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Precautionary Practices of Respiratory Therapists and Other Healthcare Practitioners Who Administer Aerosolized Medications
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    Respiratory therapists and other healthcare workers are potentially exposed to a variety of aerosolized medications. The NIOSH Health and Safety Practices Survey of Healthcare Workers describes current exposure control practices and barriers to using personal protective equipment during administration of selected aerosolized medications.


    An anonymous, multi-module, web-based survey was conducted among members of healthcare professional practice organizations representing respiratory therapists, nurses and other healthcare practitioners. A module on aerosolized medications included submodules for antibiotics (amikacin, colistin, tobramycin), pentamidine and ribavirin.


    The submodules on antibiotics, pentamidine and ribavirin were completed by 321, 227 and 50 respondents, respectively, who were mostly respiratory therapists. The relatively low number of ribavirin respondents precluded meaningful interpretation of these data and may represent the rare use of this drug. Consequently, analysis focused on pentamidine, classified by NIOSH as a hazardous drug, and antibiotics amikacin, colistin, and tobramycin which currently lack authoritative safe handling guidelines. Respondents who administered pentamidine were more likely to adhere to good work practices compared to those who administered these antibiotics. Examples included: training received on safe handling procedures (75% vs 52%), availability of employer standard procedures (82% vs 55%), use of aerosol delivery devices equipped with an expiratory filter (96% vs 53%) or negative pressure rooms (61% vs 20%), and always using respiratory protection (51% vs 13%).


    Despite the availability of safe handling guidelines for pentamidine, implementation was not universal, placing workers, co-workers, and even family members at risk of exposure. Although the antibiotics included in this study lack authoritative safe handling guidelines, prudence dictates that appropriate exposure controls are used to minimize exposure to the antibiotics as well as other aerosolized medications. Employers and employees share responsibility for ensuring that precautionary measures are taken to keep exposures to all aerosolized medications as low as practicable.

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    CC999999/Intramural CDC HHS/United States
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