Évaluation de l’exposition professionnelle aux cytotoxiques

Abstract

Introduction The administration of anticancer drugs is becoming more widespread. These drugs are highly toxic and therefore pose a risk to health care personnel. Objectives  Evaluate the risk of exposure to cytotoxic drugs for health care personnel at Sétif anti-cancer center.  Evaluate the professional practices (EPP) in order to identify the severity of the observed deviations and to suggest corrective actions. Materials and method: The audit covers the procedures for the reconstitution of anti-cancer drugs and their administration in the hematology and radiotherapy department and the preparation unit, using cytotoxic contact index(CCI) calculation , a form for pharmacy preparators and nurses , professional practices evaluation (PPE) grids and Failure mode effects and criticality analysis (FMECA) grids. This audit allowed us to observe the work methods, to check the respect of the protection measures and to identify the risks of contamination. A cross-sectional descriptive study was conducted with 22 people exposed to cytotoxics (07 preparation unit workers and 15 hematology and radiotherapy department nurses) The calculation of the Cytotoxic Contact Index (CCI) was correlated with the analysis of adverse events collected through forms. An audit allowed us to carry out an evaluation of the professional practices (EPP) using grids according to international standards. The data were analyzed using the Failure mode effects and criticality analysis (FMECA), Criticality Indices (CI) were calculated and counted according to the steps of the institutional procedure in order to target the critical points. Results The preparation stage is the most critical with a criticality index of 48, while the administration stage is average with a criticality index of 12. The average of cytotoxic contact index is 5.42 for preparators and 0.44for the nurses. The appearance of clinical signs common to several staff members (vertigo, headaches, hair loss, irritative and allergic disorders).Discussion and Conclusion This study helped to raise awareness among exposed personnel and to secure procedures, but the approach remains insufficient to limit contamination. Biometrological surveillance must be established regularly in order to achieve optimum monitoring of exposure to anti-cancer drugs.