Kudos to Annmarie Walton, assistant professor, and her entire team for the submission of her CDC/NIOSH R21 application entitled: ”Improving Practices to Limit Healthcare Workers’ Exposure to Antineoplastic Drugs." This proposal requests funding for a two-year period with a start date of April 1, 2021.

Cancer patients receive hazardous antineoplastic drugs. Health care workers who care for them experience dermal exposure to these drugs. Even at low levels, health care workers are at risk for reproductive problems and cancer. Antineoplastic drugs are being given more commonly and, as the population ages, the incidence of cancer is increasing. Antineoplastic drugs have also been found useful in non-oncology areas in treating conditions other than cancer. Professional organizations and national agencies have published position statements and recommendations to limit exposure to hazardous drugs for health care workers but risk persists. A new standard written by the United States Pharmacopeia referred to as USP <800>, details 17 control strategies to minimize risk. Studies have examined what organizational factors are related to personal protective equipment (PPE) use but not to surface contamination. The association between PPE use and surface contamination is not well understood. Measuring surface contamination is recommended as a measure of exposure control. The objective of this proposed research study is to assess associations between the lowest extent of surface contamination in patient care areas and USP <800> control strategies (Aim 1), organizational factors (Aim 2), and activity-specific PPE use (Aim 3). This proposed study is the first to assess the efficacy of USP <800>, and to examine associations between organizational factors and surface contamination as well as activity-specific PPE use and surface contamination. It is also unique in that it includes non-oncology patient care areas where these drugs are given. Our study fits precisely within the NIOSH research agenda and will do what the National Healthcare and Social Assistance Sector has prioritized. By identifying factors at the regulatory, institutional, and individual levels that are associated with the lowest extent of surface contamination, this study will provide guidance as to where to focus effort to reduce risk for health care workers in patient care areas. It will also provide critical effect size estimates to inform future studies aimed at developing multilevel interventions to create safer work environments for health care workers as well as patients and families receiving care.