Background and importance Hazardous drugs (HD) are those that exhibit one or more of the following six characteristics in humans or animals: carcinogenicity, teratogenicity or other developmental toxicity, reproductive toxicity, organ toxicity at low doses, genotoxicity, and structure and toxicity profiles of new drugs that mimic existing drugs, determined hazardous by the above criteria. Exposure to HD in the workplace could lead to serious health risks, which increase with exposure frequency. Therefore, it is crucial to limit exposure with appropriate equipment.
Aim and objectives To identify HD used in a nursing home and to analyse the use of appropriate self-protection measures by nursing staff.
Material and methods A prospective, observational study was performed in a nursing home over a 1 month period. Direct observation was carried out about how nursing staff handled HD. These drugs were identified through the medication sent to the nursing home and were categorised according to reference documentation (NIOSH and INSST (group 1, 2 or 3). Data collected were, for the nursing staff, age, sex, staff at reproductive risk and use of personal protective equipment (PPE) during HD handling. Use or not of hazardous drug waste containment was also collected.
Results A total of 152 drugs were sent weekly to the nursing home, of which 11 were HD: acenocoumarol, bicalutamide, carbamazepine, clonazepam, spironolactone, lamivudine, paroxetine, risperidone, tacrolimus, topiramate and valproic acid (18% group 1, 36% group 2% and 46% group 3). Nursing staff comprised 24 workers, 14 women (58.3%) and 10 men (41.7%), with a median age 41 years. Personnel at reproductive risk were 10 (66.7%): 7 women and 3 men. All staff used PPE insufficiently: they did not wear double gloves when handling HD or goggles with side shields when splashing was a possibility. Waste disposal was inadequate in 100% because of containers used were incorrect.
Conclusion and relevance Mishandling of HD was widespread: nursing staff did not use PPE as recommended by the administration guidelines for HD. There was no awareness of suitable waste disposal. Pharmaceutical interventions could decrease the potential risk of occupational exposure.
References and/or acknowledgements No conflict of interest.
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