Hazardsto Staff Handling Cytotoxic Agents

The urine of some nurses and of pharmacists who prepare infusions and injections of anticancer drugs was found to contain drugs even to the extent of being sometimes mutagenic to bacteria. When they stopped handling the drugs the contamination ceased. It can be assumed that absorption of even small amounts of these drugs is harmful (mutagenesis, carcinogenesis), especially when it occurs repeatedly over long periods.

Contamination occurs from spilt drugs and carelessly handled syringes (there should be a swab on the tip of the needle when expelling air); even opening an ampoule can create an aerosol. Used ampoules, syringes and absorbent swabs constitute a hazard, as may body wastes of treated patients.

Precautions appropriate to different drugs range from simply avoiding spillage, through gloves, surgical masks, goggles and aprons, to the use of laminar flow cabinets. Special training of nominated drug handlers is essential. Pregnant staff should not handle these drugs.

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