Kudos to AnnMarie Walton, assistant professor, and her entire team for the resubmission of her Centers for Disease Control and Prevention (CDC) R21 application entitled: “Improving Practices to Limit Healthcare Workers' Exposure to Antineoplastic Drugs." This proposal requests funding for a 2-year period with a start date of September 1, 2021.

Cancer patients receive hazardous antineoplastic drugs. Healthcare workers who care for them experience dermal exposure to these drugs. Even at low levels, healthcare workers are at risk f or reproductive problems and cancer. Antineoplastic drugs are being given more commonly and, as the population ages, the incidence of cancer i s 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 healthcare workers but risk persists. A new standard written by the United States Pharmacopeia referred to as USP <800>, details 17 practices 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 containment. The objective of this proposed research study is to identify USP <800>practices associated with the lowest extent of surface contamination (Aim 1) and to identify workplace safety climate and activity-specific PPE use practices associated with the lowest extent of surface contamination (Aim 2) at each of 16 unique facilities. We will be the first to simultaneously measure multiple safety practices at the regulatory, organizational, and individual levels and consider their association with extent of surface contamination and each other. 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. By identifying factors at the regulatory, organizational, and individual levels that are associated with the lowest extent of surface contamination, this study will provide guidance as to where to focus efforts to reduce risk for healthcare 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 healthcare workers.