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Medical Environment Update—Healthcare workplace may pose hazards to reproductive health

Although it might not be the next topic featured in a most-dangerous-job reality TV show, a healthcare occupation comes with significant risks.

Some of those risks are potent drugs, which can work wonders when targeted toward patients’ ills but also present occupational hazards to caregivers, including adversely affecting the reproductive systems of those exposed.

With more healthcare being delivered outside of hospitals, workers in ambulatory settings are certainly not immune to workplace reproductive hazards.

Many fields in healthcare are affected by potential exposure to reproductive hazards, says William Buchta, MD, MPH, medical director of Employee Occupational Health Services at Mayo Clinic in Rochester, MN, and recent chair of the Section on Medical Center Occupation Health for the American College of Occupational and Environmental Medicine. Oncology with the use of chemotherapy usually comes to mind first, Buchta says, but areas such as rheumatology, gastroenterology, dermatology, and the care of transplant surgery patients employ hazardous pharmaceuticals that carry reproductive warnings on drug labels.

Reproductive effects from hazardous drugs include increased fetal loss, congenital malformations depending on the length of exposure, low birth weight and congenital abnormalities, and infertility, according to the NIOSH publication Preventing Occupational Exposure to Antineoplastic and Other Hazardous Drugs in Health Care Settings [1].

The effect of hazardous drugs on the reproductive system is not just a concern for female healthcare workers. NIOSH identifies hazardous drugs as an occupational risk to female and male reproductive health.

Workers are usually immediately aware of an exposure incident involving bloodborne pathogens, but the reproductive effects of hazardous drug exposure play out on workers who might not know they are exposed, Buchta says.

Employees know what to do and what to expect when an acute exposure occurs; it’s covered in the material safety data sheet. It is the long-term, low-dose exposure that goes unnoticed or unreported by workers and might present the greatest reproductive risks in occupational settings, Buchta adds.

Engineering controls such as the use of biosafety cabinets, work-practice controls (which include adherence to wearing personal protective equipment), and worker education offer the most direct protection, Buchta says. But those types of controls, he warns, are certainly not foolproof. Environmental monitoring and medical surveillance might be needed to fill in the safety gaps.

For more on reproductive hazards in healthcare, see the October issue of Medical Environment Update [2].

How is your workplace taking precautions to prevent exposures to reproductively-harmful drugs and chemicals? Do your co-workers ask or worry about these potential hazards. Does management support or resist safety efforts on this matter? Leave a comment below.