Which factors prevent or enable the safe handling of antineoplastic drugs?

Several barriers and facilitators indicate the need to create work environments where safety is a priority for the handling of antineoplastic drugs, suggests a Canada study.

“Antineoplastic drugs are widely used in the treatment of cancer,” the authors said. “However, some are known carcinogens and reproductive toxins, and incidental low-level exposure to workers is a health concern.”

In Canada, nearly 75,000 patients are exposed to antineoplastic drugs in the workplace. Although policies and guidelines on safe handling of these drugs are in place, compliance remains low. This study then identified barriers and facilitators for the safe handling of antineoplastic drugs in workplace settings.

The authors used a unique method to assess public policy, which involved compiling policy levers, developing a logic model, conducting a literature review, and contextualizing data through a deliberative process with stakeholders to explore in-depth contextual factors and experiences for the safe handling of antineoplastic drugs.

Poor training (46 percent) was the most common barrier identified, followed by poor safety culture (41 percent) and inconsistent policies (36 percent). In terms of facilitators, the most common was adequate safety training (41 percent), followed by leadership support (23 percent) and consistent policies (21 percent). Many of these factors were interwoven.

“[W]hile this means [that] one barrier can cause other barriers, it also allows healthcare employers to mitigate these barriers by implementing small but meaningful changes in the workplace,” the authors said.

“The results of this study will assist policy makers and managers in identifying gaps and enhancing strategies that reduce occupational exposure to antineoplastic drugs,” they noted.