Minimal data is available on the possible long‐term risks to health professionals of handling these drugs (King et al. [155]; NHS PQAC [234]), but there is some research to show that staff are at risk of ‘internalization’ while handling them; this may occur via inhalation or via mucosal, oral or dermal contact (Alexander et al. [6]; Halsen & Kramer [115]; Langford et al. [167]), particularly during the preparation process (King et al. [155]). It is possible that low‐level occupational exposure may produce neutralizing antibodies against mAbs proteins, which may mean the drug would be less effective should the staff member require it therapeutically in the future (Alexander et al. [6]; Langford et al. [167]), although the evidence for this is limited. Also, as they are proteinaceous products, usually of animal origin, they have the potential to cause sensitization of healthcare staff, potentially leading to allergic reactions.

While there is limited evidence that there is a risk of toxicity from low‐grade occupational exposure to mAbs (Alexander et al. [6]; Langford et al. [167]), the lack of substantial research or evidence leads many staff to have significant concerns about what is a safe level of exposure, especially given mAbs’ increasing availability and use (Meade [193]).

Unfortunately, there is a paucity of guidance on best practice (Meade [193]), in part as mAbs either do not fulfil hazardous drugs criteria or lack sufficient agent‐specific information to be classified appropriately (NHS PQAC [234]). This has led to inconsistencies in the management of mAbs at national and international levels. There is, however, widespread agreement that every effort should be made by healthcare organizations to minimize staff exposure (Meade [193]).