NIOSH Health and Safety Practices Survey of Healthcare Workers: Training and awareness of employer safety procedures

Steege, Andrea L.; Boiano, James M.; Sweeney, Marie Haring

doi:10.1002/ajim.22305

Cited by 39 publications

(38 citation statements)

References 9 publications

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“…Information on overall methods used in the development and testing of the survey instrument, web survey design and functionality, survey population, survey implementation, respondent characteristics, and other information including strengths and limitations of the overall survey have been described elsewhere. (30) …”

Section: Methodsmentioning

confidence: 99%

Adherence to Safe Handling Guidelines by Health Care Workers Who Administer Antineoplastic Drugs

Boiano

Steege

Sweeney

2014

Journal of Occupational and Environmental Hygiene

Self Cite

100

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The toxicity of antineoplastic drugs is well documented. Many are known or suspected human carcinogens where no safe exposure level exists. Authoritative guidelines developed by professional practice organizations and federal agencies for the safe handling of these hazardous drugs have been available for nearly three decades. As a means of evaluating the extent of use of primary prevention practices such as engineering, administrative and work practice controls, personal protective equipment (PPE), and barriers to using PPE, the National Institute for Safety and Health (NIOSH) conducted a web survey of health care workers in 2011. The study population primarily included members of professional practice organizations representing health care occupations which routinely use or come in contact with selected chemical agents. All respondents who indicated that they administered antineoplastic drugs in the past week were eligible to complete a hazard module addressing self-reported health and safety practices on this topic. Most (98%) of the 2069 respondents of this module were nurses. Working primarily in hospitals, outpatient care centers, and physician offices, respondents reported that they had collectively administered over 90 specific antineoplastic drugs in the past week, with carboplatin, cyclophosphamide, and paclitaxel the most common. Examples of activities which increase exposure risk, expressed as percent of respondents, included: failure to wear nonabsorbent gown with closed front and tight cuffs (42%); intravenous (I.V.) tubing primed with antineoplastic drug by respondent (6%) or by pharmacy (12%); potentially contaminated clothing taken home (12%); spill or leak of antineoplastic drug during administration (12%); failure to wear chemotherapy gloves (12%); and lack of hazard awareness training (4%). The most common reason for not wearing gloves or gowns was “skin exposure was minimal”; 4% of respondents, however, reported skin contact during handling and administration. Despite the longstanding availability of safe handling guidance, recommended practices are not always followed, underscoring the importance of training and education for employers and workers.

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Section: Methodsmentioning

confidence: 99%

Adherence to Safe Handling Guidelines by Health Care Workers Who Administer Antineoplastic Drugs

Boiano

Steege

Sweeney

2014

Journal of Occupational and Environmental Hygiene

Self Cite

100

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“…Perhaps most importantly, spills must be considered exceptional events, and constant vigilance is required to prevent them. In addition, written procedures are essential in the event of spills, as are emergency kits providing quick absorption of HIPEC solution and first aid (especially eye wash) [37].…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

“…Supervision of staff members is essential to provide appropriate follow-up, and a register of accidents and incidents should be created where they do not already exist, including a list of staff members who come into contact with chemotherapy (during the HIPEC procedure or disposal of the waste) [36,37].…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

Professional risks when carrying out cytoreductive surgery for peritoneal malignancy with hyperthermic intraperitoneal chemotherapy (HIPEC): A French multicentric survey

Ferron

Simón

Guyon

et al. 2015

European Journal of Surgical Oncology (EJSO)

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“…26 However, there are three limitations specific to this hazard module. First, information on impediments to using aerosol delivery equipment and engineering controls was not collected and is recommended for future studies.…”

Section: Discussionmentioning

confidence: 99%

“…Methods used in the design, testing, and implementation of the survey, and strengths and limitations were described elsewhere. 26 …”

Section: Methodsmentioning

confidence: 99%

Precautionary Practices of Respiratory Therapists and Other Health-Care Practitioners Who Administer Aerosolized Medications

et al. 2015

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Introduction Respiratory therapists and other healthcare workers are potentially exposed to a variety of aerosolized medications. The NIOSH Health and Safety Practices Survey of Healthcare Workers describes current exposure control practices and barriers to using personal protective equipment during administration of selected aerosolized medications. Methods An anonymous, multi-module, web-based survey was conducted among members of healthcare professional practice organizations representing respiratory therapists, nurses and other healthcare practitioners. A module on aerosolized medications included submodules for antibiotics (amikacin, colistin, tobramycin), pentamidine and ribavirin. Results The submodules on antibiotics, pentamidine and ribavirin were completed by 321, 227 and 50 respondents, respectively, who were mostly respiratory therapists. The relatively low number of ribavirin respondents precluded meaningful interpretation of these data and may represent the rare use of this drug. Consequently, analysis focused on pentamidine, classified by NIOSH as a hazardous drug, and antibiotics amikacin, colistin, and tobramycin which currently lack authoritative safe handling guidelines. Respondents who administered pentamidine were more likely to adhere to good work practices compared to those who administered these antibiotics. Examples included: training received on safe handling procedures (75% vs 52%), availability of employer standard procedures (82% vs 55%), use of aerosol delivery devices equipped with an expiratory filter (96% vs 53%) or negative pressure rooms (61% vs 20%), and always using respiratory protection (51% vs 13%). Conclusions Despite the availability of safe handling guidelines for pentamidine, implementation was not universal, placing workers, co-workers, and even family members at risk of exposure. Although the antibiotics included in this study lack authoritative safe handling guidelines, prudence dictates that appropriate exposure controls are used to minimize exposure to the antibiotics as well as other aerosolized medications. Employers and employees share responsibility for ensuring that precautionary measures are taken to keep exposures to all aerosolized medications as low as practicable.

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NIOSH Health and Safety Practices Survey of Healthcare Workers: Training and awareness of employer safety procedures

Cited by 39 publications

References 9 publications

Adherence to Safe Handling Guidelines by Health Care Workers Who Administer Antineoplastic Drugs

Adherence to Safe Handling Guidelines by Health Care Workers Who Administer Antineoplastic Drugs

Professional risks when carrying out cytoreductive surgery for peritoneal malignancy with hyperthermic intraperitoneal chemotherapy (HIPEC): A French multicentric survey

Precautionary Practices of Respiratory Therapists and Other Health-Care Practitioners Who Administer Aerosolized Medications

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