Health Hazard Evaluation Report: HETA-2009-0148-3158, June 2012. Chemotherapy Drug Exposure at an Oncology Clinic - Florida.

摘要

On May 1, 2009, NIOSH received a confidential employee request for an HHE at an oncology clinic in Florida. The request concerned potential exposures to chemotherapy drugs and adverse health effects such as upper respiratory symptoms, rash, diarrhea, migraine, and headache. During our first site visit in September 2009, we measured the face velocity of the Class 2 BSC where chemotherapy drugs were mixed and collected surface and hand wipe samples for platinum-containing chemotherapy drugs. We also conducted health interviews with 14 of 54 employees and reviewed the OSHA Form 300 Log of Work-Related Injuries and Illnesses for 2006 through 2008. In November 2010, during our second evaluation, we collected surface wipe samples (but no hand wipe samples) for platinum-containing chemotherapy drugs in similar locations as in the 2009 evaluation. We also collected surface wipe samples for cyclophosphamide, ifosfamide, and doxorubicin at the beginning of the work day before the chemotherapy drugs were unpacked and at the end of the work day after the last chemotherapy treatment was completed. We did this to evaluate the clinic's cleaning procedures and employee work practices. Platinum-containing chemotherapy drugs were detected in most surface wipe samples during both evaluations but not on the two hand wipes collected in 2009 from nurses who had recently handled platinum-containing chemotherapy drugs. Cyclophosphamide and ifosfamide were detected on surface wipe samples collected throughout the clinic, suggesting inadequate work practices and housekeeping. Doxorubicin was not detected on any surface wipe samples but its recovery may have been poor because these wipe samples had been frozen for approximately 7 months awaiting development of an analytical method (Burr 2011a). The Class 2 BSC was certified biannually. The sash alarm that was malfunctioning during our first visit had been repaired by our second visit. The average BSC face velocity we measured was 275 feet per minute, which met the CDC recommendation of at least 100 feet per minute (CDC 2007).