic agents. The present study evaluated antineoplastic drug exposures and nurses' use of protective measures in a hospital oncology-hematology department.

Methods: Fourteen wipe samples were taken on various surfaces in patient rooms and common areas where nursing staff spend time. They were quantified for methotrexate, cyclophosphamide, and cytarabine. Fifty nursing staff completed a questionnaire that measured perceptions of chemotherapy exposures, health effects, level of training, and personal protective equipment use.

Results: Seven of the 14 surfaces contained quantifiable levels of either methotrexate or cyclophosphamide. They were detected on the bedside floor, IV pole, bathroom floor, and bathroom toilet. We found that respondents were not adhering to professional guidelines. Less than 50% of respondents reported wearing two pairs of gloves when handling antineoplastic agents. Also, only 86% reported wearing chemotherapy gowns, and 87% reported washing hands after coming into contact with these drugs. Nurses reported experiencing respiratory symptoms immediately after exposure to antineoplastic agents; in addition, 18% reported reproductive difficulties and 18% reported other chronic health issues such as menstrual dysfunction and hair loss.

Conclusion: The results show that antineoplastic agents can persist on many surfaces in patients' rooms. The high levels in bathrooms suggest that patient's excreta can be a significant source of exposure. Our survey results underscore the need for a comprehensive training program for nursing staff so that they can prevent unnecessary exposure to antineoplastic agents.

Learning Areas:
Occupational health and safety
Public health or related nursing
Public health or related research

Learning Objectives:
1. Assess the potential for chemotherapy drug exposures in a nursing department. 2. List elements of nursesí jobs that can increase the likelihood of exposures. 3. Identify adverse health effects of chemotherapy drug exposures in a nursing department.

Keywords: Health Care Workers, Occupational Exposure

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Masters of Public Health student at an ASPH-member University with work related to the field of occupational exposures to health care workers.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.