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At Carmel Pharma, we’re proud to be the official sponsor of National Safe Handling Awareness Month (April) and Day (April 20), and we’re glad to encourage safe handling awareness by sharing educational resources that may facilitate increased employee safety and the proper handling of hazardous drugs. More than 1,300 participants took advantage of the complimentary Second Annual Safe Handling Awareness Day CE Webinar presented on April 20, 2010. To view the archived version of this webinar – and other free safe handling CE programs supported by Carmel Pharma – click here.
Cytotoxic drugs were developed from mustard gas used in WWI. At that time, there were very few safety standards in place with regard to hazardous drug handling, with clinicians using only gloves, masks and gowns for protection. Horizontal laminar flow hoods were introduced later and were used in some places through the late 1970s.
By the late 1970s (specifically 1979), the University of Helsinki reported that traces of chemotherapeutic agents were found in the urine of oncology nurses. Then, in the early 1980s, nurses reported that they were experiencing side effects similar to those of chemotherapy patients – including nausea, vomiting, hair loss and mouth sores (Source: NITA 1980). This triggered the industry – particularly hospitals – to take notice and perform various studies to identify the cause of these side effects. Results from these studies showed mutagenic activity in personnel working in horizontal laminar flow hoods. This was due to consistent contamination not only on the horizontal laminar air flow hoods but also in the air samples taken from each pharmacy. Based on these findings, new vertical laminar air flow hoods, called biological safety cabinets (BSC), were implemented as the new standard for the safe handling of hazardous drugs.
Wipe studies published in the 1990s and early 2000s consistently reported similar findings, and it was soon clear that, regardless of employee skill and carefulness, contamination was still a problem. These studies found that contamination appeared in approximately 75% of samples taken from pharmacy areas such as laminar hoods, the floor of the preparation area, the work surface inside the hood and pharmacists’ shoes, gloves and gowns. Contamination also appeared in 65% of the administration areas, including the floor around the patient’s chair, the office telephone, the patient’s bed, the top of the preparation area and preparation trays.
Because of the recurring findings, OSHA published the following statement on the potential hazards of handling antineoplastic and hazardous drugs in 1996:
“Preparation, administration and disposal of hazardous drugs, may expose pharmacists, nurses, physicians and other health care workers to potentially significant workplace levels of these chemicals.”
Today, studies continue to find hazardous drug contamination throughout pharmacy and nursing settings and in the urine of oncology staff, including those not directly involved in the preparation process. It is this contamination, as well as the documented risks associated with hazardous drug exposure, that makes it particularly important to establish and adhere to a clinically-proven drug safety program intended to prevent hazardous drug exposure.
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