Hi Paul
I may be being daft here - but what is the point of the FBC with regard to
cytotoxic drug exposure? Blood tests are invasive procedures and screening
should have a specific purpose - what would be abnormal if exposed when
cytotoxic substances could affect (and has been know to affect) a wide range
of organs other then blood. Therefore if there is no specific test why test?
Surely one of the criteria for any screening is that there is a suitable
test or examination etc. etc. (many references too many to note here)? have
you asked the Marsden OH department what they do? They did the initial
research into this in the early '80s as I was involved with it.
Greta Thornbory
Consultant, Health & Education
www.gtenterprises-uk.com
01235 770156
----- Original Message -----
From: Paul Darcy <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, June 19, 2003 9:49 AM
Subject: Re: Surveillance
> Re Cytotoxic surveillance
>
> It seems that I cannot get a definitive answer regarding surveillance.
> We perform a baseline FBC for cytotoxic handlers prior to their exposure
> to see if there is a pre-existing condition. We only perform a repeat
> test one month after a significant occupational exposure such as
> needlestick injury, skin contamination or unreconstituted or
> reconstituted drugs, inhalation of powder for accidental vial
> breakages.
>
> We also send an annual questionnaire to cytotoxic handlers to ascertain
> any unreported significant exposure, unusual illness, pregnancy or birth
> defects.
>
> Having looked at lots of research for one of my degree assignments I
> found a tremendous range of surveillance from nil to regular blood tests
> or urine mutagenicity screening.
>
> The HSE have published recent research about cytotoxic drugs including
> their preparation and handling in an isolator but I cannot locate the
> reference for you. However, have a look at the American Occupational
> Health & Safety Administration handbook as there is a whole chapter
> relating to hazardous drugs including cytotoxic/ antineoplastic drugs.
>
> http://www.osha.gov/dts/osta/otm/otm_vi/otm_vi_2.html#6
>
> It would be helpful to be updated.
>
>
>
> Paul D'Arcy,
> Occupational Health Manager (Acting)
>
> Occupational Health
> Hammersmith Hospital
>
> Developing And Supporting People To Make Healthcare Better
>
> Direct Line 020 8383 1024
> Internal Ext 31024
>
>
>
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