CTAIPP launches Hazardous Drug Safety Project

Since the mid-1900s, cancer chemotherapy drugs have been used to treat millions of patients. While these drugs are life-saving, their potential risk to hospital employees who regularly come into contact with them are unclear. It is known that adhering to safety policies and procedures and using protective equipment greatly reduces health risks.

Several new devices designed to limit employee exposure to chemotherapy drugs recently have been developed. However, data on the value of these devices is limited.

MGH Cancer Center Nursing and Pharmacy leaders interested in these protective products brought them to the attention of Jeanette Ives Erickson, RN, MS, senior vice president for Patient Care Services and chief nurse, who asked the MGH Council for Technology Adoption and Innovative Process Promotion (CTAIPP) to evaluate the devices' effectiveness.

To ensure that all MGH employees who come into contact with chemotherapy drugs work in the safest possible environment and to evaluate the value of the protective devices, CTAIPP has launched the Hazardous Drug Safety Project, a comprehensive study to examine the health risks anticancer drugs may pose as they are handled at the MGH. A team of researchers and clinical leaders will review chemotherapy drug safety protocols from the time the drugs are received at the MGH loading dock, through their storage and preparation in the Pharmacy, their administration in patient care areas and their eventual disposal. The research team includes representatives from Pharmacy, Nursing, Environmental Services and Occupational Health Services, along with Harvard School of Public Health industrial hygiene experts Thomas Smith, PhD, MPH, and Robert Herrick, SD.

During the first phase of the project, the team will look for the presence of anticancer drugs in the work environment to assess the potential for employee exposure. The researchers will collect samples from surfaces throughout the MGH — floors, countertops, patient beds and other areas — and test for the presence of chemotherapy drugs. If such drugs are found, the researchers will work on approaches to reduce employee exposure, which may include analyzing employee blood or urine samples for the presence of anticancer drugs. If the team finds evidence of employee exposure, they also will evaluate new protective technology. Information gathered may also be used to revise existing hazardous drug policies and procedures to ensure that employees are working in the safest setting possible.

"This project will develop a first-of-its-kind surveillance program that will look at the entire journey anticancer drugs take through the hospital," says Harold J. DeMonaco, MS, co-chair of CTAIPP and chair of the project. "Other institutions have done limited studies to examine employee exposure. We will be taking a comprehensive approach looking at the potential of exposure to everyone who handles these drugs — nurses, pharmacists, pharmacy technicians and environmental service workers, along with patients and their family members. Based on what we find in the environment, we may ask employees for their assistance in later stages of the project. Any blood and urine samples collected from employees who volunteer will only be tested for a list of chemotherapy drugs. Recreational drug testing is not a component of this study."

Jackie Somerville, RN, PhDc, associate chief nurse, adds, "The clinical leadership at the MGH raised important concerns about the narrow focus of current chemotherapy drug safety products. With this project, we will explore how to protect our staff from potential hazards and ensure safe practices for all employees handling these anticancer drugs."

For more information about the Hazardous Drug Safety Project, contact DeMonaco at hdemonaco@partners.org or (617) 724-8253.