Risk of handling injectable antineoplastic agents

Area of Science:

• Occupational Health
• Pharmacology
• Toxicology

Background:

• Injectable antineoplastic agents pose risks of mutagenic substance exposure to healthcare personnel.
• Previous studies indicated potential uptake of hazardous materials during drug preparation.

Purpose of the Study:

• To evaluate mutagenic substance uptake in personnel preparing intravenous antineoplastic admixtures.
• To assess the effectiveness of protective measures in preventing exposure.

Main Methods:

• Urine samples from six pharmacy personnel preparing admixtures were collected over eight-day periods.
• The Salmonella/mammalian microsome mutagenicity test (Ames test) was used to analyze urine concentrates for mutagenic activity.
• Personnel used horizontal laminar-flow hoods or vertical-flow biological-safety cabinets, with and without gloves and masks.

Main Results:

• Mutagenicity was detected in urine of all personnel preparing admixtures in horizontal laminar-flow hoods, regardless of protective gear.
• No urine mutagenicity was observed when admixtures were prepared in vertical-flow biological safety cabinets while wearing gloves.
• Control group personnel showed no urine mutagenicity.

Conclusions:

• Handling antineoplastic agents requires protective interventions to prevent mutagenic substance uptake.
• Vertical-flow biological safety cabinets combined with gloves provide effective protection for personnel.