Risk of Exposure

Increasing Risk of Hazardous Drug Exposure

  • World Health Organization predicts a 50% increase of cancer cases over the next 20 years
  • Increased number of cancer cases and more potent chemotherapy drugs only elevate risk for exposure
  • Hazardous drugs are also being used to treat non-malignant illnesses
  • Investigational and experimental drugs are considered hazardous until proven otherwise

View: World Health Organization: www.who.int/cancer/en/


Potential for Hazardous Effects if Not Handled Properly

Results show that coming into contact with hazardous agents can cause numerous problems. 

  • Skin Irritations
  • Leukemia
  • Reproductive Health Issues


Contaminated healthcare workers experienced higher rates of spontaneous abortions and potential fetal malformations. Workers reported that they were experiencing side effects similar to those of a chemotherapy patient (hair loss, vomiting, mouth sores, and skin rashes). Additionally, the incidence of cancer in these workers was higher, especially for leukemia and bladder cancer.


Daily Exposure May Create Long-Term Consequences

 The National Institute for Occupational Safety and Health (NIOSH) and the American Society of Health-System Pharmacists (ASHP) revised their classification of hazardous drugs to include over 195 drugs, including International Agency for Research on Cancer’s (IARC)  group of over 29 Carcinogens:



Expanded Use of Hazardous Drugs is Occurring Outside of Oncology Departments

 Because of ongoing research and emerging evidence, hazardous drugs are now being explored and used for a number of conditions:

  • Rheumatoid Arthritis (RA)
  • Systemic Lupus Erythematosus (SLE)
  • Human Immunodeficiency Virus (HIV) or Acquired Immunodeficiency Syndrome (AIDS)


Additionally, these drugs are being used in areas where they have not traditionally been used:

  • rheumatology/immunology
  • infectious disease
  • obstetrics/gynecology
  • emergency room
  • radiology
  • operating room


Commonly Documented Contaminated Surfaces

Contamination is commonly reported on the following surfaces:

  • BSC work surface, BSC airfoil, preparation room floor;
  • gloves, gowns, shoes;
  • pharmacy floor, pharmacy office chair;
  • syringes, carts, trash cans;   
  • patient room floor, patient table, patient chair;
  • checking counters in the pharmacy.


This fact demonstrates that contamination can spread out and into the environment anywhere that hazardous drugs have been used.


Potential Routes of Exposure

Inhalation:

  • breathing contaminated air (aerosols and vapors)

Dermal contact:

  • touching contaminated surfaces
  • direct contact with drugs

Ingestion:

  • chewing gum
  • hand-to-mouth (eating and drinking)


Who is at Risk?

All hospital workers have the potential to be exposed, especially:

  • nurses
  • pharmacists
  • pharmacy technicians
  • physicians
  • paraprofessionals
  • janitorial and maintenance staff


There are also reported cases of human uptake of chemotherapeutic agents in staff who work in areas where hazardous drugs are handled but are not involved in handling the drugs themselves.

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