Hazardous Drug Exposure

July 29, 2010
Lisa Schulmeister

Chemotherapy preparation and administration called "a silent threat."

Carol Smith from InvestigateWest wrote an article for msnbc.com titled "Lifesaving Cancer Drugs May Put Workers' Lives at Risk." The article was posted on July 11, 2010 and within two days had generated 241 comments. Smith described how Sue Crump, an oncology pharmacist who had spent 23 years preparing chemotherapy, wondered if her chronic exposure to chemotherapy caused or contributed to her developing--and eventually dying from--pancreatic cancer. Bill Borwegen, occupational health and safety director for the Service Employees International Union, was interviewed for the article and called chemotherapy preparation and administration "a silent threat" that has been around for a long time, yet has received little governmental attention.

Some of the people who commented on the article were healthcare providers who, like Sue Crump in the article, had modest to extensive hazardous drug exposure while working in the oncology field in the early days, when routine use of personal protective equipment (eg, gowns, gloves), specialized pharmacy hoods for preparing hazardous drugs, and safe handling practices and devices did not exist. Considering the fact that cancer is not one disease but a spectrum of diseases and that people are exposed to a number of carcinogens and potentiating factors in daily life, it's impossible to know if handling chemotherapy is the reason why some healthcare providers have developed various types of cancer, or if prior occupational exposure to chemotherapy is simple coincidental. However, chemotherapy is a known carcinogen and as such, is categorized as a hazardous drug, or drugs known or suspected to cause cancer, miscarriages, birth defects, or other serious health consequences.

At this point in time, safe handling practices are voluntary and not mandated by the government. Consequently, there is inconsistent use of personal protective equipment and a variety of safe handling procedures in use. In addition, some institutions in which chemotherapy is prepared and administered have no formal surveillance process for workers who are routinely handle chemotherapy and other hazardous drugs. The number of comments generated by Smith's article suggests that occupational exposure to hazardous drugs is of concern to many and more needs to be done to ensure the safety of healthcare workers who handle chemotherapy.