Workplace Hazards

More than other medicines, cancer drugs can be dangerous.  Not to the patient, necessarily, but to others who handle or come into contact with them.  Indeed, some chemotherapy agents actually cause cancer and/or birth defects.  And this should be of major concern.  Medical personnel who handle these drugs often must take safety precautions to avoid or minimize exposure

Jobs that can bring exposure to antineoplastic agents include physician, physician’s assistant, various kinds of nurses, pharmacists, drug couriers, custodial workers in hospitals (including anyone who handles waste), and shipping and receiving workers at hospitals.   As veterinarians increasingly use oncology drugs, they and their technicians are at risk.

Pharmacists who prepare these drugs or nurses who may prepare and/or administer them are the two occupational groups who have the highest potential exposure to antineoplastic agents. Additionally, physicians and operating room personnel may also be exposed through the treatment of patients. Hospital staff, such as shipping and receiving personnel, custodial workers, laundry workers and waste handlers, all have potential exposure to these drugs during the course of their work. The increased use of antineoplastic agents in veterinary oncology also puts these workers at risk for exposure to these drugs.

The side effects that chemotherapy drugs produce in cancer patients show up in healthcare workers who do not have cancer but who have been exposed to the medicines,  These include nausea, anemia, infertility, and hair loss.  The drugs can also increase the problems with fetal development and pregnant workers need to be especially vigilant.

Industrial hygienists worry about employee safety and develop programs to reduce risk.  Well-managed treatment center have equipment and procedures to protect people – PPE = personal protective equipment.  The facilities are often subject to inspection by OSHA and state or regional regulatory agencies.  Such equipment as impermeable gloves, facemasks, aprons, and needles designed for safety can be part of a chemotherapy medicine management plan.

Even though sometimes the effects of the medicines on healthcare workers is not apparent in the short run, chronic low-level exposure can lead to inner ear damage (hearing loss), liver damage, kidney damage, and effects on the blood forming ability of the body and on the heart.

A study published in 2001 found over 15 percent of nurses in outpatient oncology settings had been exposed to the skin or eyes in the past year. 

There is also concern that accidental exposure is being underreported by nurses.  There has been a major increase in needle safety awareness in recent years, but it is not clear that awareness of chemical hazards is as high as it should be.