Abstract
Cytotoxic agents, also called antineoplastic agents, are used in cancer treatment due to their inherent activity to inhibit cell growth or proliferation, or DNA, RNA and protein synthesis. They are, therefore, hazardous by nature in a non-selective manner leading to disruption of cell growth and function of both diseased and healthy cells of treated patients.While the benefits of receiving cytotoxic agents may outweigh the incurred risks for patients, the same cannot be said for exposed healthcare practitioners involved in the transport, preparation, administration, and resulting waste disposal of these agents.Consequently, many professional bodies around the world have set standards of practice to prevent occupational exposure of healthcare workers to cytotoxic agents, and hospitals have been active in defining strict policies in this concern.However, due to the variability of the practice and infrastructure in academic settings, some activities performed within the cytotoxic academic research laboratory often do not adhere to recommendations published by guidelines.The present recommendations were therefore set forward by members of a working group who are experts on the subject matter representing academic, clinical, and research backgrounds in an attempt to promote safe cytotoxic handling in academic institutions.The document maps out the trajectory of cytotoxic agents being investigated in academic research laboratories while providing recommendations on the delivery, storage, use and disposal of cytotoxic agents in university settings.
Highlights
Cytotoxic agents (CAs), called antineoplastic agents, are used in cancer treatment due to their inherent activity to inhibit cell growth or proliferation, or DNA, RNA and protein synthesis
Due to the variability of the practice and infrastructure in academic settings, some activities performed within the cytotoxic academic research laboratory (CARL) do not adhere to recommendations published by guidelines
Cytotoxic research: all testing with CAs should be performed in dedicated CARL, unless major equipment is housed in other facilities
Summary
Cytotoxic agents (CAs), called antineoplastic agents, are used in cancer treatment due to their inherent activity to inhibit cell growth or proliferation, or DNA, RNA and protein synthesis. Examples of temporary CARLs include but are not restricted to (i) Chemistry research laboratories that are sometimes used for the synthesis of new compounds with potential cytotoxic activities These compounds should be treated as cytotoxic until proven otherwise as dictated by the National Institute for Occupational Safety and Health (NIOSH) definition of hazardous drugs[5]. (iii) Cell culture laboratories (iv) Instrumentation laboratories; containing HPLC, NMR, etc Activities undertaken in these laboratories may include but are not restricted to the following: synthesis of potentially cytotoxic compounds, storage of CA vials and ampoules, reconstitution of CA, dilution of CA from concentrated solutions, transferring CA into tubes or glass vials for chemical analysis, running CA samples in analytical chemistry equipment, animal testing with CA, animal retention in cages, cage wash facilities, etc. Incident: a. near miss: an event not causing harm, but has the potential to cause injury or ill health 3 b. undesired circumstance: a set of conditions or circumstances that have the potential to cause injury or ill health,[3] e.g. untrained personnel handling CA
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