From the viewpoint of health and safety, it is important that healthcare workers are not exposed to anti-cancer drugs during preparation of injections and administration to patients. In order to evaluate current procedures, we conducted a survey on handling of anti-cancer drug injections by hospital nurses in 2000 randomly selected hospital facilities throughout Japan by means of a mail questionnaire. Nurses were requested to complete the mailed questionnaire, which included questions regarding the facilities, equipment, systems and procedures of anti-cancer drug injections. Valid responses were obtained from 733 facilities. Among them, 385 facilities offered chemotherapy with anti-cancer drug injections. In approximately 30% of such facilities, nurses prepared anti-cancer drug injections. Further, nurses administered the anti-cancer drug injections in almost all of these facilities, suggesting that their risk of exposure was greater than that of pharmacists. We found that only a few hospitals currently take precautions to prevent exposure, such as wearing protective equipment and following specific procedures. Less than 50% of the facilities provided training for nurses in anti-cancer drug handling practices, and pharmacists were involved in only approximately 20% of the facilities. The nurses considered that pharmacists should prepare anti-cancer drug injections, inform them of the risk of exposure to anti-cancer drugs, and also advise them about appropriate handling. These results suggest that pharmacists should take the lead in promoting safe and appropriate handling of anti-cancer drug injections.
