User:KnightleyZ/sandbox

Background:
[https://www.ashp.org/-/media/assets/policy-guidelines/docs/guidelines/handling-hazardous-drugs.ashx Since 1970’s antineoplastic drugs were identified as hazardous drugs, the American Society of health system pharmacist (ASHP) has introduced this concept after publishing their recommendation in 1983 regarding handling the hazardous drugs. The adaptation of federal regulation came when the Occupational Safety and Health Administration (OSHA) first released its guideline in 1986 and then updated in 1996, 1999 and the most recent update was in 2006, the National Institute for Occupational Safety and Health (NIOSH) has been conducting assessment in the workplace since then regarding these drugs. Occupational exposure to antineoplastic drugs has been linked to multiple health effect including infertility and possible carcinogenic effect.]

Few cases have been reported in NIOSH alert report in 2004:

[https://www.cdc.gov/niosh/docs/2004-165/pdfs/2004-165.pdf?id=10.26616/NIOSHPUB2004165 A female pharmacist was diagnosed with papillary transitional cell carcinoma,12 years before diagnosis she worked 20 months in the hospital IV preparation preparing multiple antineoplastic drugs. She didn't have any other risk factor for cancer, and her cancer was attributed to the exposure of the antineoplastic drugs although a cause-and-effect relationship has not been established in the literature. Another case happened when a malfunction in biosafety cabinetry cause possible exposure for nursing personnel to antineoplastic drugs which evidence of genotoxic biomarkers two and nine months after that exposure was found.]

Potential occupational exposure:
[https://www.ncbi.nlm.nih.gov/pubmed/25153300 Antineoplastic drugs could be administered through intravenous, intramuscular, intrathecal, or subcutaneous and before administrating the medications to the patient most of the time if need to be prepared and handle by several workers. Any worker who handled, prepare, administrate or clean surfaces or area where an antineoplastic drug has been used have a potential exposure. exposure indicated by measure antineoplastic drugs in the worker urine and an increase in genotoxicity biomarkers.]

Main sites for exposure:
1.    Pharmacy: pharmacist and pharmacy technician were preparing and handling the antineoplastic drugs.

[https://www.cdc.gov/niosh/docs/2004-165/pdfs/2004-165.pdf?id=10.26616/NIOSHPUB2004165 2. Administration to patients: mainly performed by nurses or physicians.]

[https://www.cdc.gov/niosh/docs/2004-165/pdfs/2004-165.pdf?id=10.26616/NIOSHPUB2004165 3. Disposing of antineoplastic drugs: performed by pharmacists, nurses, and housekeeping.]