Evaluation of the risk of occupational exposure to antineoplastic drugs in healthcare sector: part II – the application of the FMECA method to compare manual vs automated preparation

Author:

Dugheri Stefano1,Cappelli Giovanni1,Squillaci Donato1ORCID,Rapi Ilaria1,Fanfani Niccolò1,Dori Fabrizio2,Cecchi Michele3,Sordi Viola3,Ghiori Andrea3,Mucci Nicola1

Affiliation:

1. University of Florence , Department of Experimental and Clinical Medicine , Industrial Hygiene and Toxicology Laboratory , Florence , Italy

2. AOU Meyer, Health and Safety Service , Florence , Italy

3. Careggi University Hospital , Pharmacy AD Preparation Unit , Florence , Italy

Abstract

Abstract Healthcare workers handling antineoplastic drugs (ADs) in preparation units run the risk of occupational exposure to contaminated surfaces and associated mutagenic, teratogenic, and oncogenic effects of those drugs. To minimise this risk, automated compounding systems, mainly robots, have been replacing manual preparation of intravenous drugs for the last 20 years now, and their number is on the rise. To evaluate contamination risk and the quality of the working environment for healthcare workers preparing ADs, we applied the Failure Mode Effects and Criticality Analysis (FMECA) method to compare the acceptable risk level (ARL), based on the risk priority number (RPN) calculated from five identified failure modes, with the measured risk level (MRL). The model has shown higher risk of exposure with powdered ADs and containers not protected by external plastic shrink film, but we found no clear difference in contamination risk between manual and automated preparation. This approach could be useful to assess and prevent the risk of occupational exposure for healthcare workers coming from residual cytotoxic contamination both for current handling procedures and the newly designed ones. At the same time, contamination monitoring data can be used to keep track of the quality of working conditions by comparing the observed risk profiles with the proposed ARL. Our study has shown that automated preparation may have an upper hand in terms of safety but still leaves room for improvement, at least in our four hospitals.

Publisher

Walter de Gruyter GmbH

Reference47 articles.

1. Institute for Safe Medication Practices (ISIMP). ISMP list of high-alert medications in acute care settings [displayed 7 March 2024]. Available at https://www.ismp.org/sites/default/files/attachments/2018-08/highAlert2018-Acute-Final.pdf

2. Carrez L, Falaschi L, Cingria L, Sadeghipour F, Bouchoud L, Bonnabry P. [Organisation et sécurisation du circuit des chimiothérapies: Exemple de la pharmacie des Hôpitaux Universitaires de Genève, in French]. Pharmactuel 2014;47:119–24.

3. Palma E, Bufarini C. Robotized compounding of oncology drugs in a hospital pharmacy. Int J Pharm Compd 2014;18:358–64. PMID: 25577883

4. Hon C-Y, Teschke K, Chua P, Venners S, Nakashima L. Occupational exposure to antineoplastic drugs: identification of job categories potentially exposed throughout the hospital medication system. Saf Health Work 2011;2(3):273–81. doi: 10.5491/SHAW.2011.2.3.273

5. Ndaw S, Remy A. Occupational exposure to antineoplastic drugs in twelve French health care setting: biological monitoring and surface contamination. Int J Environ Res Public Health 2023;20(6):4952. doi: 10.3390/ijerph20064952

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3