title: Hygienic examination and follow-up of occupational risks of handling cytostatic drugs at an oncology unit.
abstract: The results of the hygienic follow-up at two hospital wards and the outpatient department of the Oncology Unit, Faculty Hospital in Olomouc, are given. For the evaluation the routine methods of hygienic surveillance were used, with the emphasis on the layout and the standard of hygiene of the ward. Evaluation was made at each ward of the character of work and handling cytostatics. The extent of the nurse's work is documented by her time schedule showing the exposure during the preparation of the most commonly used cytostatics. Special attention was paid to the equipment of the room assigned for the admixturing and dilution of cytostatics and the use of disposable medical material and protective personal equipment. It has been found out that the layout and arrangement of the wards are fully in keeping with the hygienic requirements on such specialized workplaces. In 1987, a total of 40 different chemotherapeutical agents with antineoplastic actions were given, most often in combinations of 3 to 4 cytostatic drugs. On the whole 12,641 vials were given to 510 patients hospitalized at the wards. Nurses' time schedules were elaborated showing their exposure when preparing the infusion form of the cytostatic Platidiam and the combination Cyclophosphamide-Methorexate-Ftorafur. The results show the exposure during the preparation of individual doses to be on the average 30 to 46 min. The daily exposure of the nurse was 4 to 5 hours, of the physician 2 to 3 hours. Most of the cytostatic drugs were administered intravenously or in the form of infusion. This kind of administration may result in the formation of aerosol, or contamination of the skin and mucous membranes. The personnel may be exposed when handling the biological material from the patients or their secretions. The personnel has been informed about the principles of the protection of their health and safety of work and instructed on the use of personal protective equipment. A safety cabin with forced exhaustion of air outside the building is installed in a special room assigned for the preparation of cytostatics. Though no substantial hygienic deficiency has been found at this workplace, the health workers represent a group of increased exposure to genotoxic agents. For this reason, it is necessary to observe the guidelines for safety of work when handling these substances.
authors.affiliation: Department of Hygiene and Epidemiology, Medical Faculty, Palacký University, Olomouc, Czechoslovakia.
authors.forename: J
authors.initials: J
authors.lastname: Medková
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000139:chemically induced / Q000517:prevention & control*; D016273:Occupational Exposure
chemical_list: D000970:Antineoplastic Agents