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Effects of organizational safety practices and perceived safety climate on PPE usage, engineering controls, and adverse events involving liquid antineoplastic drugs among nurses

2017/03/22 by David M. DeJoy, Todd D. Smith, Henok G. Woldu +3 · 52 citations
Chemical Engineering · Health Professions · Medicine · #Adverse effect #Antineoplastic Drugs #Chemical Safety and Risk Management #Coronavirus disease 2019 (COVID-19) #Medicine #Occupational safety and health #Patient Safety and Medication Errors #Personal protective equipment #Pharmacology #Safe Handling of Antineoplastic Drugs #Safety climate #Workplace safety

paper · doi:10.1080/15459624.2017.1285496

published in Journal of Occupational and Environmental Hygiene 14(7), 485-493 (Taylor & Francis)

openalex publication_date 2017/03/22 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/22

Abstract

Antineoplastic drugs pose risks to the healthcare workers who handle them. This fact notwithstanding, adherence to safe handling guidelines remains inconsistent and often poor. This study examined the effects of pertinent organizational safety practices and perceived safety climate on the use of personal protective equipment, engineering controls, and adverse events (spill/leak or skin contact) involving liquid antineoplastic drugs. Data for this study came from the 2011 National Institute for Occupational Safety and Health (NIOSH) Health and Safety Practices Survey of Healthcare Workers which included a sample of approximately 1,800 nurses who had administered liquid antineoplastic drugs during the past seven days. Regression modeling was used to examine predictors of personal protective equipment use, engineering controls, and adverse events involving antineoplastic drugs. Approximately 14% of nurses reported experiencing an adverse event while administering antineoplastic drugs during the previous week. Usage of recommended engineering controls and personal protective equipment was quite variable. Usage of both was better in non-profit and government settings, when workers were more familiar with safe handling guidelines, and when perceived management commitment to safety was higher. Usage was poorer in the absence of specific safety handling procedures. The odds of adverse events increased with number of antineoplastic drugs treatments and when antineoplastic drugs were administered more days of the week. The odds of such events were significantly lower when the use of engineering controls and personal protective equipment was greater and when more precautionary measures were in place. Greater levels of management commitment to safety and perceived risk were also related to lower odds of adverse events. These results point to the value of implementing a comprehensive health and safety program that utilizes available hazard controls and effectively communicates and demonstrates the importance of safe handling practices. Such actions also contribute to creating a positive safety climate.

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