UBC Theses and Dissertations

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UBC Theses and Dissertations

Assessment and proposal of controls to reduce cytotoxic drugs exposure in pharmacy personnel Griffiths, Andrea Dawn


In health care settings, cytotoxic drugs are utilized for the treatment of various conditions such as cancer and arthritis. The properties of these products make them powerful drugs that have the capacity to elicit toxic effects indiscriminately on a variety of cell types and in some cases can cause cancer and adverse reproductive outcomes. Health care workers can be exposed to these products through dermal absorption, ingestion or inhalation. There are presently no occupational exposure limits for these products, but WorkSafeBC Regulations, the British Columbia Cancer Agency and United States Pharmacopeia 797 standards guide best practices for working safely with these products The goals of this thesis research were to evaluate current practices and to propose occupational hygiene controls to reduce exposure to cytotoxic drugs in hospital pharmacy personnel. The research was conducted in five iterative parts: 1. An environmental assessment of selected hospital pharmacies was conducted to determine presence of cytotoxic pharmaceuticals on work surfaces, and to examine factors related to presence of workplace contamination. 2. A questionnaire was developed to assess hospital pharmacy perception of cytotoxic agents, their level of training and education, and their use of personal protective equipment. 3. Focus group sessions with pharmacy personnel were conducted to obtain feedback on information collected in the first two phases of research, to identify barriers to safe working practices, and to help propose safety initiatives. 4.Safetyinitiativesweredesigned,pilottestedandevaluatedbyemployeesbasedon information obtained in parts 1 through 3 above. 5. A second worksite assessment was performed to evaluate controls to reduce exposure to cytotoxic agents. This is the first study in Canada aimed at assessing and proposing controls to reduce occupational exposure to cytotoxic drugs in acute care hospital pharmacies utilizing a strategy that included multiple methods and employee engagement to enhance a traditional occupational hygiene paradigm evaluation.

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