Manipulation des cytostatiques dans les services d’oncologie d’un Centre Hospitalo-Universitaire algérien

Abstract

Introduction: A study was conducted in the oncology wards of an Algerian university hospital in order to analyse cytostatic handling conditions. Materials and methods: Working conditions were evaluated in 2014 and then re-evaluated after opening of the cancer centre in 2015, using validated tools: professional questionnaire, ward monograph support and oncology ward audit support. The results were compared to clinical practice guidelines and oncology wards were classified according to the percentage compliance: non-compliance (< 69%), partial compliance (70-79%), substantial compliance (80-94%) and high compliance (95-100%). Exposure was evaluated by calculating the Cytotoxic Contact Index (CCI). Results: Oncology wards are situated in three hospitals. Reconstitution is performed in nonspecific treatment rooms with no collective protection measures. 62% of oncology units (oncology, gynaecology and haematology wards) were classified as level 2 and 3 exposure, requiring collective prevention measures. The level of compliance was very low (28%). All wards were classified as non-compliant for all items. Compliance essentially concerned training, quality control and hygiene measures. An improvement of cytostatic handling conditions was observed in 2015, concerning personnel training, recruitment of clinical pathologists and pharmacists, floorspace and hygiene of premises, storage of cytostatic agents and individual and collective protection equipment. Conclusion: In the light of this study, it appears relevant to improve cytostatic handling conditions by setting up a medical and environmental surveillance programme with the participation of all prevention personnel.