N1: Research Roundup Health Care

Millions of Americans receive their medications via pharmacies. Pharmacies are known to handle bulk quantities of medications of various formulations and dosages. The handling and packaging techniques performed by pharmacy workers create the potential for exposure to hazardous drugs. This could result in adverse, systemic health effects via inhalation, dermal, and/or ingestion exposure routes. The pharmaceutical manufacturing industry has historically been highly regulated. The adoption of USP standards (safe handling of hazardous drugs) by many states and proactive organizations has brought focus to enhancing EHS programs in pharmacies. In the process, gaps in Industrial Hygiene programs have been identified. The opportunity to perform IH risk assessment and limited exposure monitoring provided opportunities to identify key IH challenges and opportunities in pharmacies. 

Antineoplastic drugs can be hazardous to healthcare workers and caregivers. A large body of evidence in the literature shows that these drugs can persist on surfaces even after cleaning, increasing the potential for exposures. The contamination by these drugs has been detected on hospital, pharmacy, and administrative surfaces as well as in biospecimens from healthcare workers, emphasizing their potential to travel outside the clinical setting. To reduce the risk of this forward transmission, surfaces in contact with antineoplastic drugs are treated with strong oxidizing cleaning products. The process by which these cleaning products remove the drugs may lead to the formation of breakdown products, potentially constituting an additional health hazard. Furthermore, different cleaning products and methods could create different byproducts and subsequent exposures. It is essential to recognize that the current cleaning protocols do not account for these potential breakdown products. Little is known about the health risks they pose to the exposed workforce.