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全国の医療施設における抗癌剤の取り扱い方と組織的な防止策の実施状況を把握し,看護師の抗癌剤曝露を防止するための取り組み方を検討した.全国の310施設の看護部長を対象とし,質問紙法で抗癌剤の取り扱い状況と曝露防止策の実施について調査した.166施設から回答があり,以下の結果が得られた.①抗癌剤の準備場所は｢病棟｣が62％で最も多く,｢薬剤部｣は12％であった.②抗癌剤の準備は,他の点滴剤よりも薬剤部で行われる割合が有意に高かった.③抗癌剤の準備から与薬終了までの作業で,点滴針刺入以外の全てで｢看護師｣の実施が最も多かった.④医師と薬剤師の｢抗癌剤｣と｢抗癌剤以外の点滴剤｣の取り扱いを比べると,いずれの職種でも｢抗癌剤｣の場合に実施している割合が高かった.⑤使用されている防護具は,手袋が80％で最も多く,次いでマスクであった.⑥抗癌剤曝露について看護師への教育をしている施設は約20％であったが,全看護部長が教育は必要であると考えていた.⑦抗癌剤の職業性曝露を,｢将来社会問題化する｣と認識している看護部長から,｢どちらとも言えない｣とする看護部長はほぼ同じ割合で防止策を実施している.⑧防止策を実施する上での課題で最も多かったのは,｢他部門との調整｣であった.看護師の抗癌剤曝露を防止するために,マニュアル整備,教育訓練,国家的施策の必要性が示唆されたといえる.The purpose of this study was to investigate of management of safe handling anticancer drugs and organization’s strategy for prevention of occupational exposure to anticancer drugs. A Self-rating question¬naire was mailed to director of nursing department in 310 hospitals in Japan. A total of 166 responded. Mixing of anticancer drugs was done in 62％ in the hospital wards, and 12％ in the hospital pharmacy. Mixing of anticancer drugs in the pharmacy were significant more done than mixing of except anticancer drugs. Nurses were most handling from preparation to administration of anticancer drugs. Doctors and pharmacists were more handling anticancer drugs than except anticancer drugs. As to the personal protective measure, gloves were most used (80％), next were mask. Although the hospitals which were training and stuff education were only 20％, all of director nurses recognized to be in need of programs for education and training for safe handling of anticancer drugs. Recognition that exposure to anticancer drugs will cause social problem in the future was related to operating preventing measure. Most big problem for safe handling anticancer drugs was coordination with another department. Our results indicate needs for improving the work practice guideline, education, training for handing anticancer drugs, and governmental strategy. |
