Central Appalachian Regional Education and Resource Center (CARERC)

Current Projects


Exposure Assessments and Evaluation and Implementation of an Oncology Nurse Communication and Training Program at the University of Tennessee Medical Cancer Center, Knoxville.

As early as the late 1970s, researchers began observing that nursing and pharmacy personnel who handled antineoplastic drugs were being exposed during drug preparation and administration (Falck et al., 1979). Exposures were reported to occur through inhalation, ingestion, and/or skin contact. Acute effects included irritation to eyes and skin, nausea, vomiting, diarrhea, hearing loss, organ dysfunction, and bone marrow suppression. Chronic effects included spontaneous abortions, fetal malformations and fetal loss, low birth weight, menstrual dysfunction, mutagenicity, infertility, cytogenetic damage, and cancer (Pretty et al., 2012). Persons at risk include oncology nurses, pharmacists and pharmacy technicians, physicians, surgical staff, hospital staff (shipping and receiving, laundry, biohazard waste handlers, etc.), and in some cases veterinary staff.

It is estimated that 8 million U.S. healthcare workers are potentially exposed to hazardous drugs or drug wastes (BLS, 2011). Despite published guidelines and safety precautions for the safe handling of hazardous and antineoplastic drugs (NIOSH, 2013; Polovich, 2011; et al.), recent studies continue to identify antineoplastic drug contamination at various locations of the workplace where these drugs are handled (Kiffmeyer et al., 2012; Polovich and Martin, 2011), as well as deficiencies in health training and communication.

Guidelines for the handling of antineoplastic drugs have been published by multiple agencies, including the American Society of Health-System Pharmacists (2004), the National Institute for Occupational Safety and Health (2012), and the Oncology Nursing Society (2011). This study aims to assess handling practices for antineoplastic agents at the University of Tennessee Medical Center and ultimately to develop improved communication and training programs for clinical personnel who may be exposed to such agents in the workplace.

Specific Aims

  1. Identify, characterize and assess actual antineoplastic agents handling practices.
  2. Through the use of wipe samples and air sampling, quantitatively characterize potential contamination points and potential worker exposures to antineoplastic agents throughout their life-cycle use in hospital and clinical centers.
  3. Assess whether oncology personnel are adequately trained in antineoplastic agent hazards, risks of exposure, safe handling practices, and strategies to protect themselves.
  4. Identify any gaps in knowledge, training, communication, and safe handling practices.
  5. Develop, implement and test a comprehensive health training and communications program.

For more information contact:
Martin D. Barrie, J.D., Ph.D.
Senior Epidemiologist/Scientist
Oak Ridge Associated Universities
Occupational Exposure and Worker Health
P.O. Box 117, MS 23
Oak Ridge, TN 37831-0117
Office: 865-576-6250
Martin.Barrie@orau.org