Hazardous Drugs
Hazardous drugs, such as those used for cancer chemotherapy, antiviral treatments and hormone regimens, pose a serious hazard to healthcare workers. These effects can be irreversible even with low-level exposures.
Both clinical and nonclinical workers may be exposed to hazardous drugs when they create aerosols, generate dust, clean up spills, or touch contaminated surfaces during the preparation, administration, or disposal of hazardous drugs.
Exposure Routes
There are four major routes of entry chemicals can follow:
- inhalation (breathing),
- absorption (skin contact),
- ingestion (eating), and
- injection.
Inhalation, skin contact, or absorption are the most likely routes of exposure. However, ingestion from hand to mouth contact and unintentional injection through a needle-stick or sharps injury are also possible.
Case Study
A patient-care assistant working on an oncology floor developed an itchy rash approximately 30 minutes after emptying a commode of urine into a toilet. She denied any direct contact with the urine, wore a protective gown and nitrile gloves, and followed hospital policy for the disposal of materials contaminated with antineoplastic drugs. The rash subsided after 1 to 2 days. Three weeks later, she had a similar reaction approximately 1 hour after performing the same procedure for another patient.
Upon investigation, it was found that both hospital patients had recently been treated with vincristine and doxorubicin. The patient-care assistant had no other signs or symptoms and reported no changes in lifestyle and no history of allergies or recent infections. After treatment with diphenhydramine (intramuscular) and oral corticosteroids, her symptoms disappeared. Although the cause could not be definitely confirmed, both vincristine and doxorubicin have been associated with allergic reactions when given to patients. The aerosolization of the drug present in the urine may have provided enough exposure for symptoms to develop.
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3-3. What are the three most common routes of exposure to hazardous substances in the workplace?
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