Müller-Ramírez Claudio, Almashat Sammy, Gaitens Joanna, McDiarmid Melissa
Universidad de Concepción Concepción Chile Universidad de Concepción, Concepción, Chile.
University of Maryland Baltimore United States of America University of Maryland, Baltimore, United States of America.
Rev Panam Salud Publica. 2023 Mar 10;47:e11. doi: 10.26633/RPSP.2023.11. eCollection 2023.
Antineoplastic drugs (ANDs) used for chemotherapy can cause secondary cancers in treated patients and can pose carcinogenic risks to health-sector workers anywhere along these drugs' life cycle in a facility, from production to patient administration. Several PAHO/WHO Collaborating Centers (CCs) have experience addressing these hazards in the health sector. The objectives of this report are four-fold: 1) Provide an overview of longstanding research and prevention efforts, led by PAHO/WHO and its Occupational Health CCs, aimed at reducing the burden of occupational cancer in the Americas; 2) Discuss how robust AND exposure assessment and educational/outreach work by PAHO CCs can form the basis of exposure mitigation efforts among health-sector workers; 3) Through the presentation of original AND exposure assessment data from a pharmaceutical compounding facility in Chile, highlight relatively inexpensive methods by which such data can be generated; and 4) Discuss how effective, periodic environmental surveillance in healthcare facilities results in the identification of AND contamination in the work environment and enables the implementation of low-cost, high-impact interventions to reduce the risk of occupational cancer in health-sector workers, including in limited-resource settings. The risk of health-sector worker exposure to ANDs and other hazardous drugs is an important issue for inclusion within PAHO/WHO's broader efforts at reducing the impact of occupational cancer in the Americas. This report demonstrates that a wide range of accessible AND-exposure mitigation strategies are feasible at both a facility and a national policy level across the hemisphere.
用于化疗的抗肿瘤药物（ANDs）可导致接受治疗的患者患继发性癌症，并可能在这些药物在医疗机构从生产到患者给药的整个生命周期中，对任何接触到它们的卫生部门工作人员构成致癌风险。泛美卫生组织/世界卫生组织的几个合作中心（CCs）在应对卫生部门的这些危害方面拥有经验。本报告的目标有四个：1）概述由泛美卫生组织/世界卫生组织及其职业健康合作中心牵头开展的长期研究和预防工作，旨在减轻美洲职业癌症的负担；2）讨论泛美卫生组织合作中心强大的抗肿瘤药物接触评估以及教育/宣传工作如何能够成为卫生部门工作人员减轻接触危害工作的基础；3）通过展示来自智利一家药物配制机构的原始抗肿瘤药物接触评估数据，强调生成此类数据的相对低成本方法；4）讨论医疗机构中有效的定期环境监测如何能够识别工作环境中的抗肿瘤药物污染，并促使实施低成本、高影响力的干预措施，以降低卫生部门工作人员患职业癌症的风险，包括在资源有限的环境中。卫生部门工作人员接触抗肿瘤药物和其他危险药物的风险是一个重要问题，应纳入泛美卫生组织/世界卫生组织在减轻美洲职业癌症影响方面的更广泛努力之中。本报告表明，在整个半球的机构和国家政策层面，一系列可行的、可获取的减轻抗肿瘤药物接触的策略都是可行的。
