[MCOH-EH] Medical surveillance for hazardous drugs

[Grubbs, Scott]

Dr. Kibby - Your comments make sense. Would you be able to provide a copy of your article?  I am also curious about the cost of doing surface wipe sampling?
Thanks,
Scott Grubbs, MD
WorkWell Occupational Health, St. Francis Hospital
Greenville, SC

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Thomas Kibby
Sent: Friday, December 15, 2017 12:47 PM
To: mcoh-eh at mylist.net
Subject: #ExtMail# [MCOH-EH] Medical surveillance for hazardous drugs


Much of the discussion of medical surveillance for workers handling antineoplastic drugs (AD) has centered on measuring effects that have very limited value (CBC, metabolic panel, exams) for these conditions. I might suggest we as Occ Health providers shift the conversation from measuring effects to exposures.



My suggestion would to begin by measuring surface contamination by AD using wipe sampling. This has been demonstrated to help guide control efforts by identifying hot spots and poor compliance with recommended practices. Also as someone notices they are being measured they begin paying attention and consistently use good technique. This has been demonstrated repeatedly.



This may also be a shameless plug, but I wrote a review article on the relation of surface contamination and the rate of detectable AD in worker's urine. (A review of surface wipe sampling compared to biologic monitoring for occupational exposure to antineoplastic drugs. J Occup Environ Hyg. 2017 Mar;14(3):159-174.  PMID:27676216.) There was an approximate relation between the level of contamination and how often AD appeared in the workers' urine. While no one is suggesting collecting urine for AD, there is good support, such as in USP 800, for beginning at least semi-annual surface sampling.



Medical surveillance for AD workers is still lacking the tool to make it useful. However surface wipe sampling is a feasible exposure assessment alternative if a more active EHS approach for AD control is being considered.





Thomas Kibby, MD MPH

CMO BarnesCare

314-747-5884

________________________________________________________________________________________________________
The information in this communication is intended to be confidential to the Individual(s) and/or Entity to whom it is addressed.
It may contain information of a Privileged and/or Confidential nature, which is subject to Federal and/or State privacy regulations.
In the event that you are not the intended recipient or the agent of the intended recipient, do not copy or use the information
contained within this communication, or allow it to be read, copied or utilized in any manner, by any other person(s). Should
this communication be received in error, please notify the sender immediately either by response e-mail or by phone,
and permanently delete the original e-mail, attachment(s), and any copies.
________________________________________________________________________________________________________
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <https://mylist.net/archives/mcoh-eh/attachments/20180118/a2f9ffbb/attachment-0001.html>