The Safe Handling of Cytotoxic Drugs
It is now recognised that cytotoxic drugs represent a health hazard for those members of hospital staff who are regularly involved in their preparation and administration. There are two principal risks - one definite and one potential. The definite risk results from the fact that a number of cytotoxic agents are extremely irritant and produce harmful local effects after direct contact with skin or eyes. The potential risk stems from the knowledge that some cytotoxic drugs are proven carcinogens (see Chapter 2) and a number of studies monitoring hospital staff who were involved in preparing or giving these agents have demonstrated chromosomal abnormalities and excretion of mutagenic products in the urine. The abnormalities disappeared once exposure ceased and the actual amount of drug absorbed was extremely small. Nevertheless it has been argued that prolonged contact in this way could increase the chance of later developing a cancer. It is important to stress that this is only a theoretical possibility and that there is, as yet, no definite link between previous professional contact with cytotoxics and subsequent development of cancer. Even so, the possibility of a long-term hazard has to be taken seriously and the Health and Safety Executive in the United Kingdom, has issued Guidance Notes for the safe handling of cytotoxic drugs and these have been expanded by many Health Authorities into detailed policy documents, spelling out the necessary precautions.
KeywordsEtoposide Cytosine Carboplatin Tray Vincristine
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