Assessment of safe antineoplastic drug handling practices in community pharmacies, veterinary settings and long-term care homes in Ontario

Antineoplastic drugs play an important role in cancer and other chronic disease treatment though a number of these drugs are known to have carcinogenic, mutagenic and teratogenic properties. Healthcare workers in hospitals and cancer treatment centres are typically identified as the largest job group known to be at risk. However, recently other job groups have also been identified as likely at risk due to direct or indirect exposure such as: community pharmacists including retail pharmacy workers, veterinarians and veterinarian technicians, nursing and other healthcare workers employed in long-term care homes, as well as workers involved in related shipping and receiving, waste handling, maintenance, housekeeping and laundry etc.
Studies on exposure levels assessed outside of hospitals and cancer treatment centres revealed that there is a potential hazard present in these settings. Surface contamination of various commonly prescribed antineoplastic drugs was observed in these workplaces at measurable levels comparable to those obtained in human oncology settings. In addition, although best practices for safe drug handling have been defined, little is known about the measures and controls in use for the safe handling of antineoplastic drugs outside of acute care settings.
The purpose of this study was to provide information on the extent of use of antineoplastic drugs in veterinary clinics, long-term care homes and community pharmacies in Ontario. The goal was to present a cross section of current practices and measures in use for safe handling of antineoplastic drugs and minimizing exposure following a request from the Ontario Ministry of Labour for an evaluation of safe work practices in community pharmacies, veterinary clinics and long-term care homes. Barriers to adherence of existing safe drug handling practices were also identified. This study aims to fill the gaps in current knowledge about ongoing practices in these work places which may guide future interventions and future research. This is important because of the likely increase in the number of exposed workers due to increased cancer therapy and treatment from increasing numbers of patients with cancer and other chronic illnesses. Assessing workplaces' safety culture and identifying barriers to adherence to safe work practices can contribute to minimizing worker exposure.

Source: http://www.occupationalcancer.ca/wp-content/uploads/2018/05/Antineoplastic-Drug-Handling-Final-Report-OCRC2018.pdf

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