Int J Cancer Manag. 2018 February; 11(2):e6482. Published online 2018 February 24. doi: 10.5812/ijcm.6482. Research Article Safe Handling of Anti-Neoplastic Drugs in the University Hospitals: A Descriptive Survey Study Among Oncology Nurses Maryam Alehashem, 1 and Shadi Baniasadi 2,* 1 M.Sc in Toxicology, Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran 2 PharmD, PhD, Associate Professor of Pharmacology, Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran * Corresponding author: Shadi Baniasadi, PharmD, PhD, Tracheal Diseases Research Center (TDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Tel/Fax: +98-2126105387, E-mail: sbaniasadi@yahoo.com Received 2016 April 20; Revised 2017 February 18; Accepted 2018 February 05. Abstract Background: Occupational exposure to anti-neoplastic drugs (ANPDs) is still a concern among oncology health care workers. Objectives: The current study aims at evaluating the knowledge, attitude, and practice (KAP) of oncology nurses towards the safe handling of ANPDs as well as determining the educational needs for the promotion of safe behaviours. Methods: A cross sectional study was conducted between November 2014 and August 2015 in 6 university hospitals in Iran. A spe- cialized questionnaire (4 sections and 49-items) was developed by a clinical pharmacologist and an occupational toxicologist in order to assess the KAP of oncology nurses in terms of safe handling of ANPDs. Results: A total of 80 nurses responded to the questionnaire. The KAP scores of oncology nurses towards the safe handling of ANPDs were fairly satisfactory. The mean scores of responses for knowledge, attitude, and practice were 54.30 ± 10.86 out of 65, 32.83 ± 5.88 out of 40, and 50.35 ± 10.21 out of 60, respectively. About half of the nurses were trained in oncology ward (by in-service training) and most of them used unreliable sources of information for safe handling of ANPDs. Conclusions: While the nurses’ knowledge in safe handling of ANPDs is acceptable, training providers and information sources are not appropriate. An ongoing educational program provided by expert pharmacists could decrease the occupational exposure to ANPDs. Keywords: Anti-Neoplastic Drugs, Knowledge, Occupational Exposure, Oncology Nurses 1. Background Exposure to anti-neoplastic drugs (ANPDs) among on- cology nurses has been increasing due to the widespread use of these agents. The anti-neoplastic agents’ exposure may lead to toxicological effects including carcinogenicity, teratogenicity, and mutagenicity in human (1-3). Several guidelines and protocols have been established in order to improve the safe handling of ANPDs and protect oncology nurses against unwanted exposure (4-7). Despite the pres- ence of these guidelines, some studies have shown differ- ent levels of exposure to ANPDs among health care work- ers, particularly in developing countries (1, 3, 8). Lack of knowledge and adherence to the guidelines are important reasons for unsafe handling of ANPDs. There- fore, the guidelines cannot guarantee safe behaviors, and knowledge is an important factor to change the perfor- mance (3). Pharmacists can improve the knowledge, atti- tude, and practice (KAP) of oncology nurses by providing educational programs (1). The studies that measure the KAP of a community are important tools for organizing applicable educational programs. Some studies have been conducted to evalu- ate knowledge and/or attitude and/or practice of oncol- ogy nurses about safe handling of ANPDs, but no standard questionnaire has been presented so far (1, 3, 9). In addi- tion, no comprehensive study in this regards has been car- ried out in Iran. Therefore, we designed the current study to evaluate the KAP of oncology nurses on safe handling of ANPDs, using a specific designed questionnaire. 2. Methods 2.1. Development and Psychometric of Questionnaire A questionnaire consisted of 4 sections (49-items) was prepared to assess the KAP of oncology nurses. Since no previously validated questionnaire was available, the items were developed by the experts (a clinical pharmacol- ogist and an occupational toxicologist) in safe handling of ANPDs. Copyright © 2018, Cancer Research Center (CRC), Shahid Beheshti University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.