[Safety issues of chemo drug administration handling by nurses from an occupational exposure viewpoint-through...

A number of studies on health effects of exposure to antineoplastic agents by health professionals have been reported recently. The health effects suggested are mutagenic, teratogenic and/or carcinogenic effects. In the United States or in EU countries cancer chemotherapy nursing guidelines have been already established, whereas in Japan the management of chemotherapy agents is left to each facility and the drug is administered based on the standard of each facility. We used a chemical in this study during preparation and administrations of antineoplastic agents to visualize spills that could be generated during the procedures so that we can sort out safety issues of chemo drug handling by nurses from an occupational exposure point of view. The result showed spills all over in the procedures by nurses in the study: specifically splash to environment around the drug preparation area, contamination of needles which were used for drug preparations, contamination of environment as the result of priming with chemo agents and spills at the exchange of IV bottle or at removal of the IV line from the patient without rinsing with normal saline. For future protective measures from exposure to antineoplastic agents, it is considered that the current administration method must be reviewed, and new methods to avoid the current safe handling issues must be developed and evaluated. Furthermore, strict conformity to chemo drug administration procedures based on the authorized guideline is very important in addition to the standard of the administration procedures in each facility. Hence, the work to prepare for the upcoming Japanese guideline is expected beyond the work to translate the US chemotherapy administration guideline by the Oncology Nursing Society (ONS) into the Japanese language.