Cytotoxic drugs : risk assessment for healthcare workers

Risk assessment is compulsory in all working places and is also required for the use of drugs in healthcare environments. This includes as a first part an evaluation of exposure. For every potential source (atmosphere of workplaces, surfaces to contact) we will consider what are the means of investigation and the results obtained with cytotoxic drugs. For some cytotoxic drugs the total exposure of healthcare workers is 100 to 2,000 times lower these of the treated patients. The effects of cytotoxic drugs were widely described; they depend largely on the mode of action of these medicines (activity on the cellular cycle and the DNA). By confronting these effects with the occupational exposures, we shall try to characterize the risk connected to every effect: non specific (irritation, systemic toxicity) or specific (mutagenic, carcinogenic or toxic for the reproduction). This assessment indicates a low risk of exposure for healthcare workers in general when preventive measures are correctly set up (technical, medical and training).