Hazardous Drug Exposure
In pharmacy settings, workers can be exposed to hazardous drugs through four main routes: inhalation, absorption, ingestion, and injection.
Routes of Entry
Exposure Routes
Below are examples of how each of these exposure routes might cause an injury or illness to pharmacists.
- Inhalation: Inhalation is the most common route of entry for airborne hazardous substances. For instance, during the preparation of chemotherapy drugs in a compounding hood, aerosolized particles can become airborne. If the biological safety cabinet (BSC) is not functioning properly, or if proper technique is not used, these particles may be inhaled by pharmacy staff. Similarly, crushing tablets or opening ampules outside of containment may also release powders or vapors into the air.
- Absorption: Hazardous drugs can be absorbed through direct contact with the skin, especially when handling drugs in liquid or powdered form. For example, when compounding or transferring hazardous drugs without proper personal protective equipment (PPE), like chemotherapy gloves or gowns, drugs can splash or spill onto the skin. Even touching contaminated surfaces—such as worktops, vials, or packaging—can result in dermal exposure.
- Ingestion: Ingestion typically occurs from hand-to-mouth contact when contaminated hands, gloves, or surfaces are not cleaned properly. A pharmacist or technician might unintentionally ingest hazardous drug residues by eating, drinking, or touching their face in the compounding area without first removing gloves and washing their hands. Residual contamination on counters or phones used while wearing contaminated gloves can also contribute to ingestion risks.
- Injection: Accidental injection can happen when handling needles or other sharps used to prepare injectable drugs. It's possible that while reconstituting a hazardous drug using a needle and syringe, a technician may suffer a needlestick injury, especially if they're distracted or rushing. Improper disposal of sharps or failure to use safety-engineered devices also increases this risk.
Knowledge Check Choose the best answer for the question.
1-3. What is the most common route of exposure to hazardous drugs?
- Inhalation
- Ingestion
- Absorption
- Injection
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