[Safety notice for the use of drugs for intravesical instillations and cost analysis]

Among the objectives outlined in the National Health Plan 1998-2000 are some interventions to improve the safety of public and private health-care facilities. One of the significant risks in the health sector is the one resulting from exposure to chemotherapy drugs. The Health Surveillance must take into account that anticancer drugs are cytotoxic compounds, which can cause cancer. It is necessary that occupational exposure to antineoplastic agents be kept within the lowest possible level. The potential absorption due to exposure to chemotherapy may be significantly reduced by adopting preventive measures specific to particular concern in a centralization of structures and activities. To ensure an adequate system of protection for people who use these substances in professional health-care settings, there should be the establishment of a specific "Anticancer Drugs Unit" to entrust the working cycle. The places reserved for the preparation of cytotoxic chemotherapy must be equipped with floor and walls up to heights of appropriate plastic material easily washable. Inside the room there must be a "point of decontamination" for washing hands and eyes. The preparation of antineoplastic agents should be performed under hoods positioned away from heat sources and any air currents. It is advisable to use disposable surgical gowns with long sleeves with elastic cuffs or knitted sleeve to allow the gloves sticking above the gown itself. In the preparation of drugs the vial opening procedure must be implemented after verifying that no liquid is left at the top, and by wrapping the neck of the vial with a sterile gauze. Any accidental contamination must be reported to the Physician. All waste materials produced from the handling of cytotoxic chemotherapy should be considered as special hospital waste. To achieve high standards of safety and prevention for the personnel exposed to antineoplastic agents, it is necessary that workers are adequately informed about the risks and proper handling and disposal of anticancer drugs and contaminated materials.