Hazardous Drugs

Safe Handling of Hazardous Drugs

Antineoplastic drugs (AD) used in treatment of cancer are important tools in the fight against these diseases. Despite known adverse health effects such as reproductive effects and cancer, patients receiving these drugs benefit from their treatment, so the risk is balanced by the benefit—but healthcare workers gain no benefit from being exposed to antineoplastic drugs in the course of caring for these patients. There are an estimated eight million healthcare workers engaged in cancer care who may be at risk of exposure.

Studies of oncology nurses hsow that they are, however, at risk of spontaneous abortions, congenital malformations, mutagenic effects in blood cells and suggestions of elevated risks for leukemia, breast, and rectal cancers as a result of skin contact with contaminated surfaces. Other healthcare professionals are also at risk, including oncology pharmacy and custodial workers, volunteers and family caregivers.

ESSI's Impact:

Our Surveillance for Anti- Cancer Drugs Exposure Study (SURFACES), conducted in collaboration with our Canadian research partners at the University of British Columbia was designed to:

  1. undertake a hazard assessment of AD exposure in cancer care facilities in Alberta, and in Minnesota;
  2. characterize determinants of AD contamination;
  3. describe how AD contamination varies over time and space; and
  4. use findings from this study to recommend a sampling strategy that supports the requirements of new safe drug handling guidelines.

Over 2000 wipe samples representing more than 22,000 measurements were conducted in nine cancer centers. Several publications are in development.

PROJECT WEBSITE: https://ademp.med.ubc.ca

Student Involvement:

Master’s student Hannah Kaup conducted an observational study in two cancer clinics to inform our sampling strategy, fulfilling her master’s plan B requirements in the process. Her award winning poster was presented at the 2018 American Industrial Hygiene Conference and Exposition in Philadelphia, PA and the 2018 International Occupational Hygiene Association Conference in Baltimore, MD.

This work was published in 2019 in the Journal of Occupational and Environmental Hygiene: https://oeh.tandfonline.com/doi/abs/10.1080/15459624.2019.1667502?journalCode=uoeh20

Knowledge Transfer:

Susan Arnold & Hannah M. Kaup (2019) Assessing variability of antineoplastic drugs handling practices in clinical settings, Journal of Occupational and Environmental Hygiene, 16:12, 757-762, DOI: 10.1080/15459624.2019.1667502


AIHCe 2019 Session H2: Perspectives and Insights from the Surveillance for Anti-Cancer Drugs Exposure (SURFACE) Study, Matty Jeronimo, Carole Chambers, Susan Arnold


“Establishing Antineoplastic Drug Surveillance in Healthcare Settings”, Hannah Kaup MS; Susan Arnold PhD, CIH, FAIHA; Emily Schroeder BA, CPhT; Darcy MalardJohnson, PharmD