Procedures for handling antineoplastic injections in comprehensive cancer centers

Area of Science:

• Oncology Pharmacy Practice
• Occupational Safety in Healthcare
• Cancer Treatment Protocols

Background:

• Injectable antineoplastic drugs pose significant occupational hazards.
• Previous surveys (1979) indicated a need for improved handling procedures.
• Recent guidelines highlight best practices for antineoplastic medication management.

Purpose of the Study:

• To summarize current procedures for handling injectable antineoplastic drugs in U.S. comprehensive cancer centers.
• To compare current practices with those from a 1979 survey.
• To assess adherence to recently published guidelines.

Main Methods:

• A survey was distributed in May 1982 to pharmacy directors at 27 U.S. comprehensive cancer centers.
• The survey included questions from a 1979 survey and new questions on guideline adherence.
• Responses were received from 21 institutions.

Main Results:

• Seventeen institutions had written policies for antineoplastic preparation; only nine had training programs.
• Pharmacists or technicians prepared drugs in 12 centers, with 10 using vertical laminar-flow hoods.
• Personal protective equipment use (gloves, masks) was high, but health assessments were infrequent (six centers).
• Written disposal policies existed in 11 centers, with 13 segregating waste.
• Ten centers had administration training programs.

Conclusions:

• There is a positive trend towards increased protection for personnel handling antineoplastic agents compared to 1979.
• However, significant variation in procedures exists across comprehensive cancer centers.
• Standardization of safe handling, preparation, and disposal protocols remains a critical need.