THE ISSUES:

• Safe handling of chemotherapy drugs is a top priority for all healthcare professionals who prepare, administer and/or clean-up chemotherapy drugs.
• The current Occupational Safety and Health Administration and the American Society for Health-System Pharmacists guidelines recommend using powder-free latex gloves.^1,2
• For the latex-sensitive individual, safe handling of chemotherapy drugs must be considered.

THE SOLUTION:

• Ansell addresses all the issues by offering a variety of latex and non-latex gloving choices - from extra protection latex and nitrile examination gloves to neoprene surgical gloves - all are powder-free, all are choices for handling chemotherapy drugs.

These permeation data are based on an independent study which tested non-latex materials and one natural rubber latex material against the listed chemotherapy drugs (PVC is not recommended based on results from a previous study.³). These results are intended to guide and inform healthcare personnel, safety specialists and other qualified professionals involved in handling chemotherapy drugs in the healthcare environment under normal working conditions. Ansell believes this information is the best currently available; it is subject to revision as additional knowledge and experience is gained. Test data herein reflects laboratory performance of partial gloves and not necessarily the complete unit. Gloves used for protection against chemical exposure must be selected specifically for the type of chemicals used. Review material safety data sheets for the chemicals being used to determine the required level of protection.

Upon request Ansell will be pleased to provide a sample of product to you for your own evaluation.

1. Office of Occupational Medicine. Guidelines for Handling CDs. Occupational Safety and Health Act Instruction [PUB 8-1.1, Jan. 29, 1986].
2. American Society of Health-System Pharmacists. ASHP technical assistance bulletin on handling cytotoxic and hazardous drugs. Am J Hosp Pharm 1990; 47: 1033-49.
3. Laidlaw JL., Conner TH, Theiss JC, Anderson RW, Matncy TS. Permeability of latex and polyvinyl chloride gloves to 20 antineoplastic drugs.Am J Hosp Pharm 1984; 41:2618-23.

SAFE HANDLING OF CHEMOTHERAPY DRUGS GLOVE TYPE Drug Number of samples demonstrating permeability at 30, 60, 90 and 120 minutes (Total of 12 samples per glove material.)* CARMUSTINE 3.33 mg/ml 1 out of 6 samples at 90 minutes permeated <1% 0 ETOPOSIDE 20 mg/ml 0 0 THIOTEPA 10 mg/ml 0 1 out of 12 samples at 30 minutes permeated 5% CISPLATIN 1 mg/ml 0 0 PACLITAXEL 6 mg/ml 0 0 CYCLOPHOS- PHAMIDE 20 mg/ml 0 0 DOXORUBICIN 2 mg/ml 0 0 5- FLUOROURACIL 50 mg/ml 0 0 MITOMYCIN 0.5 mg/ml 0 0 DAUNORUBICIN HCI 5 mg/ml 0 0 IFOSFAMIDE 50 mg/ml 0 0 MELPHALAN 5 mg/ml 0 0 MECHLOROE- THAMINE HCI 1 mg/ml 0 0 IDARUBICIN 1 mg/ml 0 0 CARBOPLATIN 10 mg/ml 0 0 BLEOMYCIN SULFATE 3 mg/ml 0 0 MITOXANTRONE 2 mg/ml 0 0 CYTARABINE HCI 50 mg/ml 0 1 out of 3 samples at 120 minutes permeated <.01% A ZERO (0) SIGNIFIES THAT NONE OF THE SAMPLES PERMEATED. TECHNICAL MONOGRAPH E.P.® Powder-Free Latex Gloves Nitra-Touch® Powder-Free Nitrile Gloves Material: Natural rubber latex Thickness (Double): Fingertip -   15.0 mils | .038mm Cuff -   19 mils | 0.48 mm Material: Nitrile Thickness (Double): Fingertip -   9 mils | 0.23 mm Cuff -   9 mils | 0.23 mm ORDERING INFORMATION Catalog No. - Size Pouches 9201 - 5-5 ½ 9203 - 6-6 ½ 9205 - 7-7 ½ 9207 - 8-8 ½ 1 Pair/Package 25 Pairs/Box 4 Boxes/Case Approx. price per pair CAUTION: This Product Contains Natural Rubber Latex Which May Cause Allergic Reactions. Catalog No. - Size 3441 - Small 3442 - Medium 3443 - Large 3444 - Extra Large 100 Gloves/Box 10 Boxes/Case Approx. price per pair

Chemotherapy drugs represent a significant health risk to healthcare personnel. Such drugs have been found to be carcinogenic, to cause chromosomal damage and may also cause damage to normal skin and necrosis of compromised skin. The most common exposures are the result of inadvertent ingestion of a drug on food, inhalation of drug dusts or droplets or direct skin contact. Proper training and the use of personal protective equipment such as suitable gloves are critical to ensure the safety of healthcare workers who handle chemotherapy drugs.

GLOVE TIPS

• Use natural rubber latex gloves when handling chemotherapy drugs.
• The Oncology Nursing Society states in their Cancer Chemotherapy Guidelines and Recommendations for Practice that, "People with known or suspected latex sensitivity or allergy should use gloves made from an alternate material such as nitrile."
• Polyvinyl chloride (PVC) gloves are not recommended for handling chemotherapy drugs.
• Always use powder-free gloves. Glove powders contaminated with chemotherapy drugs can become airborne and may be subsequently inhaled. Also, powder residue will attach to supplies, work surfaces and the skin.
• If double-gloving, insert first glove under the cuff and place the second glove over the cuff. If single-gloving, place the clean glove over the cuff' of the gown.
• Use extra-thick gloves, or better yet, use double gloves.
• Before handling chemotherapy drugs, always inspect gloves for holes, tears or any type of defect. Unless the film is intact, it cannot provide a barrier.
• Although surgical gloves are recommended for preparation, administration, cleanup and general handling, sterility is not always required especially with cleanup and housekeeping procedures. Surgical gloves are available in non-sterile presentations for these purposes.

DRUG PREPARATION

• Polyvinyl chloride (PVC) gloves are not recommended for handling chemotherapy drugs.
• Never use powdered gloves during drug preparation.
• Use double gloving unless it interferes with the drug preparation technique. A double layer of gloves is substantially less permeable to chemotherapy drugs.
• Change all gloves regularly (hourly) or immediately if they are torn or punctured.
• Do not wear gloves outside the preparation area.
• Dispose of used gloves according to proper hospital toxic waste procedures.

DRUG ADMINISTRATION

• Wear high quality gloves that have demonstrated safe use when handling chemotherapy drugs. Double-gloving is recommended.
• Wash hands before putting on gloves.
• Change contaminated gloves immediately.
• Wash hands after removing gloves.
• Dispose of gloves according to proper hospital toxic waste procedures.

DRUG CLEAN UP and GENERAL HANDLING

• Wear high quality gloves that have demonstrated safe use for handling chemotherapy drugs when dealing with blood, vomitus, excreta and other bodily fluids from chemotherapy drug patients.
• Discard gloves after each use.
• Laundry personnel coming into contact with linen contaminated with chemotherapy drug patients' body fluids should wear high quality gloves that have demonstrated safe use for handling chemotherapy drugs.
• Housekeeping personnel should wear high quality gloves that have demonstrated safe use for handling chemotherapy drugs when handling waste containers.
• Spills should only be cleaned up by personnel wearing a double layer of gloves.
• Spill kits for use in responding to spills should include two (2) pair of gloves; one outer pair of utility gloves and one inner pair of latex or Latex Free gloves.
• All personnel involved in any aspect of handling chemotherapy drugs must receive an orientation on chemotherapy drugs including proper use of protective equipment.