{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T22:33:55Z","timestamp":1775601235817,"version":"3.50.1"},"reference-count":82,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Beckton Dickinson\u00ae"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>(1) Background: With the increasing incidence of cancer, the need for handling cytotoxic drugs has also grown. However, manipulating these drugs exposes healthcare professionals to significant risks, including occupational exposure to hazardous chemicals. Therefore, it is important to adopt protective measures, including personal protective equipment (PPE) and correct ergonomic practices, to ensure safe drug preparation and minimize health risks for the operators. However, while chemical exposure and PPE have been extensively addressed in the literature, the combined impact of ergonomic practices and protective measures remains insufficiently emphasized, representing a critical gap this review aims to address. Accordingly, the objective of this literature review was to analyze the ergonomic and individual protection practices during the handling of cytostatic drugs and all the implications that bad ergonomic practices and\/or poor individual protection have on the operator\u2019s health; (2) Methods: In order to perform this integrative review, a structured literature search was conducted using online databases (Web of Science\u00ae, Google Scholar\u00ae, and PubMed\u00ae) from January 2005 to June 2025. (3) Results: A total of 19 articles were analyzed, with 17 focusing on PPE and 17 on ergonomics. The findings emphasize that PPE, such as gloves, masks, gowns, sleeves and safety glasses, plays a critical role in the safe handling of cytotoxic drugs, particularly when combined with other safety measures. Additionally, maintaining correct ergonomic posture is important in preventing musculoskeletal disorders; (4) Conclusions: This review emphasizes the significance of integrating appropriate PPE use with sound ergonomic procedures. Although PPE is still the secondary line of defense against occupational exposure, ergonomic issues must also be addressed to avoid chronic musculoskeletal problems. Continuous training, rigorous attention to safety procedures, and ergonomic enhancements should be prioritized by healthcare facilities as a key element of occupational safety programs to reduce the short-term and long-term health hazards for personnel handling dangerous drugs.<\/jats:p>","DOI":"10.3390\/curroncol32100563","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T08:22:08Z","timestamp":1759911728000},"page":"563","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Health Effects of Ergonomics and Personal Protective Equipment on Chemotherapy Professionals"],"prefix":"10.3390","volume":"32","author":[{"given":"Ana","family":"Reis","sequence":"first","affiliation":[{"name":"Facultad de Farmacia, Universidad de Salamanca, Campus Miguel de Unamuno, 37007 Salamanca, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9402-0341","authenticated-orcid":false,"given":"V\u00edtor","family":"Silva","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal"},{"name":"Associa\u00e7\u00e3o Portuguesa de Licenciados em Farm\u00e1cia (APLF), 3140-348 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9979-0062","authenticated-orcid":false,"given":"Jo\u00e3o Jos\u00e9","family":"Joaquim","sequence":"additional","affiliation":[{"name":"Associa\u00e7\u00e3o Portuguesa de Licenciados em Farm\u00e1cia (APLF), 3140-348 Coimbra, Portugal"},{"name":"Farm\u00e1cia, Escola Superior de Tecnologia da Sa\u00fade de Coimbra, Instituto Polit\u00e9cnico de Coimbra, R. 5 de Outubro, 3045-043 Coimbra, Portugal"}]},{"given":"Lu\u00eds","family":"Valadares","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade (ULS) S\u00e3o Jos\u00e9 E.P.E, 1150-199 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6279-1421","authenticated-orcid":false,"given":"Cristiano","family":"Matos","sequence":"additional","affiliation":[{"name":"Associa\u00e7\u00e3o Portuguesa de Licenciados em Farm\u00e1cia (APLF), 3140-348 Coimbra, Portugal"},{"name":"Farm\u00e1cia, Escola Superior de Tecnologia da Sa\u00fade de Coimbra, Instituto Polit\u00e9cnico de Coimbra, R. 5 de Outubro, 3045-043 Coimbra, Portugal"},{"name":"European Association of Pharmacy Technicians, B-1080 Brussels, Belgium"}]},{"given":"Carolina","family":"Valeiro","sequence":"additional","affiliation":[{"name":"European Association of Pharmacy Technicians, B-1080 Brussels, Belgium"}]},{"given":"Ramona","family":"Mateos-Campos","sequence":"additional","affiliation":[{"name":"\u00c1rea de Medicina Preventiva y Salud P\u00fablica, Departamento Ciencias Biom\u00e9dicas y del Diagn\u00f3stico, Faculdade de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3452-1459","authenticated-orcid":false,"given":"Fernando","family":"Moreira","sequence":"additional","affiliation":[{"name":"LAQV\/REQUIMTE, Escola Superior de Sa\u00fade, Instituto Polit\u00e9cnico do Porto, Rua Dr. Ant\u00f3nio Bernardino de Almeida, 4200-072 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"ref_1","unstructured":"Vanderah, T. (2023). Katzung\u2019s Basic & Clinical Pharmacology, MC Graw-Hill. [16th ed.]."},{"key":"ref_2","unstructured":"Pan American Health Organization (2013). Safe Handling of Hazardous Chemotherapy Drugs in Limited-Resource Settings."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Saha, D., Anderson, A., Cisneros, L., and Maley, C. (2023). In Silico Investigations of Adaptive Therapy Using Two Cytotoxic or Two Cytostatic Drugs. bioRxiv.","DOI":"10.1101\/2023.05.12.540626"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1958","DOI":"10.1177\/10781552211034473","article-title":"Defining Cytotoxic Drugs\u2014You Know It When You See It?","volume":"27","author":"Badry","year":"2021","journal-title":"J. Oncol. Pharm. Pract."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.yrtph.2014.06.012","article-title":"Functional Differentiation of Cytotoxic Cancer Drugs and Targeted Cancer Therapeutics","volume":"70","author":"Winkler","year":"2014","journal-title":"Regul. Toxicol. Pharmacol."},{"key":"ref_6","first-page":"123","article-title":"Occupational Health and Safety of Personnel Handling Chemotherapeutic Agents in Greek Hospitals","volume":"20","author":"Constantinidis","year":"2011","journal-title":"Eur. J. Cancer Care"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"374","DOI":"10.2165\/00002018-199207050-00005","article-title":"Handling of Cytotoxic Drugs by Healthcare Workers. A Review of the Risks of Exposure","volume":"7","author":"Jochimsen","year":"1992","journal-title":"Drug Saf."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/BF00385647","article-title":"Cancer Risk Assessment for Health Care Workers Occupationally Exposed to Cyclophosphamide","volume":"67","author":"Sessink","year":"1995","journal-title":"Int. Arch. Occup. Environ. Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/0165-1110(85)90024-7","article-title":"Occupational Exposure to Anticancer Drug\u2014Potential and Real Hazards","volume":"154","author":"Sorsa","year":"1985","journal-title":"Mutat. Res."},{"key":"ref_10","unstructured":"Amjad, M.T., Chidharla, A., and Kasi, A. (2025). Cancer Chemotherapy. StatPearls, StatPearls Publishing."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1016\/S0140-6736(79)91939-1","article-title":"Mutagenicity in urine of nurses handling cytostatic drugs","volume":"313","author":"Falck","year":"1979","journal-title":"Lancet"},{"key":"ref_12","unstructured":"The National Institute for Occupational Safety and Health (2004). Preventing Occupational Exposure to Antineoplastic and Other Hazardous Drugs in Health Care Settings."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"104907","DOI":"10.1016\/j.ijnurstu.2024.104907","article-title":"Knowledge and Safe Handling Practices Affecting the Occupational Exposure of Nurses and Midwives to Hazardous Drugs: A Mixed Methods Systematic Review","volume":"160","author":"Russo","year":"2024","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_14","first-page":"165","article-title":"Important Exposure Controls for Protection against Antineoplastic Agents: Highlights for Oncology Health Care Workers","volume":"59","author":"Alehashem","year":"2018","journal-title":"Work"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1080\/10376178.2017.1315828","article-title":"Oncology Nurses\u2019 Perspectives on Safe Handling Precautions: A Qualitative Study","volume":"53","year":"2017","journal-title":"Contemp. Nurse"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"4585","DOI":"10.1111\/jocn.17488","article-title":"Global Cancer Nurse\u2019s Experiences and Perceptions of Potential Occupational Exposure to Cytotoxic Drugs: Mixed Method Systematic Review with Framework Synthesis","volume":"33","author":"Campbell","year":"2024","journal-title":"J. Clin. Nurs."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"S38","DOI":"10.12968\/bjon.2017.26.16.S38","article-title":"Perceived Adverse Effects from Handling Systemic Anti-Cancer Therapy Agents","volume":"26","author":"Simons","year":"2017","journal-title":"Br. J. Nurs."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1097\/JOM.0000000000000249","article-title":"Reproductive Health Risks Associated with Occupational Exposures to Antineoplastic Drugs in Health Care Settings: A Review of the Evidence","volume":"56","author":"Connor","year":"2014","journal-title":"J. Occup. Environ. Med."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Ratner, P.A., Spinelli, J.J., Beking, K., Lorenzi, M., Chow, Y., Teschke, K., Le, N.D., Gallagher, R.P., and Dimich-Ward, H. (2010). Cancer Incidence and Adverse Pregnancy Outcome in Registered Nurses Potentially Exposed to Antineoplastic Drugs. BMC Nurs., 9.","DOI":"10.1186\/1472-6955-9-15"},{"key":"ref_20","first-page":"511","article-title":"[Genotoxic risk in nurses handling antiblastic drugs: Systematic review of literature and meta-analysis]","volume":"108","author":"Gianfredi","year":"2017","journal-title":"Recenti. Prog. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1007\/s00420-014-0993-y","article-title":"Micronuclei and Chromosome Aberrations in Subjects Occupationally Exposed to Antineoplastic Drugs: A Multicentric Approach","volume":"88","author":"Moretti","year":"2015","journal-title":"Int. Arch. Occup. Environ. Health"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1002\/em.21852","article-title":"Chromosomal Effects of Non-Alkylating Drug Exposure in Oncology Personnel","volume":"55","author":"McDiarmid","year":"2014","journal-title":"Environ. Mol. Mutagen."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1080\/01480545.2016.1209678","article-title":"Chromosomal Aberrations, Sister Chromatid Exchanges, and Micronuclei in Lymphocytes of Oncology Department Personnel Handling Anti-Neoplastic Drugs","volume":"40","author":"Mahmoodi","year":"2017","journal-title":"Drug Chem. Toxicol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.taap.2017.01.020","article-title":"Improving the International Agency for Research on Cancer\u2019s Consideration of Mechanistic Evidence","volume":"319","author":"Goodman","year":"2017","journal-title":"Toxicol. Appl. Pharmacol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1177\/1078155217704990","article-title":"Carry-over of Antineoplastic Drug Contamination in Dutch Hospital Pharmacies","volume":"24","author":"Crul","year":"2018","journal-title":"J. Oncol. Pharm. Pract."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1080\/15459624.2020.1776299","article-title":"Occupational Exposure of Pharmacy Technicians and Cleaning Staff to Cytotoxic Drugs in Dutch Hospitals","volume":"17","author":"Crul","year":"2020","journal-title":"J. Occup. Environ. Hyg."},{"key":"ref_27","first-page":"404","article-title":"Preventing the Contamination of Hospital Personnel by Cytotoxic Agents: Evaluation and Training of the Para-Professional Healthcare Workers in Oncology Units","volume":"24","author":"Kieffer","year":"2015","journal-title":"Eur. J. Cancer Care"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Verscheure, E., Creta, M., Vanoirbeek, J., Zakia, M., Abdesselam, T., Lebegge, R., Poels, K., Duca, R.-C., and Godderis, L. (2020). Environmental Contamination and Occupational Exposure of Algerian Hospital Workers. Front. Public Health, 8.","DOI":"10.3389\/fpubh.2020.00374"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"7807","DOI":"10.1007\/s10661-014-3969-1","article-title":"Antineoplastic Drugs Contamination of Workplace Surfaces in Two Portuguese Hospitals","volume":"186","author":"Viegas","year":"2014","journal-title":"Environ. Monit. Assess"},{"key":"ref_30","first-page":"238","article-title":"Occupational Exposure to Cytotoxic Drugs: The Importance of Surface Cleaning to Prevent or Minimise Exposure","volume":"69","author":"Viegas","year":"2018","journal-title":"Arch. Ind. Hyg. Toxicol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"(2022). ISOPP Standards for the Safe Handling of Cytotoxics. J. Oncol. Pharm. Pract., 28, S1\u2013S126.","DOI":"10.1177\/10781552211070933"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.3747\/co.21.2151","article-title":"Safe Handling of Cytotoxics: Guideline Recommendations","volume":"22","author":"Easty","year":"2015","journal-title":"Curr. Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1539\/joh.50.86","article-title":"Actual Conditions of the Mixing of Antineoplastic Drugs for Injection in Hospitals in Osaka Prefecture, Japan","volume":"50","author":"Yoshida","year":"2008","journal-title":"J. Occup. Health"},{"key":"ref_34","unstructured":"Working Committee on the Safe Handling of Hazardous Drugs (2008). Prevention Guide: Safe Handling of Hazardous Drugs, IRSST."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e24","DOI":"10.1097\/OP9.0000000000000024","article-title":"Environmental Contamination with Cytotoxic Drugs in 15 Hospitals from 11 European Countries\u2014Results of the MASHA Project","volume":"3","author":"Korczowska","year":"2020","journal-title":"Eur. J. Oncol. Pharm."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"4144","DOI":"10.1002\/nop2.1626","article-title":"Effects of Safe Handling Education on Cognition, Compliance and Stress Handling of Antineoplastic Drugs in Clinical Nurses","volume":"10","author":"Jun","year":"2023","journal-title":"Nurs. Open"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1136\/ejhpharm-2020-002440","article-title":"External Contamination of Antineoplastic Drug Vials: An Occupational Risk to Consider","volume":"29","author":"Cotteret","year":"2022","journal-title":"Eur. J. Hosp. Pharm."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1177\/1078155210361431","article-title":"Reduction in Surface Contamination with Antineoplastic Drugs in 22 Hospital Pharmacies in the US Following Implementation of a Closed-System Drug Transfer Device","volume":"17","author":"Sessink","year":"2011","journal-title":"J. Oncol. Pharm. Pract."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1136\/oem.59.9.608","article-title":"Occupational Exposure to Cytotoxic Drugs in Two UK Oncology Wards","volume":"59","author":"Ziegler","year":"2002","journal-title":"Occup. Environ. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e0316","DOI":"10.15275\/rusomj.2021.0318","article-title":"Exposure To Cytotoxic Drugs Threatens The Health Of Staff In Oncology Wards","volume":"10","author":"Momeni","year":"2021","journal-title":"Russ. Open Med. J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12199-020-00850-z","article-title":"Knowledge and Associated Factors towards Cytotoxic Drug Handling among University of Gondar Comprehensive Specialized Hospital Health Professionals, Institutional-Based Cross-Sectional Study","volume":"25","author":"Simegn","year":"2020","journal-title":"Environ. Health Prev. Med."},{"key":"ref_42","unstructured":"Occupational Safety and Health Administration (2016). Controlling Occupational Exposure to Hazardous Drugs."},{"key":"ref_43","unstructured":"European Medicines Agency (EMA) (2017). Good Manufacturing Practice (GMP) Guidelines."},{"key":"ref_44","unstructured":"European Union (2004). Directive 2004\/37\/EC of the European Parliament and of the Council of 29 April 2004 on the Protection of Workers From the Risks Related to Exposure to Carcinogens or Mutagens at Work."},{"key":"ref_45","unstructured":"Health and Safety Executive (HSE) (2015). Carcinogens and Mutagens: The Control of Substances Hazardous to Health Regulations."},{"key":"ref_46","unstructured":"Federal Institute for Occupational Safety and Health (BAuA) (2021). Cytotoxic Drugs: Information for Healthcare Professionals, Federal Institute for Occupational Safety and Health (BAuA)."},{"key":"ref_47","unstructured":"Edwards, C., Fortingo, N., and Franklin, E. (2025). Ergonomics. StatPearls, StatPearls Publishing."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1002\/rnj.166","article-title":"Evidence of Health Risks Associated with Prolonged Standing at Work and Intervention Effectiveness","volume":"40","author":"Waters","year":"2015","journal-title":"Rehabil. Nurs."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"287","DOI":"10.5271\/sjweh.3954","article-title":"Combined Ergonomic Exposures and Development of Musculoskeletal Pain in the General Working Population: A Prospective Cohort Study","volume":"47","author":"Andersen","year":"2021","journal-title":"Scand. J. Work Environ. Health"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1518\/001872099779656743","article-title":"Work Organization, Job Stress, and Work-Related Musculoskeletal Disorders","volume":"41","author":"Carayon","year":"1999","journal-title":"Hum. Factors"},{"key":"ref_51","first-page":"564","article-title":"Evaluation of Work-Related Psychosocial and Ergonomics Factors in Relation to Low Back Discomfort in Emergency Unit Nurses","volume":"3","author":"Habibi","year":"2012","journal-title":"Int. J. Prev. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e11","DOI":"10.1309\/LM7BQ15TTQFBXIS","article-title":"Ergonomic Workstations and Work-Related Musculoskeletal Disorders in the Clinical Laboratory","volume":"43","author":"Lemma","year":"2012","journal-title":"Lab. Med."},{"key":"ref_53","first-page":"e14318","article-title":"Occupation-Related Injuries Among Healthcare Workers: Incidence, Risk Groups, and the Effect of Training","volume":"13","author":"Bilgin","year":"2021","journal-title":"Cureus"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"343","DOI":"10.3233\/BMR-200161","article-title":"The Factors of Non-Specific Chronic Low Back Pain in Nurses: A Meta-Analysis","volume":"34","author":"Sun","year":"2021","journal-title":"J. Back Musculoskelet. Rehabil."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1093\/ptj\/82.2.173","article-title":"Pathophysiological Tissue Changes Associated with Repetitive Movement: A Review of the Evidence","volume":"82","author":"Barr","year":"2002","journal-title":"Phys. Ther."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1136\/ejhpharm-2011-000038","article-title":"Comparing the Upper Limb Disorder Risks Associated with Manual and Automated Cytotoxic Compounding: A Pilot Study","volume":"19","author":"McLeod","year":"2012","journal-title":"Eur. J. Hosp. Pharm."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"102352","DOI":"10.1016\/j.japh.2025.102352","article-title":"Ensuring Safety in Cytotoxic Drug Preparation: A Systematic Review of Guidelines Addressing Education for Pharmacy Professionals","volume":"65","author":"Moreira","year":"2025","journal-title":"J. Am. Pharm. Assoc. (2003)"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Bernabeu-Mart\u00ednez, M.A., Ramos Merino, M., Santos Gago, J.M., \u00c1lvarez Sabucedo, L.M., Wanden-Berghe, C., and Sanz-Valero, J. (2018). Guidelines for Safe Handling of Hazardous Drugs: A Systematic Review. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0197172"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.1177\/10781552211040176","article-title":"Barriers and Facilitators for the Safe Handling of Antineoplastic Drugs","volume":"28","author":"Fazel","year":"2022","journal-title":"J. Oncol. Pharm. Pract."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1177\/10781552241307905","article-title":"Cytotoxic Surface Contamination in Hospitals: Current Practices, Challenges and Perspectives","volume":"31","author":"Favier","year":"2025","journal-title":"J. Oncol. Pharm. Pract."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"547","DOI":"10.2146\/ajhp050197","article-title":"Permeability of 13 Different Gloves to 13 Cytotoxic Agents under Controlled Dynamic Conditions","volume":"63","author":"Wallemacq","year":"2006","journal-title":"Am. J. Health Syst. Pharm."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1111\/j.1365-2702.2006.01305.x","article-title":"Turkish Nurses\u2019 Information about, and Administration of, Chemotherapeutic Drugs","volume":"15","author":"Kosgeroglu","year":"2006","journal-title":"J. Clin. Nurs."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s00420-012-0742-z","article-title":"Evaluation of Working Practices and Surface Contamination with Antineoplastic Drugs in Outpatient Oncology Health Care Settings","volume":"86","author":"Kopp","year":"2013","journal-title":"Int. Arch. Occup. Environ. Health"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"2050312120918999","DOI":"10.1177\/2050312120918999","article-title":"Occupational Health and Safety Hazards Faced by Healthcare Professionals in Taiwan: A Systematic Review of Risk Factors and Control Strategies","volume":"8","year":"2020","journal-title":"SAGE Open Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"407","DOI":"10.47626\/1679-4435-2020-527","article-title":"Handling of Antineoplastic Drugs: A Health Concern among Health Care Workers","volume":"18","author":"Rocha","year":"2021","journal-title":"Rev. Bras. Med. Trab."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Rai, R., El-Zaemey, S., Dorji, N., Rai, B.D., and Fritschi, L. (2021). Exposure to Occupational Hazards among Health Care Workers in Low- and Middle-Income Countries: A Scoping Review. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18052603"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Tang, Y., Che, X., Wang, Y.L., Ye, X., Cao, W.L., and Wang, Y. (2022). Evaluation of Closed System Transfer Devices in Preventing Chemotherapy Agents Contamination During Compounding Process-A Single and Comparative Study in China. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.827835"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1016\/j.procs.2021.12.062","article-title":"Protective Equipment Applicable to a Centralized Cytostatic Preparation Unit","volume":"196","author":"Fernandes","year":"2022","journal-title":"Procedia Comput. Sci."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1016\/j.procs.2023.01.431","article-title":"The Occupational Risks and Health Effects Resulting from Exposition to Cytotoxic Drugs Preparation","volume":"219","author":"Oliveira","year":"2023","journal-title":"Procedia Comput. Sci."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.1177\/10781552221127698","article-title":"Comparison of Permeabilities of Eight Different Types of Cytotoxic Drugs to Five Gloves with Different Materials by LC-MS\/MS Methods to Reduce Occupational Exposure of Medical Personnel","volume":"29","author":"Zhou","year":"2023","journal-title":"J. Oncol. Pharm. Pract."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1884","DOI":"10.1177\/10781552231153625","article-title":"Risk Assessment of Personnel Exposure in a Central Cytotoxic Preparation Unit Using the FMECA Method","volume":"29","author":"Bhirich","year":"2023","journal-title":"J. Oncol. Pharm. Pract."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1097\/01.jom.0000165751.21088.46","article-title":"Organizational Safety Culture\/Climate and Worker Compliance with Hazardous Drug Guidelines: Lessons from the Blood-Borne Pathogen Experience","volume":"47","author":"McDiarmid","year":"2005","journal-title":"J. Occup. Environ. Med."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1007\/s00420-004-0595-1","article-title":"Dermal Exposure to Cyclophosphamide in Hospitals during Preparation, Nursing and Cleaning Activities","volume":"78","author":"Fransman","year":"2005","journal-title":"Int. Arch. Occup. Environ. Health"},{"key":"ref_74","first-page":"20200003","article-title":"Optimisation of the Preparation of Chemotherapy Based on 5-Fluorouracil by the Use of Peristaltic Pumps","volume":"5","author":"Villain","year":"2020","journal-title":"Pharm. Technol. Hosp. Pharm."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"SHPA Committee of Specialty Practice in Oncology (2005). SHPA Standards of Practice for the Safe Handling of Cytotoxic Drugs in Pharmacy Departments. J. Pharm. Pract. Res., 35, 44\u201352.","DOI":"10.1002\/j.2055-2335.2005.tb00301.x"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1177\/1078155212459667","article-title":"Exposure of Family Members to Antineoplastic Drugs via Excreta of Treated Cancer Patients","volume":"19","author":"Yuki","year":"2013","journal-title":"J. Oncol. Pharm. Pract."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1016\/j.ijheh.2017.03.005","article-title":"Antineoplastic Drug Residues inside Homes of Chemotherapy Patients","volume":"220","author":"Sverdel","year":"2017","journal-title":"Int. J. Hyg. Environ. Health"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1186\/s12302-021-00544-5","article-title":"Levels and Risks of Antineoplastic Drugs in Households of Oncology Patients, Hospices and Retirement Homes","volume":"33","author":"Kuta","year":"2021","journal-title":"Environ. Sci. Eur."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1080\/10803548.2021.1928405","article-title":"Investigation of Occupational Safety in Oncology Nurses","volume":"28","author":"Karadakovan","year":"2022","journal-title":"Int. J. Occup. Saf. Ergon."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"188","DOI":"10.4103\/apjon.apjon_64_20","article-title":"Oncology Nurses\u2019 Needs Respecting Healthy Work Environment in Iran: A Descriptive Exploratory Study","volume":"8","author":"Soheili","year":"2021","journal-title":"Asia Pac. J. Oncol. Nurs."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"227","DOI":"10.4103\/0971-5851.195748","article-title":"Protection Behaviors for Cytotoxic Drugs in Oncology Nurses of Chemotherapy Centers in Shiraz Hospitals, South of Iran","volume":"37","author":"Abbasi","year":"2016","journal-title":"Indian J. Med. Paediatr. Oncol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"104","DOI":"10.4212\/cjhp.v68i2.1435","article-title":"Occupational Exposure to Chemotherapy of Pharmacy Personnel at a Single Centre","volume":"68","author":"Ramphal","year":"2015","journal-title":"Can. J. Hosp. 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