Download PDF
CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2016; 37(04): 227-231
DOI: 10.4103/0971-5851.195748
ORIGINAL ARTICLE

Protection behaviors for cytotoxic drugs in oncology nurses of chemotherapy centers in Shiraz hospitals, South of Iran

Khadijeh Abbasi
Emam Mohammad-Bagher Hospital, Ghirokarzin, Shiraz University of Medical Sciences, Ghirokarzin, Shiraz
,
Maryam Hazrati
Department of Nursing and Midwifery, College of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz
,
Abolfazl Mohammadbeigi
Research Center for Environmental Pollutants, Associate Professor of Epidemiology, Department of Epidemiology and Biostatistics, Qom University of Medical Sciences, Qom/Iran
,
Jasem Ansari
Bs in Medical Emergency, EMS, Shiraz University of Medical Sciences, Ghirokarzin, Shiraz
,
Mahboubeh Sajadi
Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran
,
Azam Hosseinnazzhad
Ms of Nursing, Nursing and Midwifery College, Bushehr University of Medical Sciences, Bushehr
,
Esmail Moshiri
Department of Anesthesiology, Valiaasr Hospital, Arak University of Medical Sciences, Arak, Iran
› Author Affiliations Financial support and sponsorship Nil.
› Further Information
  PDF Download Permissions and Reprints

Abstract

Context: The use of antineoplastic agents for the treatment of cancer is an increasingly common practice in hospitals. As a result, workers involved with handling antineoplastic drugs may be accidentally exposed to these agents, placing them at potential risk for long-term adverse effects. This study aimed to determine the occupational protection status of clinical nursing staff exposed to cytotoxic drugs. Subjects and Methods: The study was designed as an analytic descriptive survey. The research settings took place in six centers of chemotherapy in Shiraz, Iran. The participants were 86 nurses who worked in oncology units and administered cytotoxic drugs. Data were collected using a questionnaire and a checklist which was developed by the investigators to determine occupational protection status of clinical nursing staff exposed to cytotoxic drugs. Percentage calculations and the independent samples t-test were used to see the general distribution and analysis of data. To statistically analyze of the data, SPSS software (version 16) was applied. Results: The mean age of participants was 30.52 ± 6.50 years and 66.27% of the nurses worked on inpatient oncology wards. The mean practice score was 21.1 ± 3.76 that ranged from 12.5 to 31. The independent samples t-test showed the outpatient nurses were weaker in practice (17.2 ± 2.52) in comparison with university hospitals (23.35 ± 3.02, P< 0.001). Occupational protection status of clinical nursing staff exposed to cytotoxic drugs especially during administration and disposal of medicines was poor and rarely trained with this subject and was observed under the standard conditions. Conclusions: There is deficiency in the understanding and related protection practices of clinical nursing staff vocationally exposed to cytotoxic drugs. It is recommended that all clinical nursing staff should receive full occupational protection training about these matters and the authorities provide standard conditions of oncology wards.

Keywords

Cancer - chemotherapy - cytotoxic drugs - nurse - oncology


Publication History

Article published online:
12 July 2021

© 2016. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Sessink PJ, Wittenhorst BC, Anzion RB, Bos RP. Exposure of pharmacy technicians to antineoplastic agents: Reevaluation after additional protective measures. Arch Environ Health 1997;52:240-4.
  • 2 Ansari-Lari M, Saadat M, Shahryari D. Sister chromatid exchanges and micronuclei in lymphocyte of nurses handling antineoplastic drugs. Iran J Public Health 2001;30:37-40.
  • 3 Kopjar N, Garaj-Vrhovac V, Kasuba V, Rozgaj R, Ramic S, Pavlica V, et al. Assessment of genotoxic risks in Croatian health care workers occupationally exposed to cytotoxic drugs: A multi-biomarker approach. Int J Hyg Environ Health 2009;212:414-31.
  • 4 Testa A, Giachelia M, Palma S, Appolloni M, Padua L, Tranfo G, et al. Occupational exposure to antineoplastic agents induces a high level of chromosome damage. Lack of an effect of GST polymorphisms. Toxicol Appl Pharmacol 2007;223:46-55.
  • 5 Barale R, Sozzi G, Toniolo P, Borghi O, Reali D, Loprieno N, et al. Sister-chromatid exchanges in lymphocytes and mutagenicity in urine of nurses handling cytostatic drugs. Mutat Res 1985;157:235-40.
  • 6 Biró A, Fodor Z, Major J, Tompa A. Immunotoxicity monitoring of hospital staff occupationally exposed to cytostatic drugs. Pathol Oncol Res 2011;17:301-8.
  • 7 Valanis BG, Hertzberg V, Shortridge L. Antineoplastic drugs. Handle with care. AAOHN J 1987;35:487-92.
  • 8 Valanis BG, Vollmer WM, Labuhn KT, Glass AG. Association of antineoplastic drug handling with acute adverse effects in pharmacy personnel. Am J Hosp Pharm 1993;50:455-62.
  • 9 Fransman W, Roeleveld N, Peelen S, de Kort W, Kromhout H, Heederik D. Nurses with dermal exposure to antineoplastic drugs: Reproductive outcomes. Epidemiology 2007;18:112-9.
  • 10 Mennik F, Kennedy MS. Caution for nurses working withchemotherapy. Am J Nurs 2007;107:19.
  • 11 Connor TH, McDiarmid MA. Preventing occupational exposures to antineoplastic drugs in health care settings. CA Cancer J Clin 2006;56:354-65.
  • 12 Turci R, Minoia C. Residual hazard assessment related to handling of antineoplastic drugs: Safety system evolution and quality assurance of analytical measurement. Ann N Y Acad Sci 2006;1076:649-56.
  • 13 Acampora A, Castiglia L, Miraglia N, Pieri M, Soave C, Liotti F, et al. A case study: Surface contamination of cyclophosphamide due to working practices and cleaning procedures in two Italian hospitals. Ann Occup Hyg 2005;49:611-8.
  • 14 Roberts S, Khammo N, McDonnell G, Sewell GJ. Studies on the decontamination of surfaces exposed to cytotoxic drugs in chemotherapy workstations. J Oncol Pharm Pract 2006;12:95-104.
  • 15 Hedmer M, Georgiadi A, Bremberg ER, Jönsson BA, Eksborg S. Surface contamination of cyclophosphamide packaging and surface contamination with antineoplastic drugs in a hospital pharmacy in Sweden. Ann Occup Hyg 2005;49:629-37.
  • 16 Canadian Society of Hospital Pharmacists guidelines for the handling of hazardous pharmaceuticals. Can J Hosp Pharm 1981;34:126-8.
  • 17 Clinical Oncological Society of Australia. Guidelines and recommendations for safe handling of antineoplastic agents. Med J Aust 1983;1:426.
  • 18 American Society of Hospital Pharmacists. ASHP technical assistance bulletin on handling cytotoxic and hazardous drugs. Am J Hosp Pharm 1990;47:1033.
  • 19 National Institute for Occupational Safety and Health. NIOSH Alert: Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings. DHHS (NIOSH) Publication No. 2004-165. Cincinnati, OH: US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention; 2004.
  • 20 Hazrati M, Torabizade K, Reisi H, Pasyar N. Exploring the effect of educating standards instructions on administration of antineoplastic drugs in chemotherapy center in Shiraz. Hormozgan Med J 2005;12:103-7.
  • 21 Karadag A, Unlu H, Yavuzaslan F, Gundogdu F, Kav S, Terzioglu F, et al.. Profile of nurses working in oncology departments in Turkey. Turk J Cancer 2004;34:24-34.
  • 22 Glaus A. The Status of Cancer Nursing a European Perspective, European Oncology Nursing Society. European Oncology Nursing Society (EONS); 2007. Available from: http://www.cancernurse.eu/documents/EONSStatusOfCancerNursing.pdf. [Last accessed on 2016 Jul 07].
  • 23 Baykal U, Seren S, Sokmen S. A description of oncology nurses' working conditions in Turkey. Eur J Oncol Nurs 2009;13:368-75.
  • 24 Verity R, Wiseman T, Ream E, Teasdale E, Richardson A. Exploring the work of nurses who administer chemotherapy. Eur J Oncol Nurs 2008;12:244-52.
  • 25 Yanqin Y, Dezhong X, Bo W, Xianni W, Xiaoli Q, Xianghai M. An investigation into the occupational protection status of clinical nursing staff exposed to anti-tumor drugs. J Med Coll PLA 2012;27:113-9.
  • 26 International Labour Organization (ILO). The Standards for Health Care Workers Adopted by ILO at Nursing Personnel Convention (No. 149) and Recommendation (No. 157); 1977. Available from: http://www.ilo.org/ilolex/cgi-lex/convde.pl?C149. [Last accessed on 2016 Jul 07].
  • 27 Connor TH, Anderson RW, Sessink PJ, Broadfield L, Power LA. Surface contamination with antineoplastic agents in six cancer treatment centers in Canada and the United States. Am J Health Syst Pharm 1999;56:1427-32.
  • 28 Schmaus G, Schierl R, Funck S. Monitoring surface contamination by antineoplastic drugs using gas chromatography-mass spectrometry and voltammetry. Am J Health Syst Pharm 2002;59:956-61.
  • 29 Valanis B, McNeil V, Driscoll K. Staff members' compliance with their facility's antineoplastic drug handling policy. Oncol Nurs Forum 1991;18:571-6.