Occupational Safety in Antineoplastic Drug Handling
Summary
Handling antineoplastic agents presents a well-recognised occupational risk owing to their inherent cytotoxicity, mutagenicity and teratogenicity. Healthcare workers may be exposed through dermal contact, inhalation of aerosols or vapours, and inadvertent ingestion following surface contamination. Engineering controls such as biological safety cabinets, laminar-flow hoods and closed-system transfer devices (CSTDs) serve to confine agents and reduce environmental release. Administrative measures, including standard operating procedures, spill-response protocols and regular training, underpin safe work practices. Personal protective equipment (PPE) – gloves, gowns, eye protection and respiratory masks – forms the final barrier against exposure. Comprehensive risk assessment integrates environmental monitoring, surface wipe sampling and, where available, biological monitoring to verify the effectiveness of control measures. Continuous improvement is essential, driven by new evidence on contaminant pathways, device performance and human factors. International guidelines advocate a hierarchical approach that prioritises elimination or substitution, followed by engineering and administrative controls, and finally PPE, to achieve the lowest reasonably practicable exposure levels.
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Occupational Safety in Antineoplastic Drug Handling publication trend
The graph below shows the total number of articles in occupational safety in antineoplastic drug handling across all publications each year (not limited to Nature Index journals).
Technical terms
Antineoplastic drug: A chemical agent used in chemotherapy that inhibits the proliferation of malignant cells but poses toxicity risks to handlers.
Closed-system transfer device (CSTD): An engineering control designed to mechanically prevent the escape of hazardous drug or vapour during transfer between containers.
Personal protective equipment (PPE): Garments and devices, such as gloves, gowns and respirators, worn to reduce exposure to hazardous substances.
Dermal exposure: Contact between the skin and hazardous agents, a principal route of occupational absorption of cytotoxic drugs.
Biological monitoring: Assessment of internal exposure by measuring parent compounds or metabolites in biological matrices (e.g. urine, blood).
References
- Comparison of a novel glove connector to chemical tape as a sealing device between gloves and protection suits. Journal of Hazardous Materials (2024).
- Real-world study of the leakage of two types of infusion bags in multicenter pharmacy intravenous admixture service (PIVAS). Frontiers in Pharmacology (2023).
- Exposure to Antineoplastic Drugs in Occupational Settings: A Systematic Review of Biological Monitoring Data. International Journal of Environmental Research and Public Health (2022).
- Safe Handling of Cytotoxics: Guideline Recommendations. Current Oncology (2015).
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