[Safety evaluation of new anticancer chemotherapy administration system: compared to the results from a former study-].

Anticancer drugs can cause genotoxicities such as mutagenicity and/or chromosomal abnormalities, and/or toxicities, such as fetal malformation or cancer. In recent years, the health risks to health care workers who handle anticancer drugs at work has been considered. In 2009, we researched the exposure risk of anticancer chemotherapy in a nursing administration area using fluorescein (which was used as a contamination detection agent), to identify the problem. The result of this investigation showed that three types of events caused the risk of toxic exposure: 1 . Priming with anticancer drugs; 2 . leakage from the infusion bag when removing the spike from IV containers(exchanging of IV bottle); and 3 . removal of the IV line from the patient without rinsing with normal saline. Taking measures to cope with those problems, we have introduced our new anticancer chemotherapy administration system for prevention against toxic exposure. This system was evaluated in a leak-proof infusion bag by using fluorescein, which was used in our former study. As a result, a leakage reaction has not been detected in any handling events. Although visible leakage of fluorescein is an effective way to identify the exposure risk in an administration area, the analysis is not clear, objective or numerical. Therefore, this system's safety should be assessed with a numerical analysis of the leakage reaction in a further study, such as an environmental contamination research.

[Safety issues of chemo drug administration handling by nurses from an occupational exposure viewpoint-through visualization with contrast media for ophthalmic vasculature].

A number of studies on health effects of exposure to antineoplastic agents by health professionals have been reported recently. The health effects suggested are mutagenic, teratogenic and/or carcinogenic effects. In the United States or in EU countries cancer chemotherapy nursing guidelines have been already established, whereas in Japan the management of chemotherapy agents is left to each facility and the drug is administered based on the standard of each facility. We used a chemical in this study during preparation and administrations of antineoplastic agents to visualize spills that could be generated during the procedures so that we can sort out safety issues of chemo drug handling by nurses from an occupational exposure point of view. The result showed spills all over in the procedures by nurses in the study: specifically splash to environment around the drug preparation area, contamination of needles which were used for drug preparations, contamination of environment as the result of priming with chemo agents and spills at the exchange of IV bottle or at removal of the IV line from the patient without rinsing with normal saline. For future protective measures from exposure to antineoplastic agents, it is considered that the current administration method must be reviewed, and new methods to avoid the current safe handling issues must be developed and evaluated. Furthermore, strict conformity to chemo drug administration procedures based on the authorized guideline is very important in addition to the standard of the administration procedures in each facility. Hence, the work to prepare for the upcoming Japanese guideline is expected beyond the work to translate the US chemotherapy administration guideline by the Oncology Nursing Society (ONS) into the Japanese language.