title: Risks to health professionals from hazardous drugs in Iran: a pilot study of understanding of healthcare team to occupational exposure to cytotoxics.
abstract: Ongoing concerns exist regarding the dangers inherent when handling cytotoxics, particularly drugs which are in parenteral formulations. On occasions, nurses and medical doctors have been preparing and administrating these drugs in the open spaces of wards in the absence of suitable personal protective equipment (PPE) and safety cabinets. To explore further into the severity of occupational hazards, we conducted our research in order to evaluate the healthcare's understanding of occupational exposure to cytotoxics and occurrence of any side effects. A cross-sectional study using a self-administered questionnaire was distributed amongst oncology nurses in nine specialized cancer centers in Tehran. The questionnaire was based on most reputable international guidelines, aiming to evaluate the attitude, knowledge and safe practices of nurses' handling cytotoxic drugs. The gathered data and reported side effects were compared between "oncology/hematology" and "non-oncology" participants. The majority of nurses from oncology wards were aware of the potential hazards associated with handling of chemotherapy and reported high levels of compliance with the use of PPE during reconstitution of antineoplastic agents. Almost all nurses reported the use of a safety cabinet during preparation, however only 55 % reported that they have annual medical checkups and 45 % reported having received specialized training. This work was also to evaluate the experimental procedures as well as cleaning solutions used to reduce the level exposure. While the level of knowledge about antineoplastic agents is high among nurses, along with the level of PPE use, medical surveillance and employee training seems to be lagging behind.
authors.affiliation: Department of Tehran Medical Unit, Islamic Azad University, Tehran, Iran.
authors.forename: Abdol Ali
authors.initials: AA
authors.lastname: Shahrasbi
authors.affiliation: Department of Pharmaceutics, Islamic Azad University, Tehran, Iran.
authors.forename: Minoo
authors.initials: M
authors.lastname: Afshar
authors.affiliation: Department of Clinical Pharmacy, Islamic Azad University, Pharmaceutical Sciences Branch, Tehran, Iran.
authors.forename: Farnaz
authors.initials: F
authors.lastname: Shokraneh
authors.affiliation: Department of Clinical Pharmacy, Islamic Azad University, Pharmaceutical Sciences Branch, Tehran, Iran.
authors.forename: Faezeh
authors.initials: F
authors.lastname: Monji
authors.affiliation: Department of Clinical Pharmacy, Islamic Azad University, Pharmaceutical Sciences Branch, Tehran, Iran.
authors.forename: Mahjabin
authors.initials: M
authors.lastname: Noroozi
authors.affiliation: Department of Clinical Pharmacy, Islamic Azad University, Pharmaceutical Sciences Branch, Tehran, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Ebrahimi-Khojin
authors.affiliation: Department of Clinical Pharmacy, Islamic Azad University, Pharmaceutical Sciences Branch, Tehran, Iran.
authors.forename: Seyed Farzam
authors.initials: SF
authors.lastname: Madani
authors.affiliation: Department of Clinical Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Ahadi-Barzoki
authors.affiliation: Department of Clinical Pharmacy, Islamic Azad University, Pharmaceutical Sciences Branch, Tehran, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Rajabi
keywords: cleaning solutions; contamination; cytotoxic drugs; occupational exposure; questionnaire; surface sampling