Study shows lack of adherence to precautionary guidelines for compounding antineoplastic drugs among employers and healthcare workers

Study shows lack of adherence to precautionary guidelines for compounding antineoplastic drugs among employers and healthcare workers

A new study finds safe handling practices for compounding antineoplastic (chemotherapy) drugs are not always followed in actual healthcare practice.

The NIOSH study was published in the September issue of the Journal of Occupational and Environmental Hygiene.

The study, Adherence to Precautionary Guidelines for Compounding Antineoplastic Drugs: A Survey of Nurses and Pharmacy Practitioners is the first in more than 20 years to look into self-reported use of engineering, administrative, and work practice controls and PPE by pharmacy practitioners for reducing exposure to antineoplastic drugs.

More than 200 nurses and a hundred pharmacy practitioners who compounded antineoplastic drugs in the seven days prior to the survey were included in the study.

Findings revealed lack of adherence to precautionary guidelines and other best practices by employers and healthcare workers. The results revealed that:

  • Not always wearing two pairs of gloves (85%, 47%, respectively) or even a single pair (8%, 10%)
  • Not always using closed system drug-transfer devices (75%, 53%
  • Not always wearing recommended gown (38%, 20%)
  • I.V. lines sometimes/always primed with antineoplastic drug (19%, 30%)
  • Not always using either a biological safety cabinet or isolator (9%, 15%)
  • Lack of hazard awareness training (9%, 13%)
  • Lack of safe handling procedures (20%, 11%)
  • Lack of medical surveillance programs (61%, 45%)

“The adverse health effects associated with chemotherapy drugs are well documented, and it is incumbent upon healthcare employers and workers to acknowledge these risks and put recommended guidelines into practice,” said NIOSH Director John Howard, M.D.

“Using the hierarchy of controls is a proven strategy to achieve the safest possible workplace.”

Safe handling guidelines have been available for almost three decades now but recommended exposure controls were not always used.

Results of this survey will be used to help NIOSH, partners, employers and healthcare workers clearly understand present health and safety practices relative to working with hazardous chemical agents, identify gaps in current knowledge about these practices, and, in collaboration with partners, design further research for addressing those gaps.