Preventing chemical contamination in oncology pharmacy practice

Interview with Rudolf Schierl on chemical contamination

When it comes to hazardous drugs compounding, preventing chemical contamination is one of the main challenges for pharmacy practice.

To gain a broader perspective on that issue, we asked Prof. Rudolf Schierl to share with APOTECACommunity some thoughts on how pharmacy can avoid critical levels of chemical exposure.

Rudolf Schierl is the head of the Analytical and Monitoring Department at the Institute for Occupational, Social and Environmental Medicine, of the Munich University. He has devoted his entire professional career to researching and monitoring the effects of occupational exposure to different compounds, with focus on antineoplastic drugs, endotoxins, allergens, fine and ultra fine particles and heavy metals on human health. He’s the author of many scientific studies on that issue, published on the most influential journals.

Professor Schierl, taking advantage of your experience regarding the contamination of chemo in hospitals and pharmacies, can we say that we have reached reasonable safety risk level? What are the next challenges?

In many pharmacies there are good levels of safety precautions in place. So a “low risk” preparation of chemo is possible either by isolators or BSCs. But it is clear that the knowledge and internal pharmacy procedures still make the difference, particularly by installing more automation. A big challenge is the transfer of those good standards to the patient’s treatment areas, because too many contamination problems can be found in many hospitals or medical practices. This would be a difficult task because despite of handling errors by the staff also patients are a potent contamination source.

What are the key suggestions/recommendations a Pharmacist should follow in his practice to prevent chemical contamination?

Key point is a permanent training of the staff and optimization of weaknesses. This should be done for both the safety of staff and the quality of products (avoidance of dosage errors, surface contamination of products, etc.). A periodic monitoring of the working places may be helpful in order to verify a continuous improvement. Achieving those efforts under actual cost pressures is really challenging, but implementation of effective benchmark systems could play a key role in future.

Thinking at the APOTECACommunity as your group of pupils, what scientific studies would you involve them in? In other words, what research focus should the Community be involved in the next years?

Users of the APOTECAchemo system have to provide sufficient scientific data that this technique is able to meet the above mentioned issues (product quality and staff safety) in a daily routine. This could be achieved by publishing the scientific data they had collected. Additionally, comparative studies about key points like staff demand, total costs of therapy, maintenance and waste disposal would be really beneficial.