Antineoplastic drugs are known to cause detrimental effects to health care workers who are exposed through work tasks. Environmental monitoring studies are an excellent approach to measure the extent of surface contamination produced by the handling of antineoplastic drugs in the workplace and to assess the potential for occupational exposures in oncology health care settings. The main aim of the study was to establish the extent of surface contamination produced by the handling of antineoplastic drugs in a limited-resource oncology health care facility in Colombia by conducting an environmental monitoring study using affordable analytical instrumentation. Contamination with antineoplastic drugs was widespread in the health care facility under evaluation, which could result in health care worker exposure to antineoplastic drugs. A comprehensive review of current safety guidelines and protocols including assessment of adherence in the health care facility should be done.

Background: Environmental monitoring of workplaces where antineoplastic drugs are handled constitutes an essential tool to assess occupational exposures among health-care workers. Consequently, availability of simple, sensitive, and affordable analytical methodologies is needed, particularly in health-care settings with limited resources that restrict environmental monitoring studies. Methods: Previously validated methodologies for simultaneous determination of ifosfamide, cyclophosphamide, and paclitaxel were modified and re-validated in order to create a more sensitive and more accessible liquid chromatography-based analytical method for measuring levels of workplace contamination generated by the handling of antineoplastic drugs in oncology healthcare settings with limited resources. Results: An HPLC-UV methodology was developed and validated to simultaneously determine ifosfamide, cyclophosphamide, and paclitaxel in field wipe samples collected from oncology health-care settings with limited resources. Solid-phase extraction was incorporated to concentrate analytes and improve their detection and quantification. Adequate limits of detection for ifosfamide (0.02 ng/cm 2 ), cyclophosphamide (0.1 ng/cm 2 ), and paclitaxel (0.03 ng/cm 2 ) were obtained. Also, mean recoveries between 88.7 and 96.2 % were achieved. Conclusions: The analytical method described here using a more widely available instrumentation provides an excellent alternative to LC-MS when establishing workplace contamination levels produced by the handling of antineoplastic drugs in non-high-income country oncology health-care settings.

Background: Acetaminophen (Paracetamol) is one of the most used and prescribed anti-inflammatory and analgesic drugs worldwide. It has become one of the main drugs related to accidental and intentional overdoses in many countries, including Chile. The objective of this work was to characterize acetaminophen poisonings occurred in Chile between the years 2001 and 2020. Methods: A retrospective study of acetaminophen poisonings among patients who were hospitalized in Chilean public and private hospitals was carried out between the years 2001 and 2020. Data was obtained from the Medical Outcome Statistical Report database. Inclusion criteria were cases of patients who were admitted into either public or private healthcare settings with diagnosis of acetaminophen poisoning according to the WHO ICD-10. Statistical analyses were run to establish associations between variables selected in the study. Results: A total of 2,929 cases were included in the study. 77 % of the cases corresponded to female patients (p<0.05). Patients’ age range went from 0 to 81 years old. Adolescents and young adults resulted more involved in reported cases during the 2001-2020 period (p<0.001). During the first period of the study, accidental poisonings were more commonly reported, however in the recent years intentional cases increased their occurrence, especially among female patients (p<0.05).  A multivariate logistic regression model considered as statistically significant (p<0.05) the interaction between the variables age, gender and year of the event. Conclusion: The present study identified a large number of acetaminophen poisonings reported in Chile during the 2001-2020 period. Cases were characterized including patients’ gender, age, and poisoning intent. Health authorities should consider these findings as an opportunity to improve public health associated with the use and misuse of over-the-counter drugs, including acetaminophen

Antineoplastic drugs (ANDs) used for chemotherapy can cause secondary cancers in treated patients and can pose carcinogenic risks to health-sector workers anywhere along these drugs’ life cycle in a facility, from production to patient administration. Several PAHO/WHO Collaborating Centers (CCs) have experience addressing these hazards in the health sector. The objectives of this report are four-fold: 1) Provide an overview of longstanding research and prevention efforts, led by PAHO/WHO and its Occupational Health CCs, aimed at reducing the burden of occupational cancer in the Americas; 2) Discuss how robust AND exposure assessment and educational/outreach work by PAHO CCs can form the basis of exposure mitigation efforts among health-sector workers; 3) Through the presentation of original AND exposure assessment data from a pharmaceutical compounding facility in Chile, highlight relatively inexpensive methods by which such data can be generated; and 4) Discuss how effective, periodic environmental surveillance in healthcare facilities results in the identification of AND contamination in the work environment and enables the implementation of low-cost, high-impact interventions to reduce the risk of occupational cancer in health-sector workers, including in limited-resource settings. The risk of health-sector worker exposure to ANDs and other hazardous drugs is an important issue for inclusion within PAHO/WHO’s broader efforts at reducing the impact of occupational cancer in the Americas. This report demonstrates that a wide range of accessible AND-exposure mitigation strategies are feasible at both a facility and a national policy level across the hemisphere.

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