Study On Exposure Risk And Hierarchical Control Of Antineoplastic Injections

OBJECTIVE:To understand the exposure links and risks of antineoplastic injections of health care workers,and formulate corresponding protective measures by hierarchical control to provide scientific basis for the establishment of occupational exposure protection of antineoplastic injections for health care workers.METHODS:A questionnaire survey is conducted on the occupational exposure of antineoplastic drugs among health care workers.The determination methods of the antineoplastic drugs cyclophosphamide,fluorouracil,and gemcitabine are established to detect on the external surface contamination of the different drugs injections above,also the contamination on the surface of domestic and imported gemcitabine injections are compared.The leakage of the robot intelligent system(WEINAS)is detected when compounding the three kinds of antineoplastic drugs,and the results are compared with the leakage of the artificial(BSC).The hierarchical control is formulated to develop the protective measures of occupational exposure of antineoplastic drugs.RESULTS:A total of 350 questionnaires were issued,304 of which were effectively recovered,with an recovery rate of 86.9%,validity 0.74.only 39.8%of the 304 people who participated in the survey knew about the occupational exposure hazards of antineoplastic drugs,and the longer the total working time,the higher the awareness of health care workers against the occupational exposure hazards of antineoplastic drugs(P=0.0358).Cyclophosphamide(54.28%)was the most frequently exposed antineoplastic drug for health care workers.22.04%of the health care workers had post exposure discomfort symptoms,mainly increased hair loss(73.13%),the longer the total time of occupational exposure,the higher the incidence of discomfort(P=0.0176).The dispensing equipment in each department was mainly equipped with biosafety cabinets.The results showed that there were different levels of drug contamination on the surface of the glass bottles of cyclophosphamide,fluorouracil and gemcitabine.The contamination of cyclophosphamide was 43.51ng/vial,and that of fluorouracil was904.33ng/vial.The contamination of imported gemcitabine was 0.66ng/vail,which was lower than that of domestic 5.92ng/vail(P<0.001).All of the three antineoplastic injections showed a high amount of contamination in the arms,discs and waste disposal ports of WEINAS.Knowing by comparison,the contamination on the interior plane of WEINAS(0.15ng/cm~2 on average)is lower than that of BSC(0.51ng/cm~2 on average)(P=0.002).The contamination on the external glass plane of WEINAS(0.054ng/cm~2 on average)is also lower than that of BSC(0.26ng/cm~2 on average)(P=0.026).The contamination on the glove surface of WEINAS(5.63ng/cm~2 on average)was lower than that of BSC(16.05ng/cm~2 on average)(P=0.022).The contamination of infusion bag prepared by WEINAS(5.57ng/cm~2 on average)was lower than that prepared by BSC(53.41ng/cm~2 on average)(P=0.006).CONCIUSION:The current situation of occupational exposure to antineoplastic drugs is not optimistic.Hospitals and health care workers had a low understanding of the hazards of occupational exposure to antineoplastic drugs and self-protection measures.There were contaminations on the outer surface of different antineoplastic drug injections.Compared with the same drug,the imported has lower contamination and safer packaging.Although WEINAS has high internal drug contamination,compared with BSC,it has the characteristics of lower leakage and better safety.In order to minimize the exposure risk of antineoplastic drugs,the corresponding protective measures of exposure link should be formulated by the way of hierarchical control.