Good point Greta. This has again highlighted one of those areas where
health surveillance is carried out according to traditional OH practices
rather than as a result of the risk assessment. A benefit of this forum
is that we can compare our different practices and hopefully replace
outdated ones.
Thanks
Paul
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
>>> [log in to unmask] 06/19/03 04:07pm >>>
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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