Workplace Safety Climate in Handling Systemic Anti-cancer Chemotherapy among Pharmacists at the National Cancer Institute, Sri Lanka

Abstract

Background: Pharmaceutical agents used in Anti-Cancer Chemotherapy (SACT) are considered hazardous. Unnecessary exposure to hazardous drugs leads to increased negative health effects among healthcare workers who handle them. Pharmacists are at greater risk of exposure and an appropriate workplace safety minimizes the possible risk. Objective: To assess the Workplace Safety Climate (WSC) in handling SACT among pharmacists at the National Cancer Institute (NCI), Sri Lanka Methods: A descriptive cross-sectional study was conducted among all pharmacists (n=35) working at the NCI using the 21-item 5-point Likert scale WSC questionnaire which was adopted with the validated Hazardous Drug Handling Questionnaire (HDHQ). Sums of items ranged from 21-105 and a higher score indicates a better safety climate. Data were analyzed with non parametric analysis using SPSS version 25.0. Results: Out of the 35 pharmacists, 33 volunteered. The mean(±SD) age and professional experience were 39.88(±6.88) and 12.53(±6.85) years. Thirteen pharmacists prepared drugs at the Chemotherapy Reconstitute Unit (CRU) with 1.98(±4.31) years of mean experience in handling SACT. WSC was statistically significant with the working unit (p<0.001) (Kruskal Wallis test). The mean values of WSC for all pharmacists’ units vs. CRU were 75.45(±23.15) and 71.74(±21.73). The minimum agreement (agreed and strongly agreed) was reported by 38% for the readily accessible Chemotherapy gloves at CRU. The majority (77%) in CRU reported better WSC by exceeding the 60 values on the 0-100 scale of WSC. WSC was statistically significant with participation in in-service programs (p=0.02), experience (p=0.04) of handling SACT, and gender (p=0.000). However, WSC was not associated with age (p=0.12), professional experience (p=0.49), working experience at NCI (p=0.49), or reconstituted sample count (p=0.44) (Spearman's correlation test). Conclusions: Better WSC is reported among pharmacists in handling SACT. WSC was associated with participation in in-service programs and experience in handling SACT. Periodical surveys are vital to assess the WSC and its associated factors to minimize the possible risk of exposure by implementing suitable interventions. Keywords: Occupational health safety, Pharmacists, Systemic Anti-cancer Chemotherapy, Workplace safety climate 62