Cytotoxic Drugs: Safe Handling in the Workplace!

Oct 17, 2016

Cytotoxic drugs

-sometimes known as antineoplastics or chemotherapeutic agents, describe a group of medicines that contain chemicals which are toxic to cells, preventing their replication or growth, and so are primarily used to treat cancer. Once inside the body, their action is not generally tightly targeted, and they can produce side effects both to the patients and others who become exposed.

Potential Health Effects of Cytotoxic Drugs

Current statistics show that one in three people have a life-long risk of developing cancer. There is little scientific evidence currently available relating to whether working with cytotoxic drugs actually increases the risk of developing cancer or not. However, in the absence of such data, a strategy of prudent avoidance is recommended.

In the workplace, occupational exposure may occur where control measures fail or are not in place. Exposure may be through skin contact, skin absorption, inhalation of aerosols and drug particles, ingestion and needle stick injuries resulting from the following activities:

drug preparation

drug administration

handling patient waste

transport and waste disposal, or spills

Personnel likely to be involved in these activities include:

• nurses and medical officers

• pharmacists

• laboratory staff, and

• cleaning, maintenance and waste disposal staff.

 Where control measures are not adequate, adverse health effects may result from occupational exposure. Health effects attributed to cytotoxic drugs exposure amongst people preparing and administering cytotoxic drugs include:

• abnormal formation of cells and mutagenic activity

• alterations to normal blood cell count

• foetal loss in pregnant women and malformations in the offspring of pregnant women

• abdominal pain, hair loss, nasal sores and vomiting

• liver damage, and

• contact dermatitis, local toxic or allergic reaction, which may result from direct contact with skin or mucous membranes.

Health effects attributed to exposure to occupational cytotoxic drugs can be very serious. Research shows that where a high standard of risk control is in place, threats to health are reduced.

No exposure limits are set for cytotoxic drugs. Medical opinion is such that even low-level exposure to cytotoxic drugs should be avoided as much as possible. Research has shown that the implementation of suitable safety precautions reduces the incidence of adverse health effects.

Control of Exposure!

Measures to control exposure should be applied in the following order:

Engineering controls:

are plant or processes that reduce the generation of substance, suppress or contain substances, or limit the area of contamination in the event of spills and leaks.

ESCO Streamline Compounding Isolator

  • Install ventilation and air-filtering systems such as laminar-flow cytotoxic drug safety cabinets
  • Use containment systems such as isolators as they provide rigid product, personnel and environment protection.
  • Use wide-bore needles to transfer liquids from containers in the pharmacy
  • Use needleless injection sets for drug administration
  • Incorporate secure storage facilities

The broad measures described above will include more specific controls, such as:

  • reducing the quantities of drugs used; the number of employees potentially exposed; and their duration of exposure, to the minimum;
  • ensuring safe handling, storage and transport of cytotoxic drugs and waste material containing or contaminated by them;
  • using good hygiene practices and providing suitable welfare facilities, e.g. prohibiting eating, drinking and smoking in areas where drugs are handled and providing washing facilities;
  • training staff who handle cytotoxic drugs or deal with contaminated waste, on the risks and the precautions to take.

Isolation:

involves separating people from the substance by distance or barriers to prevent or reduce exposure.

  • Adopt closed-system operations
  • Conduct drug preparation work in a properly designed and secure cleanroom
  • Place dispensed drugs in impermeable packaging for delivery to administration areas
  • Designate a cytotoxic drug administration area, which only permits entry to authorized people.

Personal Protective Equipment (PPE)

Personal protective equipment includes:

  • coveralls
  • gowns
  • head covering
  • closed footwear
  • overshoes
  • gloves of appropriate material and thickness
  • safety glasses
  • respiratory protective devices

PPE should be provided and used wherever risks cannot be adequately controlled in other ways. PPE should be selected based on your risk assessment. It is important that the PPE offers adequate protection for its intended use. Employees must be trained in the use of PPE and it must be adequately maintained and stored.

Our equipment provides a comprehensive range of personnel and product protection in addition to protection for the surrounding work areas and the environment.

Product…Personnel…Environment Protection?

Worry No More! Esco Pharma has the Solution!

References:

Safe Handling of Cytotoxic Drugs in the Workplace. [ONLINE] Available at: http://www.hse.gov.uk/healthservices/safe-use-cytotoxic-drugs.htm. (Accessed 14 October 2016)

Worksafe Victoria: Handling Cytotoxic Drugs in the Workplace. [ONLINE] Available at: https://www.worksafe.vic.gov.au/__data/assets/pdf_file/0010/12223/handling_cytotoxic.pdf.. (Accessed 14 October 2016)

Other News


Esco Pharma at the 52nd ASHP Midyear Clinical Meeting and Exhibition 2017

Date: Dec 15, 2017


Raising Your Standards with Esco Downflow Booth
Airflow Containment on Its Best

Date: Nov 29, 2017


Bio-decontamination Within
The Efficiency of Esco BioVap™ Inside the Isolators

Date: Nov 28, 2017


Esco Pharma GB exhibited at CPhI and P-Mec in Germany

Date: Nov 08, 2017


Survivor 101: Safe Change Filtration

Date: Nov 07, 2017


The Horror Behind the Gross Art of Sneeze and Cough

Date: Oct 27, 2017


Esco Life Sciences and Healthcare is Strengthening its Core in Biocontainment

Date: Oct 18, 2017


Esco Pharma is at Two Places at Once

Date: Oct 05, 2017


A Perfect Mate

Date: Sep 27, 2017


Nanotechnology: Containment Strategies and Engineering Controls

Date: Sep 26, 2017


It’s more than just being Fragile : How to Handle Potent Formulation?

Date: Sep 25, 2017


Innovative Solutions for the Next Generation: Esco Pharma at ISPE 2017

Date: Aug 30, 2017


How SAFE is your FOOD?

Date: Aug 30, 2017


Nanotechnology in Pharmaceutical R&D: Drug Delivery System

Date: Jul 25, 2017


Inhaled Insulin: Boon or Bane?

Date: Aug 11, 2017


Esco Pharma at High Potent Medicines Conference 2017

Date: Jun 21, 2017


Quality Assurance System

Date: Jun 16, 2017


Defects

Date: Jun 16, 2017


Esco Pharma GB is moving!

Date: May 30, 2017


Esco Pharma at INTERPHEX 2017

Date: Apr 04, 2017


Esco Isoclean® Isolators Aid in a Pharmacy Compounding Facility in Singapore

Date: Mar 17, 2017


Esco Pharma Advancing Aseptic Pharmaceutical Processing with SP Scientific PennTech and ESS Technologies

Date: Jan 26, 2017


Esco joins the biggest pharma event in South Asia!

Date: Nov 28, 2016


Feeling Alienated by Safety?

Date: Dec 01, 2016


Blow-Fill-Seal Technology and Isolators

Date: Nov 22, 2016


How Clean is Clean Enough?

Date: Nov 08, 2016


Why isolators are still preferred when handling HPAPIs?

Date: Oct 27, 2016


Be SAFE in Handling High Potency APIs

Date: Oct 26, 2016


Esco isolator finally arrives in the land of the rising sun

Date: Sep 26, 2016


Esco Healthcare exhibits at the 16th ISPE – Singapore Affiliate

Date: Sep 16, 2016


Unidirectional or Turbulent Airflow: Which is best for Sterile Pharmacy Compounding?

Date: Sep 01, 2016


Discover the most diverse compounding pharmacy isolators

Date: Aug 18, 2016


The need for engineering controls in preventing compounding pharmacy mishaps

Date: Jul 19, 2016


Esco at the ASHP in Baltimore!

Date: Jun 23, 2016


Esco at the 2016 PPhA National Convention in Cebu City

Date: Jun 01, 2016


Esco Pharma ships out General Processing Platform Isolator (GPPI) to a client in Canada

Date: Jan 04, 2016


Esco Launches VacciXcell and TapestleRx

Date: Dec 03, 2015


VacciXcell commences the 1st day of exhibition at the Europe Vaccine Congress 2015 in Madrid

Date: Nov 10, 2015


Esco Pharma exhibited concurrently in Pharma Expo Las Vegas and IPEX Packaging Expo in Jakarta

Date: Oct 07, 2015


Esco Pharma partners with UP College of Pharmacy

Date: Jul 09, 2015


Thank you for visiting Esco at ACHEMA 2015!

Date: Jun 26, 2015


Esco at ISPE Exhibition

Date: Jun 09, 2015


Esco Pharma is Proud to Launch its New Range of Containment Isolators

Date: Apr 28, 2015


Esco GB Ltd hosted the 2014 Training at its new premises in Barnsley

Date: Dec 15, 2014


Esco Pharma at ISPE Event in Singapore.

Date: Aug 13, 2014


Esco at INTERPHEX 2014!

Date: Jul 17, 2014