October 24, 2019

NIOSH Examines Handling of Chemotherapy Drugs at Veterinary Hospital

NIOSH recently conducted a health hazard evaluation of a veterinary specialty hospital in response to concerns about possible occupational exposures to chemotherapy drugs. Agency staff assessed whether work surfaces were contaminated by sampling surfaces in the chemotherapy administration area after drugs were administered. NIOSH personnel did not find chemotherapy drugs on any of the surfaces that were tested in the chemotherapy administration area. However, a small amount of the drug cyclophosphamideon was detected on the floor just outside the area. NIOSH’s report suggests several potential reasons for this contamination: a spill might have been not reported or not cleaned appropriately; contamination may have spread if housekeeping staff used the same mop and water bucket in the chemotherapy administration area to clean other areas of the hospital; or contamination might have been tracked out of the area on a day NIOSH did not sample or from another area that was not sampled. Overall, NIOSH staff found that the hospital’s standard operating procedures for handling hazardous drugs provided “adequate guidance on safe techniques in preparing, administering, and disposing of hazardous drugs as well as managing chemotherapy drug spills.”

During confidential interviews with NIOSH staff, hospital employees did not report health symptoms or concerns related to handling and administering chemotherapy drugs. According to the agency’s report, most employees were satisfied with the hospital’s current health and safety training program, especially for new hires, who complete a comprehensive chemotherapy training program. Employees also reported wearing required personal protective equipment when working with chemotherapy drugs.

NIOSH recommended that the employer continue rigorously training new staff and begin comparable refresher training for tenured employees who began work at the hospital before the comprehensive chemotherapy training program was established. The agency also urged the hospital to provide face shields in place of respirators to facilitate splash protection during chemotherapy administration.

More information is available in NIOSH’s full report (PDF).