Chemotherapy Risk to Nurses
Chemotherapy is designed to kill unhealthy cells, but it can also damage the healthy ones. While handling chemotherapy drugs and other potent or hazardous drugs for their patients, nurses must be extremely careful not to ingest them in any quantity. The National Institute for Occupational Safety and Health (NIOSH) has released an alert outlining the risks of handling chemotherapy drugs for nurses and millions of other health workers.
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Chemotherapy
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Cancer is an abnormal cell growth and chemotherapy is a drug regimen designed to stop that growth. Chemotherapy can also harm healthy cells, according to the National Institutes of Health (NIH), and cause side effects in cancer patients. Healthy cells often recover and side effects gradually disappear in many cases. Chemotherapy is administered intravenously, by shot or by mouth. Without taking proper precautions, nurses and other health industry workers can be exposed to the drugs.
Exposure
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People who handle chemotherapy drugs at any point from manufacture to patient dosing and administration are at risk. In a public alert, NIOSH estimates more than five million workers could be exposed through various activities. Nurses and other workers are exposed through prolonged contact with vial exteriors, counting out doses, crushing tablets, priming intravenous sets and handling contaminated clothing or waste, among other practices.
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Routes
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The most common exposure routes, the NIOSH alert says, are absorption through the skin and inhalation. Ingestion also occurs through accidental hand to mouth contact. In less likely scenarios, injection can occur through accidental needle sticks or through other puncture wounds.
Effects
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Handling chemotherapy drugs can lead to relatively mild symptoms, like skin rashes. In other cases, adverse reproductive events and cancer have been linked to exposure. A 2001 review of several studies, cited in the NIOSH alert, revealed that reproductive problems linked to handling chemotherapy drugs included miscarriage, infertility, low birth weight and congenital deformities.
Hazardous Drugs
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Concern about antineoplastic drugs first came to light in the 1970s and NIOSH contends these drugs are still the main focus of the alert. Other drugs are also being investigated because they are either extremely potent or can cause irreversible effects. At least one of six specific characteristics will lead to a drug being added to the "hazardous drugs" list: carcinogenicity, developmental toxicity, organ toxicity at low doses, reproductive toxicity, genotoxicity or any drug mimicking the structure of drugs that meet the other criteria.
Recommendations
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To ensure that exposure to chemotherapy drugs and other hazardous drugs is limited in the workplace, NIOSH has outlined a broad set of rules. First, workers must assess the hazards of the working environment. Next, they must be sure to handle all drugs safely, regardless of time constraints or other inconveniences. Finally, equipment must be used and maintained properly, including ventilation cabinets and drug-transfer devices.
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References
Resources
- Photo Credit operation nurse image by Andrey Rakhmatullin from Fotolia.com
