Safe handling of cytotoxic and other hazardous drugs: Knowledge and practices among oncology staff in a teaching hospital

Abstract

Background

Cytotoxic drugs play a crucial role in cancer care but are highly hazardous to the health of healthcare workers if not handled safely. However, despite global guidelines for safe handling, knowledge and practice gaps persist, particularly in low- and middle-income countries (LMICs). There is no documented evidence in Ghana regarding this problem. The objective of this study was to evaluate the knowledge and practice of oncology personnel regarding safe handling of cytotoxic and hazardous drugs at Komfo Anokye Teaching Hospital, Ghana.

Methods

A cross-sectional survey was conducted among 75 healthcare workers, comprising pharmacists, nurses, medical officers, and pharmacy technicians, who were involved in handling cytotoxic drugs. Data were gathered using a structured, pretested questionnaire and analysed using SPSS v20. Descriptive statistics and linear regression analyses were used to evaluate knowledge, practices, and predictors.

Results

Most respondents (mean age, 30.9 years) demonstrated good knowledge of safe handling practices, with a mean knowledge score of 7.67/10. All identified hand hygiene and worker protection as important safety practices. Significant gaps were identified; only 19% were aware of glove variability, and 15% knew that gowns could not be reused. Reported practices were good overall (mean practice score = 7.24/10), although 15% reported touching cytotoxic tablets with bare hands, and 19% reused personal protective equipment (PPE). The availability of PPE was high for gloves and aprons, but less so for head and shoe covers, which were also underutilised. Professional cadre was a significant predictor of knowledge (p = 0.022), but no factor significantly predicted practice.

Conclusion

While oncology personnel had high knowledge and compliance rates with safe handling procedures, there are crucial gaps, especially in the use of PPE and awareness of equipment standards. Regular training and institutional policy reinforcement are recommended to enhance safety and minimise occupational hazards in cytotoxic drug handling.