Department of Pharmacy, Princess Alexandra Hospital, Brisbane, Australia.
Centre for Health Services Research, The University of Queensland, Brisbane, Australia.
Asia Pac J Clin Oncol. 2023 Dec;19(6):723-730. doi: 10.1111/ajco.13943. Epub 2023 Mar 10.
The aims were to (a) review the scientific literature on occupational risk, including exposure mechanisms and risk assessment, with regards to handling monoclonal antibodies (mABs) in healthcare settings; and (b) update the recommendations in the Clinical Oncology Society of Australia (COSA) safe handling of monoclonal antibodies in healthcare settings position statement, published in 2013.
A literature search was conducted between April 24, 2022, and July 3, 2022, to identify evidence relating to occupational exposure and handling of mABs in healthcare settings. Evidence in the literature was compared to the Position Statement published in 2013, and any potential additions, deletions, or revisions were discussed by the authors, and then agreed changes were made.
Thirty-nine references were included in this update, comprising of the 2013 Position Statement itself and 10 of its references, as well as 28 new references. The risks to healthcare workers in the preparation and administration of mABs arise from four distinct exposure mechanisms: dermal, mucosal, inhalation, and oral. Updates included recommendations on using protective eyewear during the preparation and administration of mABs, developing a local institutional risk assessment tool and handling recommendations, considerations for using closed system transfer devices, and to have awareness of the nomenclature change from 2021 for new mABs.
Practitioners should follow the 14 recommendations to lower occupational risk when handling mABs. Another Position Statement update should occur in 5-10 years to ensure the currency of recommendations.
(a)回顾有关在医疗保健环境中处理单克隆抗体(mAB)的职业风险的科学文献,包括暴露机制和风险评估;(b)更新 2013 年发表的澳大利亚临床肿瘤学会(COSA)“在医疗保健环境中安全处理单克隆抗体”立场声明中的建议。
2022 年 4 月 24 日至 2022 年 7 月 3 日进行了文献检索,以确定与医疗保健环境中职业暴露和 mAB 处理相关的证据。对文献中的证据与 2013 年发表的立场声明进行了比较,作者讨论了任何潜在的添加、删除或修订,并同意进行修改。
本更新纳入了 39 篇参考文献,包括 2013 年的立场声明本身及其 10 篇参考文献,以及 28 篇新参考文献。医护人员在制备和管理 mAB 时面临的风险来自四个不同的暴露机制:皮肤、黏膜、吸入和口服。更新内容包括在制备和管理 mAB 时使用防护眼镜的建议,制定当地机构风险评估工具和处理建议,考虑使用密闭式传输装置,并了解自 2021 年以来新 mAB 名称的变化。
从业者在处理 mAB 时应遵循 14 项建议,以降低职业风险。应在 5-10 年内再次更新立场声明,以确保建议的时效性。