gms | German Medical Science

Background: Nursing staff may be exposed to substances harmful to their health in activities involving drugs. In operational practice however, the answer to the question as to what health risks employees may be exposed to when handling drugs, is often inadequate, as information on the properties of the drugs used (e.g. carcinogenic, mutagenic, toxic for reproduction, sensitising) and on exposure, is in most cases lacking.

For businesses in the health service to get practical information on risk assessment faster and more easily and be able to introduce possible protective measures, a generally applicable method for providing the relevant information has been developed and tested based on specific lead substances in the project "Providing safety-related information about drugs and related activities (BESI)" of the BGW.

Materials and Methods: Firstly, 93 agents from the group of anti-infectives were evaluated in terms of their health-damaging potential and classified in so-called "BESI categories". Secondly, the research team examined the possible release of drug components, occurring during the handling of drugs and the application of protective measures in operational practice. 104 workers (87 nurses, 17 ward managers) were interviewed about their situation at work and common activities, such as de-blistering tablets, opening capsules or preparing infusions, were reconstructed in terms of the exposure behaviour in the laboratory.

Results: 26 of the 93 agents tested (28%) had toxic, very toxic or CMR properties. 58 of the 93 substances (62%) can cause sensitisation in humans. The most frequently mentioned activities involving drugs included providing tablets, followed by setting up and administering infusions and providing drops for oral application. The most basic precautionary measures, the regular use of gloves in the provision of patient-related drugs was observed by only 34 percent of respondents. 43 percent occasionally wore gloves and 22 percent worked without gloves. Just under a quarter of respondents reported possible stress reactions, predominantly on the skin, after suspected, accidental contact with drugs.

From the results, preliminary recommendations were derived for work-related protective measures to support OSH professionals and managers in risk assessment.

Conclusion: Basically, frequently used drugs can be evaluated and classified based on their intrinsic properties. This requires close, inter-professional collaboration between pharmacists and nurses. The project also gives a good overview of the release of active pharmaceutical ingredients in exposure-related activities in the care sector and possible protection measures. But it also became clear that quantifying the inner stress on the employees possibly resulting from releases and resulting exposures on the basis of the test results available, is not immediately possible.