NURSES AND PHARMACISTS EXPOSURE TO ANTINEOPLASTIC DRUGS - FINDINGS FROM INDUSTRIAL-HYGIENE SCANS AND URINE MUTAGENICITY TESTS

Data from 83 nurses and pharmacists handling antineoplastic drugs and 35 nurse/pharmacist controls who participated in a national study of a ntineoplastic drug-handling risks were examined to investigate antineo plastic drug exposure. Measures of external exposure included self-com pletion drug logs and industrial hygiene scans conducted in clinical s ettings. Internal exposure was measured by urine mutagenicity tests on end-of-week 24-hour urine specimens. To control for potential confoun ders, the staff was asked to complete food and hobby diaries and to av oid identified mutagenic substances for 1 week before collection of 24 -hour urine samples. On the scans of the drug handlers, 13% showed one or more spots of drug contamination on gloved and ungloved hands, gow ns, or shoes. Of the 24-hour urine samples, 15% were mutagenic for Sal monella typhimurium: Rates did not differ significantly for drug handl ers and controls. Among nurses who both prepared and administered anti neoplastics, those with positive mutagenicity tests handled more doses of the drugs, used less skin protection, and had more skin contact wi th the drugs than those with negative tests. Nurses who only administe red the drugs and had positive mutagenicity tests handled fewer doses of drugs than those with negative tests, but they also reported less u se of protection and more skin contact. For both groups of nurses, ski n contact with antineoplastics was associated with positive mutagenici ty test results (p < 0.01).