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Chemotherapy and pharmacy: a toxic mix?

Roussel-C; Connor-TH
Oncol Pharm 2013 May; 6(2):1,32-33
Pharmacists and nurses know that chemotherapy can be dangerous, but many are unfamiliar with the large body of research documenting the magnitude of workplace contamination, extent of chemical absorption (worker exposure), and downstream effects these chemicals may exert on healthcare workers. While oncology pharmacists are good at discussing new trial data, rarely do they chat about the recent urinary excretion or chromosomal damage study in exposed healthcare workers. When studies documenting the risk of hazardous medications are published in major oncology journals every other year or so, they are hardly ever accompanied by a summary of the current recommendations and regulations. The variety of guidelines and regulatory publications available can make full comprehension and application difficult, with information that can be too broad or too narrow. Chemotherapy drugs constitute the majority of hazardous drugs as defined by the National Institute for Occupational Safety and Health (NIOSH) and other organizations. Obviously, these chemotherapy and other drugs provide a therapeutic benefit to patients, but may pose health risks to workers who must handle them on a daily basis. Because most chemotherapy drugs are nonselective in their mechanism of action, their adverse effects have been well recognized in patients. Additionally, similar adverse effects have been observed in healthcare workers who prepare and administer these drugs. The effects can range from acute, such as skin and mucous membrane irritation, headache, and hair loss, to more long-term effects, such as adverse reproductive outcomes (spontaneous abortion, teratogenicity) and genotoxic effects (chromosomal and other genetic damage) to possible cancer. In fact, the healthcare setting has a large and diverse mixture of chemicals that are genotoxic, teratogenic, reproductive hazards, and carcinogenic.
Humans; Men; Women; Pharmacists; Nurses; Chemotherapy; Hazards; Exposure-levels; Risk-factors; Workers; Work-environment; Worker-health; Health-care-personnel; Medical-personnel; Medicinal-chemicals; Drugs
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Journal Article
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NIOSH Division
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Healthcare and Social Assistance
Source Name
The Oncology Pharmacist