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. 2023 Apr 1;65(4):e204-e210.
doi: 10.1097/JOM.0000000000002781.

Limited Health Risks in Performing Drug Reconstitution and Handling Tasks in Pharmacies-Results of an Occupational Risk Assessment Study

Mirjam Crul  1 , Oscar Breukels, Shiwai Ng, Maaike Le Feber, Eelco Kuijpers, Oscar Smeets
Affiliations

Limited Health Risks in Performing Drug Reconstitution and Handling Tasks in Pharmacies-Results of an Occupational Risk Assessment Study

Mirjam Crul et al. J Occup Environ Med. .

Abstract

Objective: Some drugs need processing before they can be administered or dispensed. We measured airborne exposure of pharmacy staff to small particles when performing these tasks.

Methods: Reconstitution of powdered drugs in vials; crushing, splitting, and counting of tablets; and opening of capsules, using different ventilation strategies, were investigated in five pharmacies after in a worst-case approach. Airborne particulate matter was determined for a range of particles sizes.

Results: Mean particle concentrations ranged from not detectable to 1.03 μg/m 3 (<1 μm) and 589.7 μg/m 3 (<10 μm). Dust exhaust made tasks safer. Most hazardous was pouring out tablets from a bulk supply, and least hazardous was reconstitution of a powder for injection.

Conclusions: Occupational exposure during routine handling of drugs can occur, but the risks vary greatly with the nature and duration of the tasks.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

FIGURE 1
FIGURE 1
Risk matrix for inhalation risks during compounding and reconstitution in the pharmacy. Risks are stratified into three classes: small (green), moderate (blue), and high (red). GM, geometric mean; exposure is given as particle exposure in air.
FIGURE 2
FIGURE 2
Moving average of OPC measurements during the experiments over time. Green lines represent particles with a particle size <1 μm, purple lines represent particles with a particle size <2.5 μm, and yellow lines represent particles with a particle size <10 μm. Top, Measurements in pharmacy A. Middle, Measurements in pharmacy C. Bottom, Measurements in pharmacy B.
FIGURE 3
FIGURE 3
Boxplots of the measured mass concentration (in μg/m3) on a log scale of the APS (red) OPC in near field (green) and OPC in far field (blue) for each of the three particle size groups (PM1 = A, PM 2.5 = B, and PM 10 = C). Results are corrected for background. FF, far field; NF, near field.
FIGURE 4
FIGURE 4
Risk levels of the handling tasks with and without ventilation measures for 15 minutes, 2 hours, and 8 hours of performing these handling tasks.
See this image and copyright information in PMC

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