Handling antineoplastic drugs in the European Community countries

Alkylating antineoplastic drugs (ADs) are carcinogenic to humans and most ADs cause reproductive failures in animal experiments. Studies of occupationally exposed health personnel have shown increased risks for miscarriages (two studies), malformations (two studies) and leukaemia (two studies). During the past decade, work practice guidelines have been issued by authorities in several countries but universal agreement on a set of guidelines which would secure both the work environment and the treatment of patients is yet to come. We reviewed the existing guidelines in the European Community (EC) countries on health personnel's handling of ADs. Five countries had guidelines on the safe handling of ADs. The main principles were to use exhaust cabinets and personal protective equipment. Two sets of guidelines included recommendations for pregnant women. In general, the EC countries' guidelines were less extensive than those issued by the US Occupational Safety and Health Administration. It is argued that the existence of more uniform guidelines in all the member states would be valuable. Specifically, measures should be devised to prevent adverse effects on reproduction.