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Healthcare workers caught between drugs that save and drugs that kill

That life-saving drugs for patients also pose life-threatening hazards for healthcare workers, was made painfully evident in a report by msnbc.com [1] on chemotherapy’s deadly toll on pharmacists and nurses.

The report focuses on a number of pharmacists and nurses who are struggling from or have succumbed to the hazards of second-hand chemo exposures in healthcare workplaces, including Sue Crump who for 23 years as a hospital pharmacist in Seattle, WA, prepared chemotherapy drugs for administration.

Crump developed pancreatic cancer which she believed was from occupational exposure.

In a video profile accompanying the msnbc.com article [1], Crump explains that for years she prepared chemo drugs in areas that were not segregated for other preparation areas, that gloves and masks were not provided until much later in her career, and then only as an option, and  that she experienced routine splashes.

“I had no concern,” said Crump, “because there was nothing to tell that I wasn’t safe.”

Crump died last September at the age of 55.

“There is no other occupation population (that handles) so many known human carcinogens,” said Thomas Connor, a research biologist with the NIOSH. For 40 years, Connor has been studying the effect on workers of the chemical agents used in chemotherapy and is one of the lead authors of a just-completed NIOSH study confirming “that chemo continues to contaminate the workspaces where it’s used, and in some cases is still being found in the urine of those who handle it, despite knowledge of safety precautions,” according to msnbc.com.

The msnbc.com report also cites an investigation by InvestigateWest showing that OSHA does not specifically regulate exposures to chemotherapy drugs in the workplace with a standard, relying instead on the use of the general duty clause. According to InvestigateWest, OSHA has issued such a citation only once in ten years in “any health care institution, including hospitals, clinics, dental and veterinary offices, for their handling of hazardous drugs.”

The NIOSH Web site on Occupational Exposure to Antineoplastic Agents [2], the classification of many chemotherapy drugs, includes information on environmental sampling, decontamination, the use of personal protective equipment, and publications for assessing hazardous drug exposure and implementing policies to protect workers, including the 2004 NIOSH alert, Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings [3].

Two tools from that publication, “Common Hazardous Drugs in Healthcare” and “Handling Hazardous Drugs Safely Checklist” may be downloaded from the OSHA Healthcare Advisor Tools page [4] under the hazard communication heading.

Are hazardous drugs, especially those used in chemotherapy, a concern in your workplace. What safeguards do you have or wish you did have? Is an OSHA standard specific to hazardous drugs necessary? Let us know in the comments section below.