The National : DRYCLEANER JAN APRIL 2019
34 THE AUSTRALIAN NATIONAL DRYCLEANER & LAUNDERER JANUARY FEBRUARY MARCH APRIL 2019 Chapter 11: Cytotoxic contaminated laundry Workers may be at risk of exposure to cytotoxic drugs and related waste when handling contaminated linen or clothing. This chapter provides guidance on the control measures which may be considered to elimi- nate or reduce cytotoxic drug expo- sure. Cytotoxic contaminated laundry is defined as linen or clothing which has been contaminated with cytotoxic drugs or contaminated body substances, including urine, faeces, vomitus, bile, and fluids drained from body cavities. Contaminated laundry may include bed linen, towels, curtains, gowns, coveralls, washable PPE, and any other washable item. There is currently little evidence to support the suggestion cytotoxic drugs or their metabolites are excreted in significant quantities in sweat, so the risk of exposure by this route is rated as low. Therefore, it is recommended only linen which is obviously wet with perspiration be treated as cytotoxic contaminated laundry. Otherwise the linen can be treated as general laundry. 11.1 Risk management Workers may be exposed to cyto- toxic drugs or contaminated waste through handling of cytotoxic con- taminated laundry. A risk assess- ment should be conducted to determine the characteristics of an exposure to cytotoxic contaminated laundry, and appropriate control measures selected and implemented. Exposure may occur while handling a treated patient’s clothing or bed linen, or when handling items used to clean up after a cytotoxic spill. All workers who handle cytotoxic con- taminated laundry during transport and processing may be at risk of exposure, and should be consulted during the risk management pro- cess. Refer to chapter 3 for details of the risk management process. 11.1.1 Consultation In the risk management process, consultation is important to identify and assess risks associated with cytotoxic contaminated laundry and to develop appropriate control mea- sures. It is recommended safe work practices be developed following consultation between workplace health and safety representatives, hospital workers, laundry workers and contractors to ensure all work- ers are protected at all stages (for more information on risk manage- ment, see chapter 3). In developing the most appropriate procedures for laundry management, consultation issues may include: sources of cytotoxic contaminated laundry Cytotoxic drugs are intended primarily for the treatment of cancer. They are known to be highly toxic to cells, princi- pally through their action on cell reproduction. Many have proved to be carcinogens, mutagens or teratogens. Patients receiving therapeutic doses of these drugs have exhibited a long list of acute and chronic adverse effects, including cancers. Workers who come into contact with cytotoxic drugs and related waste are also at risk of exposure and possible adverse effects. Cytotoxic drugs are used in a variety of healthcare settings, in laboratories, manufacturing and research facilities and veterinary clinics. As well as their application in the treatment of cancers, cytotoxic drugs are also being used for the treatment of other medical conditions such as multiple sclerosis, psoriasis and systemic lupus erythematous. These drugs are also applied topically in ophthalmology for an increasing number of indications. Information about medical waste, and laundry generated by medical facilities is therefore very important. We have gleaned information from several sources, all of which are noted. The material presented in this publication is distributed by the Queensland Government for information only and is subject to change without notice. The Queensland Government disclaims all responsibility and liability (including liability in negligence) for all expenses, losses, damages and costs incurred as a result of the information being inaccurate or incomplete in any way and for any reason. © State of Queensland 2018 PN10522 Version 4 Last updated February 2017 – Guide for handling cytotoxic drugs and related waste Chapter 11 Laundry PN10522 VERSION 4 LAST UPDATED FEBRUARY 2017 – GUIDE FOR HANDLING CYTOTOXIC DRUGS AND RELATED WASTE CHAPTER 11 LAUNDRY Do you know what CYTOTOXIC means? Do you know how it affects you, and workers at your laundry, including drivers?
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