Despite the increased awareness of the risk of adverse health effects for medical personnel with occupational exposure to anticancer drugs, proper safety controls have not yet been implemented in Japan.The immediate need is to establish appropriate conditions for mixing of anticancer drugs.This study examined the procedures currently used for mixing of anticancer drugs in Japanese hospitals. Two thousand hospitals were randomly selected, and asked to complete a questionnaire about the facilities, equipment and techniques used to mix anticancer drugs. We obtained 1,073 valid responses (among them, 360 hospitals prepared anticancer drug injections and 713 did not).We found that the availability of a biological-safety cabinet for mixing of anticancer drug injections was related to the number of prescriptions issued per day; a cabinet was available in 97.1% of hospitals that issued more than 10 prescriptions per day, 86.3% of hospitals that issued more than 1 and less than 10 prescriptions a day, and 38.4% of hospitals that issued less than 1 prescription per day.Hospitals that issued more than 10 prescriptions per day tended to have safer conditions for mixing anticancer drugs, but conditions in some hospitals were dangerous (e.g., use/non-use of clean benches). Some hospitals commented that equipment for safe mixing of anticancer drugs was too expensive to purchase.There appears to be an urgent need to modify the present system of mixing of anticancer drugs to ensure the safety of hospital personnel.This problem should be tackled by not only pharmacists, but also other staff including managers.
