OSHA Inspection: LAKE CHAMPLAIN GYNECOLOGIC ONCOLOGY

Issued

Jul 16, 2008

Abate by

Jul 28, 2008

Penalty

Initial $1,500

General-duty citation text

Vermont Statute, TITLE 21 LABOR: CHAPTER 3. SAFETY: Subchapter 5.
Occupational
Safety and Health: Section 223. Duties and Section 5(a)(1) of the
Occupational Safety and
Health Act of 1970: The employer did not furnish employment and a place of
employment
which were free from recognized hazards that were causing or likely to
cause death or
serious physical harm to employees, in that, employees were exposed or
potentially exposed
to antineoplastic drugs such as; cisplatin, adriamycin, S-fluorouracil.
Lake Champlain
Gynecologic Oncology, P.C., chemo preparation area employees(nurses) were
exposed to
anti-neoplastic(chemotherapeutic) drugs by inhalation, contact, injection
and or ingestion
through improper work practices and/or engineering controls. Possible
health effects from
exposure to chemotherapeutic drugs include; chromosome damage to cells and
teratogenesis
development of neoplasms, leukemias and organ damage. Some feasible and
acceptable
abatement methods include; gowns worn during chemotherapy drug preparation
should
not be
worn outside of the preparation area. Leave the blower on the BSC(laminar
flow biological
safety cabinet) used in preparing chemotherapy at Lake Champlain
Gynecological Oncology
practice operating 24 hrs a day 7 days a week.[OSHA Technical Manual,
Chapter 2,
Controlling Occupational Exposure to Hazardous Drugs Chapter V, Part3,
paragraph D].
Establish spill control written policy and training for respiratory
protection.  Upgrade local
ventilation to Type B2 total circulation with ducts and plenums under
negative
pressure.[(ASHP American Society Health System Pharmacists), Guidelines on
Handling
Hazardous Drugs 2004,]. Double glove technique should be used for
chemotherapy
gloves(NIOSH, Occupational Exposure to Antineoplastic Agents).[Connor
1999; Brown et
al.2001]. Establish environmental sampling and biological monitoring
programs.