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< ベッドでシックハウス症候群 | メイン | 清掃係の労働衛生←European A... >
2008.10.26 20:30 |  診療  |  仕事 / 職場  |  その他（医療関連）  |  ミチバ  | 推薦数 : 2

医療従事者の危険な薬剤からの防御

・「危険な薬剤って，何じゃ？」と言われたら，hazardous drugsを私が，勝手に訳したモノです．正しい訳があったら教えて下さい．

・NIOSH Publication No. 2009-106で，以下の様な記事がありました．看護師さんや薬剤師さんが抗癌剤等「危険な薬剤」を扱う場合の，個人防護具について書かれています．最近の日本ではどうなっているでしょうか？このブログの最後にＮＩＯＳＨが言っている「危険な薬剤」について貼り付けておきます．

Personal Protective Equipment for Health Care Workers Who Work with Hazardous Drugs

http://www.cdc.gov/niosh/docs/wp-solutions/2009-106/default.html

 

最初の部分だけ貼り付け。

Summary

Health care workers who handle hazardous drugs are at risk of skin rashes, cancer, and reproductive disorders. NIOSH recommends that employers provide appropriate personal protective equipment (PPE) to protect workers who handle hazardous drugs in the workplace.

 



・以下OSH TECHNICAL MANUAL SECTION VI: CHAPTER 2より引用したhazardous drugsの表です．（これが全てを網羅しているわけではありません） 

CONTROLLING OCCUPATIONAL EXPOSURE TO HAZARDOUS DRUGS 

 

CHEMICAL/GENERIC NAME

SOURCE*

ALTRETAMINE

C

AMINOGLUTETHIMIDE

A

AZATHIOPRINE

ACE

L-ASPARAGINASE

ABC

BLEOMYCIN

ABC

BUSULFAN

ABC

CARBOPLATIN

ABC

CARMUSTINE

ABC

CHLORAMBUCIL

ABCE

CHLORAMPHENICOL

E

CHLOROTIANISENE

B

CHLOROZOTOCIN

E

CYCLOSPORIN

E

CISPLATIN

ABCE

CYCLOPHOSPHAMIDE

ABCE

CYTARRABINE

ABC

DACARBAZINE

ABC

DACTINOMYCIN

ABC

DAUNORUBICIN

ABC

DIETHYLSTILBESTROL

BE

DOXORUBICIN

ABCE

ESTRADIOL

B

ESTRAMUSTINE

AB

ETHINYL ESTRADIOL

B

ETOPOSIDE

ABC

FLOXURIDINE

AC

FLUOROURACIL

ABC

FLUTAMIDE

BC

GANCICLOVIR

AD

HYDROXYUREA

ABC

IDARUBICIN

AC

IFOSFAMIDE

ABC

INTERFERON-A

BC

ISOTRETINOIN

D

LEUPROLIDE

BC

LEVAMISOLE

C

LOMUSTINE

ABCD

MECHLORETHAMINE

BC

MEDROXYPROGESTERONE

B

MEGESTROL

BC

MELPHALAN

ABCE

MERCAPTOPURINE

ABC

METHOTREXATE

ABC

MITOMYCIN

ABC

MITOTANE

ABC

MITOXANTRONE

ABC

NAFARELIN

C

PIPOBROMAN

C

PLICAMYCIN

BC

PROCARBAZINE

ABCE

RIBAVIRIN

D

STREPTOZOCIN

AC

TAMOXIFEN

BC

TESTOLACTONE

BC

THIOGUANINE

ABC

THIOTEPA

ABC

URACIL MUSTARD

ACE

VIDARABINE

D

VINBLASTINE

ABC

VINCRISTINE

ABC

ZIDOVUDINE

D


*  Sources
A - The National Institutes of Health, Clinical Center Nursing Department
B - Antineoplastic drugs in the [italicize the following text name] Physicians' Desk Reference
C - American Hospital Formulary, Antineoplastics
D - Johns Hopkins Hospital
E - International Agency for Research on Cancer

http://www.osha.gov/dts/osta/otm/otm_vi/otm_vi_2.html

 

・日本での取り組みはどうか？以下のような論文があります。

（もうちょっと新しいものもあったような気がするのですが、いま、部屋の中が乱雑でみつかりません） 
抗がん剤を取り扱う医療従事者の健康リスク
冨岡 公子1), 熊谷 信二1)
1) 大阪府立公衆衛生研究所　生活衛生課

 

産業衛生学雑誌
Vol. 47 (2005) , No. 5 p.195

 

抄録：  欧米では，抗がん剤を取り扱う医療従事者の職業性曝露に関する危険性について，1970年後半から警告的内容の報告がなされ，1980年代から1990年にかけて安全な抗がん剤の取扱いに関するガイドラインが制定されている．ガイドラインによって，個人保護具や作業環境が改善されてきている．また，職業性抗がん剤曝露の健康影響に関する調査・研究も盛んに行われている．日本においては，1991年に，日本病院薬剤師会がガイドラインを制定し，それ以降，抗がん剤の安全な取扱いに対する認識が看護師を中心に関心が持たれるようになったが，医療現場はあまり変化してきていない．産業衛生の分野に限ってみると，抗がん剤の安全な取扱いに対する記事や研究は，ほとんど見あたらない．抗がん剤を取り扱う医療従事者の職業性曝露に関する危険性についてはいまだに不明な点が多い．しかし，医療従事者における抗がん剤曝露の低減は，産業衛生上の重要な課題である．日本においては，抗がん剤の取扱いに適切な保護具や作業環境を普及させ，抗がん剤の安全な取扱いに関して検討する必要がある．また，欧米同様に，国家レベルの実効性や強制力が付与された抗がん剤の安全な取扱い指針が策定されることが望まれる．

 

  
・朝起きて身支度していたら，ＴＶが「マッチョ・カフェ」といっていたので驚いた．マッチョ（筋肉もりもりの男性）が，喫茶店で色々サービスするところかなと思ったら「抹茶パフェ」の「聞きまつがい」でした。

cf.『言いまつがい』

http://www.1101.com/iimatugai/index.html

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抹茶パフェ、チョコレートパフェのお味はその喫茶店レストランの評価をするのにかなり最高に近い基準であると思っています。

>Paul Carpenterさま、私は、オヤジの恥じらいがあり、まず、喫茶店ではパフェを食べません。喫茶店の評価は、コーヒーと、ケーキセットで行います。
この機にパフェに挑戦してみましょうか...娘と一緒の時に。
written by Paul Carpenter / 2008.10.27 08:39

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