Staff who comes in contact with cytotoxic agents in conjunctions with preparation, administration, nursing care and cleaning are at risk for exposure. These hazardous drugs can alter DNA or affect other intracellular processes that interfere with cancer cell growth. Using personal protection equipment (PPE) and closed systems reduce but doesn’t eliminate the risks of exposure. Current guidelines vary between countries and few organization test exposure risks systematically.
We performed tests on occupational exposure (from 10 different health care surfaces) from three types of chemotherapy (Cyclophosphamide, Gemcitabine and Fluorouracil) from three different hospitals in Sweden. The tests were analyzed at an accredited lab according to protocol. We also collected survey data from cancer nurses on safety awareness, adherence to safety protocol and education from the same hospitals. Data on cleaning routines were also collected.
Preliminary results showed exposure above recommended risk level at all three hospitals and for all three drugs. The survey data showed that nurses only partly follow the recommended PPE but all responded that they had knowledge and competence to handle cytotoxic drugs, even if 37 % reported not to receiving any education from the employer. Cleaning routines differed between the hospitals and may explain some of the exposures.
Nurses in chemotherapy care are exposed to cytotoxic drugs. Efforts are needed to reduce these occupational risks and managers need to adopt a systematic approach to test exposure risks and to intervene. Guidelines need to be revised and include recent research results. Clinical nurses should always use PPE.
Clinical trial identification
Legal entity responsible for the study
Regionalt cancercentrum Stockholm-Gotland.
All authors have declared no conflicts of interest.