Chemo Safe Handling and Extravasation

Antineoplastic drugs can harm the person preparing or administering them even when the patient is receiving an appropriate therapeutic dose. There is no established occupational exposure limit for cytotoxic drugs: a quantity that appears very small may still be harmful. Safe handling therefore aims to prevent release and contact rather than to remain below a supposedly harmless threshold. Occupational exposure occurs through inhaled droplets, particles, or vapours; skin or mucous membrane contact with contaminated equipment or surfaces; ingestion from contaminated food or drink in a handling area; and needlestick or other sharps injury. Reported effects include acute skin, eye, and mucous membrane irritation, nausea, headache, and dizziness. Repeated or longer-term exposure has been associated with genotoxic effects and reproductive harm, including infertility, miscarriage, low birth weight, and congenital anomalies. Extravasation is a different safety problem: the drug escapes from the vein or vascular-access device into surrounding tissue. A vesicant can blister tissue and cause necrosis. An irritant generally causes inflammation and pain along the vein without tissue death, but the distinction is not always reassuring. Some agents labelled irritants, including...