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Monitoring surface contamination for thirty antineoplastic drugs: a new proposal for surface exposure levels (SELs)

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Dugheri S., Mucci N., Bucaletti E., Squillaci D., Cappelli G., Trevisani L., Bonari A., Cecchi M., Mini E., Ghiori A., Tognoni D., Berti N., Alderighi F., Li Vigni N., Orlandi I., Arcangeli G.
Medycyna Pracy
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2022
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vol. 73
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issue 5
383-396
EN
Background Chemotherapy drugs are widely used to treat cancer, but their active compounds represent a danger for workers who could be exposed to them. However, they aren’t yet included in directive CE No. 1272/2008 and the European Biosafety Network has only recommended a limit value of 100 pg/cm2 for surface contamination. Thus, it is crucial to assess surface contaminations in healthcare environments. Currently, the technique of choice is surface wipe test combined with liquid chromatography tandem mass spectrometry to achieve high sensibility. Material and Methods A campaign involving Careggi University Hospital (Florence, Italy) was performed from January 2020 to December 2021, collecting 1449 wipe samples between administration units, preparation unit, and personnel gloves. From the obtained data, the 90th percentile was calculated for 30 antiblastic drugs and proposed as surface exposure levels (SELs); while from data concerning personnel glove contamination, weekly contamination was estimated. Results In the 2-year period only 417 wipe samples were found positive (28.8%), the majority of which regard samples coming from administration unit bathrooms. The proposed SELs are almost all <100 pg/cm2, except for few drugs which produce higher contamination on bathroom surfaces. Also, the estimation of pharmacy personnel’s glove contamination highlighted very low results (ng/week). Conclusions Deeply established protocols and procedures for safe handling of ADs allow for obtaining excellent cleaning results and thus a safer work environment, however, the risk of cytostatic contaminations cannot be avoided in healthcare workplaces, and thus a harmonization of classification and labeling of chemotherapy drugs throughout the European Union should be done.
2
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Consideration on the health risk reduction related to attainment of the new particulate matter standards in Poland: A top-down policy risk assessment approach

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Kobza J., Pastuszka J. S., Gulis G.
International Journal of Occupational Medicine and Environmental Health
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2015
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vol. 29
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issue 1
1-14
EN
Policies can influence health of a population in various ways. Numerous epidemiological studies supported by toxicological investigations demonstrate a positive association between ambient concentrations of airborne particulate matter and increased adverse cardio-respiratory events, including morbidity and mortality. The aim of this paper was to present the concept of the top-down health policy risk assessment approach model developed to estimate the expected health risk reduction associated with policy aiming at attaining the new particulate matter ≤ 10 μm in diameter (PM 10) standards in Poland. The top-down approach guides the analysis of causal chains from the policy to health outcomes. In this case study we tried to estimate the predicted health effects of the policy change over the past 20 years. Since Polish annual standard for PM 10 changed from 50 μg/m³ in 1990 to 40 μg/m³ in 2010, we calculated the relative risk associated with decreasing PM 10 in diameter to 10 μg/m³ in the annual level of PM 10 for 6 adverse health effects. The relative risk slightly decreased for almost all adverse health effects, which means that the relative decrease in the incidence of health effects from the baseline incidence should range from about 0.5–0.6% for heart disease admissions to > 1% for respiratory admissions. The obtained results indicate that implementation of the new ambient air standards could influence improvement of the health status of Polish population. A top-down policy health risk assessment model can be one of the main tools in this process, providing harmonized guidance how to seek evidence-based information, which could serve policy-makers.
3
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Chemical incidents resulted in hazardous substances releases in the context of human health hazards

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Pałaszewska-Tkacz A., Czerczak S., Konieczko K.
International Journal of Occupational Medicine and Environmental Health
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2017
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vol. 30
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issue 1
95-110
EN
Objectives The research purpose was to analyze data concerning chemical incidents in Poland collected in 1999–2009 in terms of health hazards. Material and Methods The data was obtained, using multimodal information technology (IT) system, from chemical incidents reports prepared by rescuers at the scene. The final analysis covered sudden events associated with uncontrolled release of hazardous chemical substances or mixtures, which may potentially lead to human exposure. Releases of unidentified substances where emergency services took action to protect human health or environment were also included. Results The number of analyzed chemical incidents in 1999–2009 was 2930 with more than 200 different substances released. The substances were classified into 13 groups of substances and mixtures posing analogous risks. Most common releases were connected with non-flammable corrosive liquids, including: hydrochloric acid (199 cases), sulfuric(VI) acid (131 cases), sodium and potassium hydroxides (69 cases), ammonia solution (52 cases) and butyric acid (32 cases). The next group were gases hazardous only due to physico-chemical properties, including: extremely flammable propane-butane (249 cases) and methane (79 cases). There was no statistically significant trend associated with the total number of incidents. Only with the number of incidents with flammable corrosive, toxic and/or harmful liquids, the regression analysis revealed a statistically significant downward trend. The number of victims reported was 1997, including 1092 children and 18 fatalities. Conclusions The number of people injured, number of incidents and the high 9th place of Poland in terms of the number of Seveso establishments, and 4 times higher number of hazardous industrial establishments not covered by the Seveso Directive justify the need for systematic analysis of hazards and their proper identification. It is advisable enhance health risk assessment, both qualitative and quantitative, by slight modification of the data collection system so as to enable the determination of released chemical concentration and exposed populations. Int J Occup Med Environ Health 2017;30(1):95–110
4
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Completing a worksite health risk assessment correlates with continuing employment, lower health care costs and utilization

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Merrill R. M., Aldana S. G.
International Journal of Occupational Medicine and Environmental Health
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2022
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vol. 35
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issue 4
449-457
EN
ObjectivesCompanies that understand the collective health risks of their employees, as well as worker productivity as it relates to health risks can provide more effective and necessary interventions. Health Risk Assessments (HRAs) are an important source of information for understanding overall health risks of a company’s employees. However, HRA data tend to represent only a subset of employees, thereby providing employers an incomplete picture of employee health risks. The current study identifies the representativeness of those completing a worksite HRA by selected demographics, health care costs, and health risks in a large US company.Material and MethodsA retrospective analysis of employees in a large US company during 2017–2019, with statistically significant results reported, adjusted for sex, age, and year.ResultsThe percentage of employees completing the HRA increased from 23.9% in 2017 to 28.4% in 2018 to 32.3% in 2019. These employees were more likely women, middle aged, have lower health care costs, remain employed from year to year, and have better health behaviors and biometric scores. If all employees looked like employees completing the HRA, total medical costs would be 17% lower. If all employees looked like employees completing the HRA who had a health perception rating (1–10 [excellent]) of 7–8 (57.4%) or 9–10 (25.2%) vs. 1–6, total medical costs would be 21.9% and 25.6% lower, respectively.ConclusionsA minority of employees completed the worksite HRA. Basing overall employee health risks on the HRA underestimates health risks and can result in a poorly representative health intervention program.
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