Antineoplastic drug handling and potential for exposure among veterinarians

Veterinary practices use antineoplastic (chemotherapeutic) drugs to treat various cancers in companion animals. The primary health concern with this is that veterinary staff largely use drugs designed for human treatments that can involuntarily harm those who handle them. Antineoplastic drugs are known to cause cancer and adverse reproductive health effects that have been largely studied in human health care settings. However, it is unknown the degree to which these drugs affect veterinary workers with respect to their unique protocols. This thesis furthers the understanding of antineoplastic drug use and exposure in veterinary practices. The thesis was comprised of two parts to address the research objectives. First, an online survey was administered in veterinary clinics to examine the drug preparation and administration practices, COVID-19 implications, training and guidelines, and personal protective equipment used with antineoplastic drugs. Second, surface wipe sampling was conducted to quantify the contamination on various surfaces, examine which drugs were found and where they were located within veterinary settings. The survey was completed by 80 participants in British Columbia and Minnesota. Twenty-four percent (19/80) reported that their clinic ever administered antineoplastic drugs. Eighty-two percent of participants who did not handle antineoplastic drugs referred animals to other practices. Sixty-eight percent (13/19) of respondents who administered antineoplastic drugs never received any formal safe handling training while 74% (14/19) of practices reported not following any specific guidelines on antineoplastic drug handling. Most clinics did not report significant change in their preparation and administration processes during the COVID-19 pandemic. In the surface wipe sampling, cyclophosphamide was the drug found most frequently for contamination. The surfaces most commonly contaminated included the floor where antineoplastic drugs were prepared and administered, door handles of antineoplastic storage and waste bins near antineoplastic drug administration and preparation, suggesting potential for exposure among workers. This thesis builds upon the limited existing literature to address how veterinary protocols affect exposure to antineoplastic drugs. Further research is recommended both on best practices specific to veterinary settings and on determining occupational exposure limits for antineoplastic drugs.Medicine, Faculty ofPopulation and Public Health (SPPH), School ofGraduat