ArticleFrontiers in oncology2026
Occupational exposure risk assessment for cytotoxic drugs among clinical nurses in oncology care settings: development of a Delphi-AHP indicator system.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To develop a scientific and systematic occupational exposure risk indicator system for cytotoxic drugs (CDs) among clinical nurses and to provide an evidence-based basis for institutional risk management and targeted occupational protection strategies. Methods: This methodological study used a mixed-methods consensus-building design. Based on the work breakdown structure-risk breakdown structure (WBS-RBS) framework, an initial risk matrix was constructed through literature analysis, policy and guideline review, and semi-structured interviews. Three rounds of Delphi consultation were conducted with 16 experts in oncology nursing, nursing management, pharmacy, and occupational protection/infection control. Indicators were screened using a 5-point Likert scale, and weights were determined using the analytic hierarchy process (AHP). Results: The response rates for the three Delphi rounds were 80.00%, 93.75%, and 100.00%, respectively. The expert authority coefficients were 0.803, 0.856, and 0.891. In the third round, the coefficient of variation ranged from 0.000 to 0.264, and Kendall's coefficient of concordance was 0.265 (P<0.01). The final indicator system included five first-level indicators, 13 second-level indicators, and 33 third-level indicators. All AHP judgment matrices met the consistency requirement (CR<0.10). Conclusion: The indicator system developed in this study integrates full-process clinical work links with multidimensional risk sources, providing a structured and quantifiable framework for early identification, prioritization, and targeted management of occupational exposure risks related to cytotoxic drugs among clinical nurses. It may serve as a practical decision-support reference for developing graded and precise occupational protection strategies, particularly in institutions without centralized intravenous admixture services.
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