Are you and your team aware of the risks involved in hazardous drug handling?
Antineoplastic drugs, more commonly known as ‘Hazardous’ drugs, used in treating oncology patients have been a cornerstone of cancer treatment. The cytotoxic nature of these drugs is what makes them so powerful when combating cancer in patients. As we know, these drugs also affect all cells in the body; there is no differentiation when it comes to cytotoxic drugs’ effects on cells. Therefore, healthcare professionals are exposed to the potentials of these powerful drugs, and their associated risks.
According to the Center for Disease Control and Prevention, there are currently 8 million U.S. healthcare workers that are potentially exposed to hazardous drugs. That means pharmacists, oncology nurses, physicians, operating room personnel, laboratory researchers, veterinarians, and support staff, including shipping and receiving personnel are potentially at risk to contaminated packaging, vapors and aerosols these chemotherapy drugs can emit.
What are the risks these drugs pose, and how exactly do healthcare practitioners (and even shipping personnel) become contaminated by these hazardous drugs?
Here’s a list of possible antineoplastic drug exposure outcomes from the CDC:
- Skin rashes
- Allergic reactions
- Nausea
- Hair loss
- Liver and kidney damage
- Hearing loss
- Menstrual Cycle disruption
- Reproductive complications
- Spontaneous abortion in pregnant women
- Malformations in offspring
- Immunity system malfunctions
- Leukemia and other cancers
As listed above, the risks from hazardous drug exposure vary between acute and chronic effects, reproductive complications, and possible cancer.
Here are some routes of exposure from the Public Services Health and Safety Association:
- Absorption through the skin (e.g. contact with contaminated surfaces)
- Inhalation of dust and aerosols
- Accidental injection
- Unintentional ingestion (e.g. contaminated food or objects, such as finger and pencils, placed in the mouth)
- Counting, breaking, or crushing pills
- Preparing, handling, administering, and disposing of solutions
- Handling drug administration equipment, contaminated waste, and patient body fluids
As seen above, all types of handlers of these hazardous drugs, and even patient caretakers and cleaning crew, face a risk of exposure. And, this exposure can be found in the most surprising of places. According to the Occupational Safety and Health Administration, wide spread contamination can appear on work surfaces, counter tops, door handles, and even floors. The OSHA control guide goes further and mentions that one multi-site study in North America found 75% of samples from pharmacies and 65% from nursing treatment areas showed measurable results of hazardous drugs (Connor, 1999).
Chemotherapy drugs are lifesavers, but dealing with them comes with many risks. All personnel involved should make sure to take the necessary precautions to prevent harmful exposure. These precautions consist of using personal protective equipment (PPE), complying with OSHA and NIOSH regulations and recommendations, and utilizing the proper tools when handling chemotherapy drugs, including Closed System Transfer Devices (CSTDs), such as Equashield’s closed system. Implementing such a device ensures efficient and safe drug administration to patients as well as proper protection for the healthcare practitioners handling these drugs.
