Department of Medical and Surgical Sciences, University of Bologna, Via Pelagio Palagi 9, 40138 Bologna (Ita-ly).
Department of Science and High Technology, University of Insubria, via Valleggio 11, 22100 Como (Italy).
Med Lav. 2024 Apr 24;115(2):e2024012. doi: 10.23749/mdl.v115i2.15609.
Several antiblastic drugs (ADs) are classified as carcinogenic, mutagenic, and/or toxic for reproduction. Despite established guidelines and safe handling technologies, ADs contamination of the work environments could occur in healthcare settings, leading to potential exposure of healthcare staff. This systematic review aims to investigate the main techniques and practices for assessing ADs occupational exposure in healthcare settings. The reviewed studies unveil that workplace contamination by ADs appears to be a still-topical problem in healthcare settings. These issues are linked to difficulties in guaranteeing: (i) the adherence to standardized protocols when dealing with ADs, (ii) the effective use of personal protective equipment by operators involved in the administration or management of ADs, (iii) a comprehensive training of the healthcare personnel, and (iv) a thorough health surveillance of exposed workers. A "multi-parametric" approach emerges as a desirable strategy for exposure assessment. In parallel, exposure assessment should coincide with the introduction of novel technologies aimed at minimizing exposure (i.e., risk management). Assessment must consider various departments and health operators susceptible to ADs contamination, with a focus extended beyond worst-case scenarios, also considering activities like surface cleaning and logistical tasks related to ADs management. A comprehensive approach in ADs risk assessment enables the evaluation of distinct substance behaviors and subsequent exposure routes, affording a more holistic understanding of potential risks.
一些抗肿瘤药物（ADs）被归类为致癌、致突变和/或对生殖有毒。尽管有既定的指导方针和安全处理技术，但 ADs 在医疗保健环境中的污染仍有可能发生，导致医护人员潜在暴露。本系统评价旨在研究评估医疗保健环境中 ADs 职业暴露的主要技术和实践。综述研究表明，ADs 对工作场所的污染似乎仍然是医疗保健环境中的一个重要问题。这些问题与以下方面的困难有关：（i）在处理 ADs 时遵守标准化方案，（ii）操作人员有效使用个人防护设备进行 ADs 的管理或管理，（iii）对医护人员进行全面培训，以及（iv）对暴露工人进行全面的健康监测。“多参数”方法似乎是暴露评估的一种理想策略。同时，暴露评估应与引入旨在最小化暴露的新技术（即风险管理）同时进行。评估必须考虑到易受 ADs 污染的各个部门和卫生工作者，不仅要考虑最坏情况下的情况，还要考虑表面清洁和与 ADs 管理相关的后勤任务等活动。对 ADs 风险的综合评估方法能够评估不同物质的行为和随后的暴露途径，从而更全面地了解潜在风险。
