John Libbey Eurotext

Journal de Pharmacie Clinique

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Evaluation of pharmacy technicians handling cytotoxic agents in a centralized unit Volume 22, issue 2, avril-mai-juin 2003

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Service de pharmacie, centre régional de lutte contre le cancer Léon Bérard, 28 rue Laennec, 69008 Lyon

Detectable levels of cytotoxic agents have been found in urine of people handling these drugs. Training and regular evaluation of pharmacy technicians involved in the preparation of antineoplastic agents seem essential to reduce occupational exposure. The purpose of this study is to implement an annual simulation test using a fluorescent agent to assess each workers‘ performance. Pharmacy staff was asked to prepare a safe simulated liquid cytotoxic drug with a fluorescein solution. Ultra‐violet light (365 nm) was employed to determine surface contamination. After two evaluations, competency test scores among technicians improved (from 13% to 18%). The main reason to explain this result is a better accordance to the standard operating procedures. However, as spillage during preparation can occur with anyone, the workplace must always be considered as contaminated. These results indicate that thanks to regular evaluation, it is possible to improve compliance with general handling procedures. But at the same time, environmental contamination is not completely removed. Thus, high levels of fluorescein are still found on utility drapes and on latex gloves. This study gives us information about contaminated locations and preparation‘s steps which may allow the escape of the drug into the workplace. Occupational exposure to antineoplastic drugs can not be reduced if the reasons for exposure remain unknown.