Safe Handling and Administration of Antineoplastic Chemotherapy

Abstract

Antineoplastic chemotherapy describes a group of hazardous drugs commonly used in the treatment of cancer. Since the discovery of their presence in nurses and pharmacists more than 2 decades ago, numerous studies have reported on the short- and long-term consequences of exposure. Guidelines describing proper equipment and procedures have been established in an effort to eliminate or minimize environmental and biologic exposure. Nursing compliance, however, has been variable. This article describes the dangers of exposure, how it occurs, and steps to keep nurses safe while working with these hazardous drugs.

Systematic Review of Control Measures to Reduce Hazardous Drug Exposure for Health Care Workers

“…Double gloving, however, is controversial and not universally practiced. 12 Face shields and eye protection are also recommended whenever the risk of splashing may occur. NIOSH-approved respirators are recommended in the event of a spill.…”

“…Across the set of publications, 5 major strategies were identified: engineering controls, 1,7,12-32 personal protective equipment (PPE), * medical and environmental monitoring, † hazard identification, 1,7,12,15,[20][21][22][23][24][25][26][27][28][29][30][31][32]36,37 and the need for a comprehensive hazardous drug control program that includes education and training for health care workers. 26,27,31,32,36 …”

Factors Influencing Nurses’ Use of Hazardous Drug Safe-Handling Precautions

“…Prior to the development of protective standards, however, healthcare provider HD exposure resulted in toxicities and reproductive effects, such as fetal defects and difficulties with fertility (Connor, Lawson, Polovich, & McDiarmid, 2014; Eisenberg, 2009; Polovich, 2011). Those who had direct contact with patients receiving HDs reported acute symptoms such as nausea, vomiting, headaches, dizziness, rash, shortness of breath, and hair loss—symptoms similar to patients receiving these drugs (Valanis, Vollmer, Labuhn, & Glass, 1993).…”

NIOSH Safe Handling of Hazardous Drugs Guidelines Becomes State Law

“…[10][11][12][13] Connor and colleagues 14 reported on widespread environmental contamination of HDs in 6 cancer centers, demonstrating that the workplace is a common source of exposure. 17 15,16 For nurses, exposure frequently occurs during administration: priming and disconnecting intravenous tubing, changing bags or syringes, and disposing equipment.…”