Rome, 22 Oct – There are many problems and risks that concern the professional figures of personnel working in the veterinary medicine sector, starting from those linked to the risks in the manipulation of chemical agents, to the risks deriving from the interaction with biological agents, but also physical, ergonomic or psychological risks.
In particular, the European College of Internal Veterinary Medicine for Companion Animals (Ecvim-ca) “reports a growing increase in the use of dangerous drugs (which include carcinogens, mutagens and toxicants for reproduction) in the veterinary sector since 2007”. And one of the “main professional problems for veterinary staff” is also “that relating to exposure to various agents that can cause cancer”.
This is remembered in a new document, created by the Department of Medicine, Epidemiology, Occupational and Environmental Hygiene (Dimeila) of the Inailwith the explanatory title “Risk prevention and management in the veterinary sector. Focus on the handling of dangerous drugs in light of Directive (EU) 2022/431”.
The introduction of the document – written by Paola Castellano, Giovanna Tranfo and Daniela Pigini (Inail, Dimeila), Giorgio Neri (Anmvi, Anicura Veterinary Institute Novara), Daniela Boltrini (Anmvi, Veterinary Clinic, Caprarola) and Marco Melosi (Anmvi, Cremona ) – recalls that on 9 March 2022 the European Parliament and the Council of the European Union adopted Directive (EU) 2022/431 (CMRD), transposed by d.lgs. 135/2024which “amends the CMD on the protection of workers professionally exposed to risks deriving from carcinogenic and mutagenic agents at work by extending the scope of application of the CMD also to substances toxic to reproduction”.
It is then indicated that the Commission statement that “establishes the inclusion, in the scope of application of the aforementioned directive, of dangerous drugs (HMPs) or those drugs containing substances that meet the classification criteria as carcinogenic, mutagenic, toxic for reproduction of category 1A and 1B, pursuant to the CLP (Classification, Labeling and Packaging), for each of the aforementioned classifications”.
The article, presenting the document, focuses on the following topics:
Risk prevention and management in the veterinary sector: the documents
Also in the introduction of the Inail document it is noted that i dangerous drugs, beyond what is indicated above, may also have others negative health effects“such as contact dermatitis, allergic reactions, hypersensitivity, damage to the central nervous system, organs such as the liver, heart and lungs, chromosomal and blood cell abnormalities”.
And theobjective of the monograph is to “deepen knowledge of professional risks in the veterinary field, in relation to the problem of the use and management of dangerous drugs, describing the innovations introduced by the CMRD and by the “Guidance for the safe management of hazardous medicinal products at work” published in April 2023 by the European Commission”.
In fact, it is indicated that these guidelines, which are aimed at both the healthcare and veterinary sectors, “represent a starting point for the development of national guidelinesas they are designed to be used by Member States and local organizations to support their approaches to protecting workers from exposure to dangerous medicines.”
Prevention in the veterinary sector and dangerous drugs: the guidelines
We then remember that in the various phases of drug manipulation (transport, storage, administration, waste disposal) “various figures are involved, in the context of activities carried out both in clinics, hospitals and veterinary surgeries, and in external contexts, such as those relating to home therapies or conducted in kennels/cats, in livestock farms, on exotic and wild animals in bioparks and on experimental animals”. And risk management “must, therefore, be implemented through suitable collective and individual safety measures, as well as procedural ones, for example by using specific guidelines to be drawn up to guarantee the protection of the health and safety of all personnel in the sector ”.
We refer you to the full reading of the document, which focuses extensively on the national reference framework and the definition of dangerous drugs, given, and we come briefly to the European Commission guidelines.
Please note that in compliance with the development of guidelines by the EU for the safe handling of HMPs (Hazardous medicinal products), the Directorate-General for Employment, Social Affairs and Inclusion of the European Commission published on 28 April 2023 ” a non-binding guidelinebased on existing European legislation, designed to be used by Member States and local organizations to support their approaches to protecting workers from HMPs.”
The indications provided, “which do not prejudice any applicable European or national provisions, are aimed at increasing ‘awareness’ of exposure to HMPs by informing workers and management”.
In particular, in the guidelines, “an overview of the good practices available in relation to the type of formulation (e.g. tablets/capsules, oral or injectable solutions, etc.), the potential absorption routes, what is indicated by international bodies (Iarc, Niosh) and the procedures related to the activities carried out in each phase of the life cycle of HMPs (production, transport, storage, preparation, administration, incident management, cleaning of premises and disposal of materials and excrement, also considering the aforementioned aspects in the context of home prescriptions)”.
And the guideline is “applicable to all types of structures, public or private, regardless of size, including those dedicated to clinical trials with the aim of creating greater awareness for employers on the professional risks to which they are exposed operators in the sector, providing indications on good practices to follow, shared throughout the EU, as a useful point of reference also to support training and information activities”.
It is then highlighted that, “although the ideal method to eliminate or reduce worker exposure, according to the control hierarchy” of the CMRD (Carcinogenic, Mutagenic and Reprotoxic Agents Directive), and “that of replacing HMPs with drugs that are not dangerous or are less dangerous for the health of workers, this is rarely applicable as the intrinsic properties of HMPs are usually essential for the treatment of the patient (human or animal) whose health must never be compromised”. And at the basis of the drafting of the guideline, various European directives and regulations were taken into account, including, in addition to CLP Regulation and the REACH Regulation, Regulation (EU) 2016/425 on personal protective equipment and Directive. 92/85/EEC concerning the implementation of measures aimed at promoting improvements in the safety and health at work of pregnant workers, workers who have recently given birth or are breastfeeding.
The European Commission guidelines also took into account the importance of “a safe handling of HMPs in the veterinary field, dedicating chapter 12 to this sector which addresses the issues relating to the handling of these drugs in all phases (from storage to preparation, administration, disposal)”.
The index of the Inail document
We conclude by referring to the full reading of the document and reporting the index of the Inail document “Risk prevention and management in the veterinary sector. Focus on the handling of dangerous drugs in light of Directive (EU) 2022/431”.
Introduction
Veterinary medicine and the veterinary doctor
Work environments
Notes on risks in the veterinary profession
Dangerous drugs
Notes on the environmental and biological monitoring of dangerous drugs
Veterinary pharmacovigilance
Conclusions
Bibliographical and website references
Regulatory references
Acronyms
Tiziano Menduto
Download the document from which the article is taken:
Inail, Department of medicine, epidemiology, occupational and environmental hygiene, ” Risk prevention and management in the veterinary sector. Focus on the handling of dangerous drugs in light of Directive (EU) 2022/431”, authors: Paola Castellano, Giovanna Tranfo and Daniela Pigini (Inail, Dimeila), Giorgio Neri (Anmvi, Anicura Veterinary Institute Novara), Daniela Boltrini (Anmvi, Veterinary Clinic, Caprarola) and Marco Melosi (Anmvi, Cremona), 2024 edition , Health and safety series (PDF format, 1.24 MB).
Go to the subscribers’ area dedicated to “Risks in the veterinary sector. Focus on the handling of dangerous drugs”.
Download the documents and regulations mentioned in the article:
Directive (EU) 2022/431 of the European Parliament and of the Council of 9 March 2022 amending Directive 2004/37/EC on the protection of workers from the risks arising from exposure to carcinogenic or mutagenic agents at work.
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