Walton Submits CDC R21 Application

Kudos to AnnMarie Walton and her entire team for the submission of her Centers for Disease Control Prevention (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 March 1, 2019.

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 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, federally enforceable standard written by the United States Pharmacopeia, referred to as USP <800>, comprehensively details 18 practices 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 requirements are extensive and expensive. The objective of the proposed research study is to determine which of the USP <800> requirements are most effective at reducing surface contamination with antineoplastic drugs. 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 requirements 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> requirement of provision of personal protective equipment (PPE) to understand what PPE employees actually use. From this, we will be able to conclude which of the 18 requirements in USP <800> (using the “Ready for <800>” checklist) are the most consequential in limiting surface contamination with antineoplastic drugs as determined by surface wipe sampling. Aim 1 will determine associations between implementation of USP <800> requirements 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.