NIOSH Safe Handling of Hazardous Drugs Guidelines Becomes State Law

The Improvement of Indoor Air Quality in Residential Buildings in Dubai, UAE

Due to unprecedented urbanization, UAE had built many new residential projects with poor choices of material and ventilation. This social phenomenon is leading UAE to Sick Building Syndrome (SBS) faster than any other countries. The Dubai Municipality regulates the indoor air quality with strict stipulation, but the detailed regulations are still insufficient. The objective of this paper is to measure the indoor air quality of new residential projects in Dubai to suggest the improvement of the regulations for indoor air quality. As a methodology, a field survey was conducted to investigate the status of indoor air pollution in residential buildings. Based on the field survey data, lab experiments for building materials were conducted and a computer simulation on radon gas was conducted. The result had shown that radon gas was mainly detected in new townhouses and labor camp houses, and its concentration was found to exceed the standard. Volatile organic compounds (VOCs) and formaldehyde (CH2O) were mainly detected in showhouses and new townhouses, and the concentration distribution was about 10 times higher than that of outdoors. It was proven that emission concentration of radon gas from various building materials were detected, and the order was red clay, gypsum board, and concrete. Volatile organic compounds (VOCs) are mainly detected in oil paints and PVC floor and the radiation amount of all pollutants increased with temperature increase. In computer simulation, it was found that a new townhouse needs a grace period from 20 days to 6 months to lower the radon gas concentration by 2 pCi/L. This study will serve as a basic data to establish more detailed regulation for the building materials and improve the IAQ standards in Dubai.

Safe Handling of Hazardous Drugs in Home Infusion

Chemotherapy agents used for cancer treatment are considered hazardous drugs (HDs). Guidelines and standards for handling HDs have been in place for several decades to protect oncology nurses working in hospitals and outpatient infusion areas. However, chemotherapy is frequently being administered in home settings, often by infusion nurses who do not necessarily have the requisite knowledge and training. Providing appropriate education for home infusion nurses is key to ensuring they are practicing in a manner that minimizes potential exposure to HDs.

Clinical Utility of Basophil CD203c as a Biomarker for Predicting the Timing of Hypersensitivity Reaction in Carboplatin Rechallenge: Three Case Reports

PURPOSE

Drug desensitization has been found to be an effective option for carboplatin rechallenge in patients at risk for severe hypersensitivity reaction. However, identifying such patients requires precise clinical tests. This study was performed to evaluate the clinical utility of basophil CD203c to predict the timing of carboplatin-induced severe hypersensitivity reaction.

METHODS

Here we report on 3 patients undergoing a carboplatin-desensitization protocol at Mie University Hospital. For all patients, ex vivo exposure to carboplatin resulted in increased levels of activated basophils in a previous occurrence of carboplatin-induced severe hypersensitivity reaction.

FINDINGS

Basophil activation test using carboplatin was returned to negative just before the first course of carboplatin-desensitization protocol in all patients, and they successfully received their first course of the protocol with no signs of anaphylaxis. However, for all of the patients, increased basophil activation was once again detected after subsequent readministration of carboplatin and grade 3 or 4 anaphylaxis developed. Basophil activation test coincided precisely with the timing of carboplatin-induced anaphylaxis in all patients.

IMPLICATIONS

CD203c basophil activation testing might prove to be a reliable tool for risk stratification and clinical decision making for carboplatin desensitization in which severe hypersensitivity reaction is likely to occur.

Best Practices for Chemotherapy Administration in Pediatric Oncology: Quality and Safety Process Improvements (2015)

The administration of chemotherapy to children with cancer is a high-risk process that must be performed in a safe and consistent manner with high reliability. Clinical trials play a major role in the treatment of children with cancer; conformance to chemotherapy protocol requirements and accurate documentation in the medical record are critical. Inconsistencies in the administration and documentation of chemotherapy were identified as opportunities for errors to occur. A major process improvement was initiated to establish best practices for nurses who administer chemotherapy to children. An interdisciplinary team was formed to evaluate the current process and to develop best practices based on current evidence, protocol requirements, available resources, and safety requirements. The process improvement focused on the establishment of standardized and safe administration techniques, exact administration times, and consistent electronic documentation that could easily be retrieved in medical record audits. Quality improvement tools including SBAR (Situation, Background, Assessment, Recommendation), process mapping, PDSA (Plan, Do. Study, Act) cycles, and quality metrics were used with this process improvement. The team established best practices in chemotherapy administration to children that have proven to be safe and reliable. Follow-up data have demonstrated that the project was highly successful and improved accuracy, patient and nurse safety, and effectiveness of chemotherapy administration.

Chemotherapy safety in clinical veterinary oncology

Exposure to chemotherapy is a health hazard for all personnel in facilities that store, prepare, or administer antineoplastic agents. Contamination levels have been measured as much as 15 times higher in the veterinary medicine sector than in human facilities. Recent publications in human and veterinary medicine indicate that exposure extends beyond the clinic walls to affect the patient's home and family. This article provides an update on the advances in chemotherapy safety, the current issues, and the impact on cancer management in veterinary medicine.

Compliance with safe handling guidelines of antineoplastic drugs in Jordanian hospitals

Objective

To evaluate the compliance of healthcare workers with standard safety guidelines during the preparation and administrations of antineoplastic medications.

Design

A cross-sectional survey study.

Setting

All hospitals in Jordan where healthcare workers are involved in preparation and administration of antineoplastic medications.

Participants

All healthcare workers who are involved in preparation and administration of antineoplastic medications in Jordanian hospitals.

Intervention

A questionnaire that covered information about work place, healthcare workers, and use of personal protective equipments during handling of antineoplastic medications was self-filled by each participant.

Main outcome measures

Compliance rates with workplace requirements, healthcare workers, and use of personnel protective equipments.

Results

Majority of participants (74.2%), representing nine out of 15 (60%) hospitals, reported full compliance of workplace with all requirements of the guidelines. Items with full compliance in all hospitals were availability of policies and procedures for safe handling of antineoplastic agents, availability of reporting system, and availability of sharp containers. Concerning healthcare workers’ guidelines, worker with full compliance were 46.4% of participants. Items with least compliance rate were working inside biological safety cabinet (65.1%) and having training program on handling chemotherapy medications (66.7%). Finally, concerning items-related personal protective equipments, only 10.7% of participants reported full compliance. Items with least compliance rates were wearing goggles (eye protection), shoe cover, and hair cover.

Conclusions

Results of this study showed the levels of compliance with guidelines pertaining to work place and workers who prepare and administer antineoplastic medications. Among other points, compliance with guidelines pertaining to wearing personnel protective equipments was limited and required further improvement.