Aim: Health care workers can be exposed to various
hazardous drugs. Medications containing
carcinogenic or mutagenic pharmaceuticals
or those which are toxic to reproduction
(CMR-medications) and medications containing
sensitizing substances can pose serious
health risks. Recognition of the hazardous substances
is difficult since drug labels do not declare
chemical hazards. This often makes it difficult
to take adequate safety measures. Aim
of the study was the identification of drugs
with sensitizing or CMR-properties as a contribution
to risk assessment and evaluation
of the impact of potentially hazardous drugs.
Methods: In the course of an investigation
of chemical hazards in pharmacies, an extensive
review of the literature was performed
to identify drugs with known sensitizing or
CMR-properties.
Results: The study revealed that more than
500 drugs are reported to have sensitizing or
CMR-properties. The identified substances
are not limited to cytotoxic drugs but include
pharmaceuticals of all 20 most frequently
prescribed medication-groups.
Conclusions: It has to be acknowledged
that pharmaceuticals frequently have sensitizing
or CMR-properties. The impact of the
hazardous properties varies among the pharmaceuticals
and the actual risks involved in
handling the drugs remains to be determined.
Therefore, adequate safety measures
need to be established to ensure the safety
of healthcare workers. Since various safety
measures are available for the preparation
and application of drugs, the choice of measures
needs to be discussed with respect to
their efficiency, practicability, and economy.
