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Medical Surveillance Programs for Workers Exposed to Hazardous Medications

A Survey of Current Practices in Health Care Institutions

Breeher, Laura E. MD, MPH; Molella, Robin G. MD, MPH; Vaughn, Andrew I. MD, MPH; Swift, Melanie D. MD; Spaulding, Aaron C. PhD; Brueggen, Carol M. MS, APRN, CNS; Green-McKenzie, Judith MD, MPH; Newcomb, Richard D. MD, MPH

Journal of Occupational and Environmental Medicine: February 2019 - Volume 61 - Issue 2 - p 120–125
doi: 10.1097/JOM.0000000000001494

Objective: To assess current medical surveillance monitoring practices for health care workers who prepare, handle, or administer hazardous medications.

Methods: A cross-sectional survey was distributed to members of the American College of Occupational and Environmental Medicine and the National Comprehensive Cancer Network.

Results: Forty-six of the 91 survey respondents indicated that their institution had a hazardous medication surveillance program. We identified the most frequent laboratory (complete blood count) and physical (skin) examination components. A health history was frequently used. Statistical analysis did not suggest an association between institutions with greater resources and presence of a surveillance program.

Conclusions: A consensus standard for medical monitoring was not reported by the respondents. We recommend using a standardized surveillance questionnaire and applying uniform laboratory testing across institutions, in addition to establishing a national repository for surveillance data.

Division of Preventive, Occupational and Aerospace Medicine (Drs Breeher, Molella, Vaughn, Swift, and Newcomb); Department of Nursing (Ms Brueggen), Mayo Clinic, Rochester, Minnesota; Department of Health Sciences Research, Robert D. and Patricia E. Kern Center for Science of Health Care Delivery, Mayo Clinic, Jacksonville, Florida (Dr Spaulding); and Division of Occupational Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania (Dr Green-McKenzie).

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

Source of funding: This study was not externally funded.

Conflict of interest: None.

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Copyright © 2019 by the American College of Occupational and Environmental Medicine