Chemotherapy drugs used today are potent and nonselective, meaning they kill both cancerous and non-cancerous cells. That’s why many cancer patients experience so many troublesome side effects. It’s also why a pair of University of North Carolina researchers want the healthcare industry to remember to ask another question: Are these drugs handled as safely as they should be?
Stephen Eckel, the assistant director of pharmacy at UNC Hospital, and Bill Zamboni, an assistant professor at UNC’s Eshelman School of Pharmacy, started work on what would eventually become ChemoGLO LLC about five years ago. They combined their expertise in hazardous drug contamination and anticancer drugs, respectively, to create a wipe kit and reference lab where they could help institutions, clinics and pharmacies measure the level of contamination on the surfaces of their facilities.
Based on the levels of contamination they saw, they’re launching a new product that these facilities can use to clean up spills of five commonly used hazardous drugs.
With the Rise of AI, What IP Disputes in Healthcare Are Likely to Emerge?
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
Despite safe handling guidelines recommended by organizations including the American Society of Health System Pharmacists and the National Institute for Occupational Safety and Health, chemotherapy and other hazardous drugs are still being splattered and spilled more often than we might think. In the more than 2,000 tests ChemoGLO has run so far, Zamboni and Eckel said 80 to 90 percent of the sites have shown detectable levels of contamination — many of them levels that were ten to a hundred times higher than those needed to kill cells if it’s absorbed (PDF).
“It has been well-documented that, through the preparation of doses by pharmacists to the administration of doses by nurses, there’s low-level of exposure to chemo throughout that whole process,” Eckel said. In fact, the CDC estimates that about 8 million U.S. healthcare workers are potentially exposed to hazardous drugs.
The question that’s still relatively unanswered is how exactly how spills of these drugs affect the people handling them. “(Healthcare workers) have documented skin rashes, spontaneous abortions, acute toxicity,” Eckel said. “There’s other suggestions that there could be secondary cancers, but that’s not as well studied or documented.”
But it’s certainly caused some alarm. The state of Washington, for example, last year passed a law that will require healthcare employers to follow certain requirements for handling hazardous drugs. BD and Equashield have also also designed a closed-system transfer devices to prevent leaks and spills during the reconstitution and administration of hazardous drugs.
A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
Hospitals, pharmacies and labs can use ChemoGLO’s kit to quantify amounts of contaminants on surfaces in their facilities. The test measures five types of anticancer agents (docetaxel, paclitaxel, 5-FU, cyclophosphamide, and ifosfamide) and delivers results within two to three weeks.
What the ChemoGLO team learned from processing these tests for repeat clients was that just implementing best practices after the initial test wasn’t completely eliminating contamination.
That was a problem they were confident they had a solution for. Eckel and Zamboni developed a two-towelette system called HDClean, short for Hazardous Drug Clean, that they say can be used in conjunction with established best practices to clean up surface residue from the drugs detected by the wipe kit. They licensed the technology from UNC in 2012, and sales of the product have already begun, Zamboni said.
The company’s near-term goals are focused around getting the reference lab test and HDClean used in more clinical and pharmacy practices. “Even though we’re testing these exposures, that’s probably less than 2 percent of hospitals that mix chemotherapy in the world,” he said. “The biggest thing we need to do as a company and as a profession is educating about the importance of monitoring. We know these spills are out there.”
[Photo from flickr user Tips Times]
