Risico's van gebruik van cytostatica in de dierenartsenpraktijk

Little is known about the chronic health problems caused by working with cytotoxic drugs. These drugs, including mitotane (Lysodren), chlorambucil (Leukeran), and azathioprine (Imuran), are usually teratogenic but can also be mutagenic and carcinogenic. The principle governing working with cytotoxics is to keep exposure as low as possible (the ALARA principle, as low as reasonably achievable). The Dutch Arbo-wet (Factories Act) requires that employer and employee restrict exposure to a minimum. This necessitates relatively expensive facilities, trained personnel, and good procedures. The owners and other people close to the patient are also potentially at risk and should be told of this and informed about drug administration and the disposal of faeces, vomit, urine, saliva, and blood. The prescription and/or administration of cytotoxic drugs, including those that are used as immunosuppressive agents in veterinary medicine, should be restricted to specialist veterinarians who have adequate knowledge and appropriate facilities to work with these agents. A work group to establish standards for working with cytotoxic drugs in veterinary practice is advocated.