Occupational safety measures in the intraoperative period of hyperthermic intraperitoneal chemotherapy: scoping review

Riboli, Gabriela Bolsoni; Santos, Caroline Braga dos; Gomes, André Nascimento Honorato; Araújo, Bárbara Rodrigues; Sakamoto, Victória Tiyoko Moraes; Caregnato, Rita Catalina Aquino

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Brasil

Acta Paulista de Enfermagem

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Brasil

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Sumário

Review Article • Acta Paul Enferm 35 • 2022 • https://doi.org/10.37689/acta-ape/2022AR03543 copy

Occupational safety measures in the intraoperative period of hyperthermic intraperitoneal chemotherapy: scoping review

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To map the occupational safety measures recommended to professionals involved in the intraoperative care of patients undergoing Hyperthermic Intraperitoneal Chemotherapy.

Methods

Qualitative scoping review based on the Joanna Briggs Institute. Searches were performed in Pubmed, VHL, ScIELO, Scopus, Web of Science, Google Scholar, The Chocrane Library databases and gray literature. The PCC acronym was used in the research question: what occupational safety measures are necessary in the operating room for professionals working directly or indirectly in the intraoperative period of HIPEC? A search for articles published between 2015 and 2019 was performed.

Results

Literature on the subject was scarce. Ten articles were selected: a systematic review; two control cases; two descriptive studies; four literature review studies; an experience report. In the analysis of articles, the recommended safety measures for professionals who work directly or indirectly in this surgical procedure was evidenced, namely: education and training of the staff involved; use of individual and collective protective equipment; provision of infrastructure and general guidelines.

Conclusion

Recommended safety measures for professionals involved in the intraoperative care of patients undergoing Hyperthermic Intraperitoneal Chemotherapy are: team training; use of specific individual and collective protection equipment; necessary infrastructure, such as adjusting the air conditioning to higher pressure inside the operating room; and general guidelines regarding the organization of the operating room, waste disposal, cleaning of the room/materials used, and monitoring of the occupational health of the team involved in the surgical procedure.

Occupational health; Security measures; Occupational risks; Hyperthermia, Induced; Surgicenters; Drug therapy; Peritoneal neoplasms; Hyperthermic intraperitoneal chemotherapy

Database	Strategy used
PUBMED	(Occupational Risks OR Occupational Health OR Occupational Exposure) AND (Therapy, Fever OR Fever Therapy OR Hyperthermia, Therapeutic OR Therapeutic Hyperthermia OR Thermotherapy OR Induced Hyperthermia OR Hyperthermic Intraperitoneal Chemotherapy OR Chemotherapy, Hyperthermic Intraperitoneal OR Hyperthermic Intraperitoneal Chemotherapies OR Intraperitoneal Chemotherapy, Hyperthermic OR Hyperthermia, Local OR Local Hyperthermia)
VHL	(“Occupational Risks” OR “Occupational Health” OR “Occupational Exposure”) AND (“Therapy, Fever” OR “Fever Therapy” OR “Hyperthermia, Therapeutic” OR “Therapeutic Hyperthermia” OR “Thermotherapy” OR “Induced Hyperthermia” OR “Hyperthermic Intraperitoneal Chemotherapy” OR “Chemotherapy, Hyperthermic Intraperitoneal” OR “Hyperthermic Intraperitoneal Chemotherapies” OR “Intraperitoneal Chemotherapy, Hyperthermic” OR “Hyperthermia, Local OR Local Hyperthermia”)
SCIELO	(Occupational Risks) OR (Occupational Health) OR (Occupational Exposure) AND (Therapy, Fever) OR (Fever Therapy) OR (Hyperthermia, Therapeutic) OR (Therapeutic Hyperthermia) OR (Thermotherapy) OR (Induced Hyperthermia) OR (Hyperthermic Intraperitoneal Chemotherapy) OR (Chemotherapy, Hyperthermic Intraperitoneal) OR (Hyperthermic Intraperitoneal Chemotherapies) OR (Intraperitoneal Chemotherapy, Hyperthermic) OR (Hyperthermia, Local) OR (Local Hyperthermia)
Scopus	(Occupational Risks) OR (Occupational Health) OR (Occupational Exposure) AND Therapy, Fever OR Fever Therapy OR Hyperthermia, Therapeutic OR Therapeutic Hyperthermia OR Thermotherapy OR Induced Hyperthermia OR Hyperthermic Intraperitoneal Chemotherapy OR Chemotherapy, Hyperthermic Intraperitoneal OR Hyperthermic Intraperitoneal Chemotherapies OR Intraperitoneal Chemotherapy, Hyperthermic OR Hyperthermia, Local OR Local Hyperthermia)
Web of Science	(Occupational Risks OR Occupational Health OR Occupational Exposure) AND (Therapy, Fever OR Fever Therapy OR Hyperthermia, Therapeutic OR Therapeutic Hyperthermia OR Thermotherapy OR Induced Hyperthermia OR Hyperthermic Intraperitoneal Chemotherapy OR Chemotherapy, Hyperthermic Intraperitoneal OR Hyperthermic Intraperitoneal Chemotherapies OR Intraperitoneal Chemotherapy, Hyperthermic OR Hyperthermia, Local OR Local Hyperthermia)
Google Scholar	(Occupational Risks OR Occupational Health OR Occupational Exposure) AND (Therapy, Fever OR Fever Therapy OR Hyperthermia, Therapeutic OR Therapeutic Hyperthermia OR Thermotherapy OR Induced Hyperthermia OR Hyperthermic Intraperitoneal Chemotherapy OR Chemotherapy, Hyperthermic Intraperitoneal OR Hyperthermic Intraperitoneal Chemotherapies OR Intraperitoneal Chemotherapy, Hyperthermic OR Hyperthermia, Local OR Local Hyperthermia)
The Cochrane Library	“Occupational Risks” OR “Occupational Health” OR “Occupational Exposure” AND “Therapy, Fever” OR “Fever Therapy” OR “Hyperthermia, Therapeutic” OR “Therapeutic Hyperthermia” OR “Thermotherapy” OR “Induced Hyperthermia” OR “Hyperthermic Intraperitoneal Chemotherapy” OR “Chemotherapy, Hyperthermic Intraperitoneal” OR “Hyperthermic Intraperitoneal Chemotherapies” OR “Intraperitoneal Chemotherapy, Hyperthermic” OR “Hyperthermia, Local OR Local Hyperthermia”

Title	Year Country	Objective	Method	Safety measures established
Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy, Part II: Implementation⁽²⁾	2019 USA	To Discuss HIPEC implementation strategies; describe preoperative care and patient preparation; describe intraoperative care; identify perioperative nursing interventions.	Literature review	Policies and procedures for implementing HIPEC in hospitals; education of the care team about HIPEC; description of suitability of the operating room; description of personal and collective protective equipment.
Safety considerations for Health care Workers involved in Cytoreductive Surgery and Perioperative chemotherapy⁽³⁾	2016 India	To describe safety measures when performing HIPEC.	Descriptive study	Policies and procedures to prevent spills; staff education about HIPEC; description of suitability of the operating room; description of personal and collective protective equipment.
Techniques and Safety Issues for Intraperitoneal Chemotherapy⁽¹²⁾	2018 Spain	To expose techniques and technologies used in the practice of HIPEC, advantages and disadvantages.	Literature review	Staff education and training on HIPEC; indication of personal protective equipment; indication of waste collection; periodic exams for the team; management of direct contact or chemotherapy spills; cleaning of the operating room after HIPEC.
Evaluation of oxaliplatin exposure of healthcare workers during heated intraperitonealperioperative chemotherapy (HIPEC)⁽¹³⁾	2015 France	To evaluate air and surfaces contamination and of professionals during open technique HIPEC using oxaliplatin.	Case control	Description of personal and collective protective equipment; description of suitability of the operating room; suggested use of the closed technique to avoid direct contact with the drug.
Occupational exposure to platinum drugs during intraperitoneal chemotherapy. Biomonitoring and surface contamination⁽²²⁾	2018 France	To investigate exposure to platinum compounds of medical personnel during a HIPEC procedure and a PIPAC procedure.	Case control	Description of the necessary personal protective equipment; suggested use of the closed technique to avoid spills.
Current practice in cytoreductive surgery and HIPEC for metastatic peritoneal disease: Spanish multicentric survey⁽²³⁾	2018 Spain	To obtain up-to-date information on clinical practice in different perioperative areas of the CRS-HIPEC.	Descriptive study	Policies and procedures to prevent spills; staff education about HIPEC; description of suitability of the operating room; description of personal and collective protective equipment.
Is hyperthermic intraperitoneal chemotherapy (HIPEC) safe for healthcare workers?⁽²⁴⁾	2017 France	To provide an overview of HIPEC safety.	Systematic review	Description of personal and collective protective equipment; indication of periodic exams for the care team.
Operating personnel safety during the administration of Hyperthermic Intraperitoneal Chemotherapy (HIPEC)⁽²⁵⁾	2016 Greece	To summarize evidence on HIPEC safety considerations in order to minimize risks to the OR staff during the procedure.	Literature review	Adequacy of the operating room; selection of the care team; description of recommended periodic exams; education of the care team about HIPEC; policies and procedures to prevent spills; chemical waste management policy; proper use of PPE.
Pautas de protección frente al riesgo de exposición a citostáticos en quimioterapia intraperitoneal hipertérmica⁽²⁶⁾	2016 Spain	To identify risks associated with the handling of cytostatics used in HIPEC.	Experience report	Description of individual and collective protective equipment; description of suitability of the operating room; staff education about HIPEC.
Professional risks when carrying out cytoreductive surgery for peritoneal malignancy with hyperthermic intraperitoneal chemotherapy (HIPEC): a french multicentric survey⁽²⁷⁾	2015 France	To address the need for standardized practices.	Literature review	Description of personal and collective protective equipment; description of suitability of the operating room; staff education about HIPEC; policies and procedures to prevent spills; policy for chemical waste management.

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
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[1] Corresponding author: Gabriela Bolsoni Riboli E-mail: gabiriboli@gmail.com