title: Occupational health and safety of anti-tumour necrosis factor alpha monoclonal antibodies with casual exposure.
abstract: BACKGROUND
  As the incidence of chronic inflammatory diseases continues to rise, so has cumulative use of biological therapy particularly anti-tumour necrosis factor (TNF) alpha agents. As longer term data emerges about the safety of these drugs, there is increasing attention drawn to safety of those with casual exposure. At present, there is little in the published literature to give guidance for healthcare workers regarding their health and safety in handling of anti-TNF agents, nor the appropriate precautions required.
  
  
  METHODS
  The aim of this review is to summarize the currently known adverse effects, risk assessment tools for classifying and handling hazardous substances, and present evidence for systemic absorption through occupational exposure in handling anti-TNF antibodies at the level of reconstitution.
  
  
  CONCLUSIONS
  There is no evidence for systemic absorption of these drugs in context of handling or accidental spillage and no reports of subsequent biological adverse effects. Given the need of this class of medication to be used for long-term maintenance therapy and their increasing indications, improved efficiency and cost-containing measures are recommended. As such, simple universal precautions of protective clothing of glove, gown, facemask and eye goggles are appropriate measures for reconstitution of anti-TNF antibodies.
authors.affiliation: Concord Hospital, Gastroenterology and Liver Services , Level 1 West, Hospital Rd, Concord NSW 2139, Sydney , Australia +61 2 9767 6111 ; +61 2 9767 6767 ; rupertleong@outlook.com.
authors.forename: Jeff
authors.initials: J
authors.lastname: Chang
authors.forename: Rupert W L
authors.initials: RW
authors.lastname: Leong
mesh_terms: D000062:Accidents, Occupational / Q000517:prevention & control; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D002626:Chemistry, Pharmaceutical; D004339:Drug Compounding; D006282:Health Personnel; D006801:Humans; D016273:Occupational Exposure / Q000517:prevention & control; D016272:Occupational Health; D018570:Risk Assessment; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000276:immunology
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha