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Medical Surveillance for Hazardous Drugs

A Qualitative Assessment of Current Practices

Newcomb, Richard D. MD, MPH; Frasso, Rosemary PhD, MSc, CPH; Cruz, Phoebe MPH; Breeher, Laura E. MD, MPH; Molella, Robin G. MD, MPH; Green-McKenzie, Judith MD, MPH

Journal of Occupational and Environmental Medicine: June 2018 - Volume 60 - Issue 6 - p 521–527
doi: 10.1097/JOM.0000000000001238

Objective: The National Institute for Occupational Safety and Health recommends that institutions establish a medical surveillance program for workers who handle hazardous drugs. Our aim was to investigate current practices with occupational medicine practice (OMP) national leaders.

Methods: A series of qualitative telephone interviews were conducted with 11 OMP national leaders from medical centers in 10 states. Interviews were recorded, transcribed, and coded using a directed content analysis. Codes were organized into themes.

Results: All respondents were board-certified physicians in medical center OMP. Interviews up to 45 minutes found three themes: policy interpretation, benefits and barriers to surveillance, and potential respondent-generated solutions. Three of 10 medical centers provided medical surveillance.

Conclusions: Medical surveillance for hazardous drugs is infrequent, and consensus is lacking regarding standard practices. Further work is needed to minimize risk to health care workers.

Division of Preventive Occupational and Aerospace Medicine, Mayo Clinic, Rochester, Minnesota (Drs Newcomb, Breeher, and Molella); Center for Public Health Initiatives (Dr Frasso), School of Social Policy and Practice, University of Pennsylvania, Philadelphia, Pennsylvania (Ms Cruz); and Division of Occupational and Environmental Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania (Dr Green-McKenzie).

Address correspondence to: Richard D. Newcomb, MD, MPH, Division of Preventive Occupational and Aerospace Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (

Dr. Frasso is now at College of Population Health, Thomas Jefferson University, Philadelphia, Pennsylvania.

Presented as a poster at the American Occupational Health Conference, Baltimore, Maryland, April 10–13, 2016.

The authors report no conflicts of interest.

Supplemental digital contents are available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

Copyright © 2018 by the American College of Occupational and Environmental Medicine