HEALTH AND OCCUPATIONAL EXPOSURE TO ANTI-CANCER DRUGS

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The objectives of this study are to determine whether handling antineoplastic drugs or caring for patients receiving treatment with these drugs presents a risk to the health of staff and to evaluate the relationship between work practices and various measures of exposure to these drugs. The specific aims are (1) to describe the work practices of nurses and pharmacists when handling antineoplastic drugs and of nurses and aides when caring for patients currently receiving antineoplastic treatment, (2) to investigate whether specific work practices are associated with acute, chronic, or reproductive effects on health among nurses, pharmacists and nurses' aides, (3) to evaluate the relationship between work practices and exposure to antineoplastic drugs as measured by an industrial hygiene test and a urine mutagen test and (4) to investigate relationships among internal and external exposure measures and results on clinical laboratory tests which may reflect effects of exposure. Subjects will be all exposed nurses and pharmacists who handle antineoplastics and nurses' aides caring for patients on treatment protocols at participating member facilities of the NSABP project of the NCI, including private physician's offices involved in NSABP clinical trials. Controls will be unexposed pharmacists, nurses, and aides from these same facilities. NSABP data managers will generate a list of individuals in the exposed groups at their facility and a list of potential controls. Data is to be gathered in two phases. Phase I is a survey using a self-completion questionnaire covering demographic and control variables, exposure history, and a health and reproductive history. Phase II will collect, from a subsample of subjects in Phase I, updated exposure and health histories, data on other chemical exposures which could affect urine mutagenesis, an industrial hygiene measure of adriamycin exposure, blood and urine samples for clinical laboratory tests and urine mutagenesis, and an exposure log. An exposure index, based on work practices, will be derived for all Phase II subjects and compared with data from the industrial hygiene and urine mutagen test and with results from the clinical laboratory tests on blood and urine.