PURPOSE: This paper synthesizes research findings on known exposure risks to and compliance among health care professionals in the handling of neoplastic agents and suggests implications for practice and future research. CONCLUSIONS: The exposure risk for experiencing mutagenicity and alterations in fertility from chemotherapy agents among health care professionals has been extensively studied. Exposure risk and its relationship to health care professionals' compliance to established protocols for the safe handling and administration of chemotherapy agents continues to be a concern for health care institutions. Research in this area has been mainly retrospective and most studies have used a causal-comparative design; the degree of mutagenicity has been quantified for an identified exposed group and compared with a group that has not been exposed to antineoplastic agents. The evaluation of exposure has been found to be a complex problem because of the considerable mediating factors that are multifactorial and interactive in nature. Despite these confounding factors, the findings of past studies suggest that unsafe practice leads to an increased risk of exposure. IMPLICATIONS: Findings from existing research indicate that compliance with established safety guidelines offers adequate protection to those health care workers involved in the handling, administration and care of patients receiving chemotherapy agents.