Hazardous Drug Exposure: Case Report Analysis From a Prospective, Multisite Study of Oncology Nurses’ Exposure in Ambulatory Settings

Friese, Christopher R.; Wong, Mandy; Fauer, Alex; Mendelsohn-Victor, Kari; Polovich, Martha; McCullagh, Marjorie C.

doi:10.1188/20.cjon.249-255

Cited by 13 publications

(14 citation statements)

References 13 publications

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“…15 Drug spills were reported by nurses both with (67%) and without (28%) the use of a CSTD. 29 PPE donned during spills was deemed “suboptimal”. 29 The perceived workplace safety climate was recently deemed a factor significantly associated with the use of PPE by nursing staff.…”

Section: Discussionmentioning

confidence: 99%

“…29 PPE donned during spills was deemed “suboptimal”. 29 The perceived workplace safety climate was recently deemed a factor significantly associated with the use of PPE by nursing staff. 15…”

Section: Discussionmentioning

confidence: 99%

“…29 PPE donned during spills was deemed "suboptimal". 29 The perceived workplace safety climate was recently deemed a factor significantly associated with the use of PPE by nursing staff. 15 The majority of participating centers provided specific training on hazardous drugs for the cleaning personnel, but annual training was not frequently provided.…”

Section: Safe Handling Practicesmentioning

confidence: 99%

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Canadian monitoring program of the surface contamination with 11 antineoplastic drugs in 122 centers

Delafoy

Roussy

Hudon

et al. 2022

J Oncol Pharm Pract

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Introduction Occupational exposure to antineoplastic drugs can lead to long-term adverse effects on workers’ health. Environmental monitoring is conducted once a year, as part of a Canadian monitoring program. The objective was to describe contamination with 11 antineoplastic drugs measured on surfaces. Methods Six standardized sites in oncology pharmacy and six in outpatient clinic were sampled in each hospital. Samples were analyzed by ultra-performance liquid chromatography coupled with tandem mass spectrometry (non-platinum drugs) and by inductively coupled plasma mass spectrometry (platinum-based drugs). The limits of detection (in ng/cm2) were: 0.0006 for cyclophosphamide; 0.001 for docetaxel; 0.04 for 5-fluorouracil; 0.0004 for gemcitabine; 0.0007 for irinotecan; 0.0009 for methotrexate; 0.004 for paclitaxel, 0.009 for vinorelbine, 0.02 for doxorubicine, 0.0037 for etoposide and 0.004 for the platinum. Sub-analyses were done with a Kolmogorov-Smirnov test Results 122 Canadian hospitals participated. Cyclophosphamide (451/1412, 32% of positive samples, 90th percentile of concentration 0.0160 ng/cm2) and gemcitabine (320/1412, 23%, 0.0036 ng/cm2) were most frequently measured on surfaces. The surfaces most frequently contaminated with at least one drug were the front grille inside the biological safety cabinet (97/121, 80%) and the armrest of patient treatment chair (92/118, 78%).The distribution of cyclophosphamide concentration was higher for centers that prepared ≥ 5000 antineoplastic drug preparations/year (p < 0.0001). Conclusions This monitoring program allowed centers to benchmark their contamination with pragmatic contamination thresholds derived from the Canadian 90th percentiles. Problematic areas need corrective measures such as decontamination. The program helps to increase the workers’ awareness.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Safe Handling Practicesmentioning

confidence: 99%

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Canadian monitoring program of the surface contamination with 11 antineoplastic drugs in 122 centers

Delafoy

Roussy

Hudon

et al. 2022

J Oncol Pharm Pract

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“…Call the difference between a linear model and a real process. These uncertain dynamic models are often referred to as robust models or uncertain state-space models [8][9].…”

Section: Robust Modelmentioning

confidence: 99%

Short-term Load Forecast of Integrated Energy System in Multi-station Fusion Scenario Based on Robust Model

2021

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Integrated Energy System (IES) is the development direction of energy consumption in the future. Through the coordinated design and planning of energy systems such as electricity, cooling, and heat, energy utilization can be effectively improved and the development of renewable energy units can be promoted. The purpose of this paper is to predict the short-term load of an integrated energy system in a multi-station fusion scenario based on a robust model. Convex Quadratic Loss Functions to Suppress Negative Effects of Outliers Non-convex Quadratic Loss Functions limit the maximum loss penalty for outliers. First, the loss function is expressed as the difference of two quadratic functions, and the corresponding robust model is built. Second, the optimization problem corresponding to the robust model is transformed into a system of linear equations using the CCCP technique and KKT conditions. Finally, the prediction accuracy of RLS-SVR model, SVR model and BP neural network model is compared. The results show that for cooling load prediction, the average relative error of the prediction model constructed by RLS-SVR is 1.05% and 1.12%, which is lower than other models.

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“…The findings of a survey of chemotherapy exposure among nurses who administer chemotherapy show that 14% of 1,814 nurse participants reported being exposed to chemotherapy or experiencing spills in a period of 7 days (DeJoy et al, 2017). In addition, a more recent study indicates that across 12 oncology settings, 61 chemotherapy spill incidents and 11 chemotherapy exposure incidents while cleaning the spills were reported by 51 nurse participants over a period of 2 years (Friese et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

The Factors That Influence Chemotherapy Exposure Among Nurses: An Integrative Review

Abu-Alhaija

Bakas

Shaughnessy

et al. 2023

Workplace Health Saf

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Background: Exposure to chemotherapy is an occupational hazard predisposing nurses to severe health effects. The purpose of this integrative review was to identify the recent literature describing the risk factors for occupational exposure to chemotherapy among nurses. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology was employed to conduct the review. The databases searched were Scopus, PubMed, and CINAHL using the search terms “chemotherapy,” “drugs,” “exposure,” and “nurses.” Included articles were published between January 2010 and February 2022, published in peer-reviewed journals for research conducted in the United States, and written in English language. Excluded articles were studies that did not involve nurses in their samples. Review articles, books, theses, and dissertations were excluded as well. The Johns Hopkins Nursing Evidence-Based Practice Model was used to assess the level of evidence from the reviewed studies. Findings: Fourteen studies were included in this review. Ten studies were rated on Evidence Level III, two on Evidence Level II, one on Evidence Level I, and one on Evidence Level V. The main risk factors for occupational exposure were nurses’ knowledge of chemotherapy handling guidelines, nurses’ adherence to using the personal protective equipment, nurses’ health beliefs regarding chemotherapy exposure, and workplace-related factors such as workload and managerial support. Conclusion: Addressing the identified risk factors would protect nurses from chemotherapy exposure. More research on nurses’ health beliefs regarding chemotherapy exposure and the cues to adhere to chemotherapy handling guidelines in the work environment is needed.

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Hazardous Drug Exposure: Case Report Analysis From a Prospective, Multisite Study of Oncology Nurses’ Exposure in Ambulatory Settings

Cited by 13 publications

References 13 publications

Canadian monitoring program of the surface contamination with 11 antineoplastic drugs in 122 centers

Canadian monitoring program of the surface contamination with 11 antineoplastic drugs in 122 centers

Short-term Load Forecast of Integrated Energy System in Multi-station Fusion Scenario Based on Robust Model

The Factors That Influence Chemotherapy Exposure Among Nurses: An Integrative Review

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