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Published on: September 20, 2019
Antineoplastic drug exposure in an ambulatory setting: a pilot study
Christopher R Friese1, Cristin McArdle, Ting Zhao
1Author Affiliations: School of Nursing (Drs Friese and McCullagh) and College of Pharmacy, Pharmacokinetics Core (Dr Zhao), University of Michigan, Ann Arbor; Department of Epidemiology and Biostatistics, Michigan State University College of Human Medicine, East Lansing (Ms McArdle); Department of Medicine, Duke University Medical Center and Duke Cancer Institute Pharmacokinetics/Pharmacodynamics Bioanalytical Core Lab, Durham, North Carolina (Dr Spasojevic); and Byrdine F. Lewis School of Nursing, Georgia State University, Atlanta (Dr Polovich).
Workers exposed to antineoplastic drugs, even without spills, had detectable drug levels. This highlights risks from both spills and environmental contamination, necessitating improved safety protocols.
Area of Science:
- Occupational Health
- Environmental Health
- Pharmacology
Background:
- Antineoplastic drugs pose health risks to healthcare workers.
- Limited data exists on exposure following drug spills.
- The link between antineoplastic drug exposure and organizational factors is understudied.
Purpose of the Study:
- To prospectively evaluate drug spills using biological measures.
- To correlate drug spills with organizational factors like staffing and work environment.
Main Methods:
- Prospective collection of timed urine samples from nursing and pharmacy personnel reporting spills.
- Comparison with urine samples from workers not reporting spills.
- Analysis using liquid chromatography tandem mass spectrometry (LC-MS/MS).
- Retrospective surveys on workload, practice environment, and safety behaviors.
Main Results:
- Four spills reported, involving nine personnel; four spill-exposed participants had detectable antineoplastic drugs.
- Four participants not reporting spills also had detectable docetaxel.
- Workers reporting spills had poorer collegial relations with physicians compared to non-spill reporters.
Conclusions:
- The study successfully documented drug spills and collected biological samples.
- Detectable levels of antineoplastic drugs were found in workers due to spills and environmental contamination.
- Further multisite research and quality improvement initiatives are crucial for enhancing safety procedures.
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