Kudos to AnnMarie Walton, assistant professor, and her entire team for the resubmission of her NIOSH/CDC R21 application entitled “Improving Strategies to Limit Healthcare Workers’ Exposure to Antineoplastic Drugs." This proposal requests funding for a two-year period with a start date of April 1, 2020.

Cancer patients receive hazardous antineoplastic drugs. Healthcare workers who care for them experience dermal exposure to these drugs. Even at low levels, this exposure causes an increased risk for healthcare worker 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 occupational exposure to hazardous drugs for healthcare workers but exposure persists. A new, standard written by the United States Pharmacopeia referred to as USP <800>, parts of which are federally enforceable, comprehensively details 17 control strategies to minimize exposure, from engineering controls to training and use of personal protective equipment. Measuring surface contamination is recommended as a measure of exposure control. The control strategies are extensive and expensive. The objective of the proposed research study is to determine which of the USP <800> control strategies are most effective at reducing surface contamination with antineoplastic drugs in patient administration areas. This information will increase efficiency and decrease cost for institutions implementing USP <800> within and outside of oncology areas. To complete this objective, this study will examine the extent to which the control strategies have been implemented in both oncology and non-oncology areas and compare this to the respective levels of surface contamination. Employee surveys will help us to go beyond the USP <800> control strategy of provision of personal protective equipment (PPE) to understand what PPE employees actually use and what factors influence that use. Aim 1 will determine associations between implementation of USP <800> control strategies and surface contamination with antineoplastic drugs. Aim 2 will determine differences in oncology and non-oncology units with regard to exposure risk. An innovative aspect of this study is that it will include non-oncology areas where these drugs are administered. Results will be used to guide interventions to reduce surface contamination and create safer environments for healthcare workers, patients, and families.