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Cytotoxic Drug Handling Practices Among Pharmacy Technicians in Portugal: The Dig Deeper Study
Ana Reis1,2, Vítor Silva3,4, João José Joaquim4,5,6
1REQUIMTE/LAQV, Escola Superior de Saúde, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal.
Healthcare (Basel, Switzerland)
|April 14, 2026
Summary
Pharmacy technicians handling cytotoxic drugs show good use of basic safety gear but lack consistent training and environmental monitoring. Improved national guidelines are needed to standardize occupational safety practices.
Area of Science:
- Occupational Health and Safety
- Pharmaceutical Sciences
- Public Health
Background:
- Occupational exposure to cytotoxic drugs poses significant health risks (carcinogenic, mutagenic, organ-specific effects) to pharmacy personnel.
- International guidelines exist, but compliance, training, and operational conditions vary widely across healthcare settings.
Purpose of the Study:
- To characterize cytotoxic drug handling practices among pharmacy technicians in Portugal.
- To assess working conditions, training, safety procedures, exposure patterns, and perceived risks.
Main Methods:
- A cross-sectional descriptive study utilizing a structured questionnaire based on international standards (ISOPP, NIOSH, ASHP, USP <800>).
- Data collected electronically from 124 pharmacy technicians actively handling cytotoxic drugs in Portugal (April-May 2025).
Main Results:
- High adherence to core protective measures (gowns, double gloves, biological safety cabinets) was observed.
- Significant gaps identified: inconsistent use of closed system transfer devices, inadequate respiratory/foot protection, limited automation, and insufficient environmental monitoring.
- Frequent absence of structured competency assessment, periodic training, and formal documentation; prolonged exposure and high workloads were common.
Conclusions:
- Cytotoxic drug handling in Portugal shows satisfactory basic safety but reveals organizational gaps in workload management, monitoring, and training.
- Lack of unified national guidance leads to institutional variability in occupational safety practices.
- Standardization of occupational safety practices is crucial for pharmacy personnel handling hazardous drugs.
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