Occupational exposure to pharmaceuticals has a long history. Bernardino Ramazzini, in 1713, described diseases of apothecaries as a result of exposures to poisonous substances in the work environment. He reports that opium could induce stupor and lethargy, as well as root of arum, inflammation, and haemorrhage, and volatile cantharides could cause injuries to the bladder and kidneys of ancient pharmacists. More recently, these issues have been again considered due to the development of more and more potent compounds that exert important therapeutic roles; however, the same drugs could also affect workers health, even at low doses. Air contamination of the work environment has been considered one of the most concerning issues, and several studies dealing with adverse health effects in exposed workers were carried out, starting from the 1940s. Although in latest years improvements of occupational settings were provided and more detailed risk assessments have reduced the inhalation of airborne compounds, some questions are still present, and issues, regarding particular compounds with carcinogenic activity or the effect of occupational exposure to active pharmaceutical ingredients (APIs) at low doses, are not completely solved, and consequently they cannot be disregarded. This chapter aims to provide an overview of environmental monitoring techniques, risk assessment processes and principal health adverse effects that could affect workers, to draw a picture of quality of air in pharmaceutical industry, as comprehensive as possible.
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