Accidental exposure to hazardous drugs, reproductive toxicity risk and proper use of PPE in the hospital setting evidence from an observational study

Alberto Firenze; Floriana Bravatà; Salvatore Calagna; Rosangela Carletta; Francesco Di Piazza; Eleonora Genco; Corinna Grasso; Serafino Nucera; Salvatore Gabriele Sardo; Omar Enzo Santangelo

Alberto Firenze Department of Health Promotion, Maternal-Infant, Internal Medicine and Specialization of Excellence "G. D'Alessandro", University of Palermo, Italy.
Floriana Bravatà School of Specialization in Occupational Medicine, University of Palermo, Italy
Salvatore Calagna School of Specialization in Occupational Medicine, University of Palermo, Italy
Rosangela Carletta School of Specialization in Occupational Medicine, University of Palermo, Italy
Francesco Di Piazza School of Specialization in Occupational Medicine, University of Palermo, Italy
Eleonora Genco School of Specialization in Occupational Medicine, University of Palermo, Italy
Corinna Grasso School of Specialization in Occupational Medicine, University of Palermo, Italy
Serafino Nucera School of Specialization in Occupational Medicine, University of Palermo, Italy
Salvatore Gabriele Sardo School of Specialization in Occupational Medicine, University of Palermo, Italy
Omar Enzo Santangelo Regional Health Care and Social Agency of Lodi, ASST Lodi, 26900 Lodi, Italy

Keywords: Hazardous Drugs, Reproductive Toxicity, Personal Protective Equipment (PPE), Healthcare Workers, Occupational Safety

Abstract

Background: Workplace safety in healthcare is crucial, especially regarding the handling of hazardous drugs, which pose significant risks due to their carcinogenic and teratogenic properties. This study focuses on the risks of reproductive toxicity associated with accidental exposure to hazardous drugs and assesses the effectiveness of personal protective equipment (PPE) in mitigating these risks. The COVID-19 pandemic has highlighted vulnerabilities in healthcare safety protocols.
Methods: This observational cross-sectional study was conducted at the Azienda Ospedaliera Universitaria Policlinico di Palermo, involving healthcare personnel across various departments. Data were collected via an anonymous questionnaire administered through the hospital's intranet, focusing on demographics, exposure to hazardous drugs, PPE use, and health outcomes. The survey spanned six months, and statistical analyses, including Pearson Chi-square tests and multivariable logistic regressions, were employed, with a significance level set at 0.05.
Results: The study revealed a significant lack of awareness among healthcare workers about non-antineoplastic hazardous drugs, with 61.7% of respondents unaware of these risks. The correct use of PPE was reported by 90.8% of participants, with nurses showing higher compliance than other categories. Despite these precautions, 6.45% of exposed workers reported difficulties in conception, though this association was not statistically significant (OR = 1.25, p = 0.802).
Conclusion: The findings highlight the need for improved training and stricter enforcement of safety protocols regarding hazardous drug handling. While PPE use is widespread, the lack of awareness about non-antineoplastic drugs and reported reproductive issues suggest current measures may be insufficient. The study advocates for implementing advanced protective technologies and continuous education to better protect healthcare workers and meet evolving safety standards.