Exposure to antineoplastic agents poses a potential health risk to staff who:16
- prepare, handle, or administer the drugs
- care for individuals following administration
- dispose of these drugs or related waste.
Many antineoplastic agents, proven to be carcinogenic, mutagenic and teratogenic, are classified as hazardous substances. Direct exposure to antineoplastic agents can occur during administration or handling, and involves inhalation, ingestion or absorption.20-22
Safe levels of occupational exposure to hazardous agents and a reliable method of monitoring exposure have proven difficult to determine.3 The health risk of any procedure involving antineoplastic agents stems from the inherent toxicity of the drug and the extent to which individuals are exposed.
Health professionals working with antineoplastic agents are guided by guidelines, policies, and procedures to ensure maintenance of standards of care and to reduce occupational exposure.16
Access your state or territory policy document guiding practice with antineoplastic agents (examples below), and your own institution's policy and procedure for handling cytotoxic substances.
- Safe Handling of Cytotoxic Drugs and Related Wastes: Guidelines for South Australian Health Services 2012 (PDF, 1.51MB)
- Guide for handling cytotoxic drugs and related waste (PDF, 1.14MB). Workplace Health and Safety Queensland, 2014
- The Guidelines for the Safe Prescribing, Supply and Administration of Cancer Chemotherapy(PDF, 213KB)16
- Cancer Nurses Society of Australia Position Statement on the Minimum Education Requirements for Nurses in the Administration of Anti-Cancer Drugs within the Oncology and Non-Oncology Setting23 (CNSA member access only)
Appraise the current policy and procedures in your facility in light of the key guidelines.
Outline the key elements of an in-service program for nurses new to cancer control on safe handling of antineoplastic agents and their waste products.
Outline the principles of safe practice you would apply when advising a person regarding cytotoxic precautions in their home and community.
Discuss strategies used to ensure cytotoxic safety for the following groups and individuals:
- Support staff (i.e. cleaners, orderlies).
- Nurses in specialties other than cancer.
- Radiology staff.
- Pathology staff.
- Accident and emergency staff.