Whether the safety of the oncology nurses is guaranteed, it must not rule out the fact that they are exposed to a life-threatening amount of chemotherapy drugs. However, these nurses are actually at risk of contamination from potentially harmful cytotoxic chemotherapy drugs because of lack of monitoring by the health trusts.
An oncology nurse was in the ward, watching as the chemotherapy drugs dripped into her bloodstream. She was a nurse for up to 23 years, and spent those years mixing chemotherapy drugs. One would begin to wonder whether it was the exposure to the chemotherapy drugs that caused the cancer in her, or not.
Under lab conditions, chemo is a poison by design. Getting its origin from the deadly mustard gas used in World War I against soldiers. Today, it is applied to stop the growth of cancer.
The nurse died of pancreatic cancer at age 55.
There are a lot of questions on whether the nurses are safe from the contamination from cytotoxic chemotherapy. But is her exposure to chemo directly related to the development of her own cancer?
Are the workplace regulations adequate?
Chemotherapy drugs has been one of the reasons, if not the only reason, why a lot of people survived cancer. But, sadly, it also took out its negative effects on the hospital workers who handled and administered them. The healthcare workers have been constantly and chronically exposed to the chemotherapy agents before safety guidelines were put in place. This has led to a lot of nurses and other healthcare workers getting diagnosed with cancer, and this was linked to their exposure to the chemotherapy agents. This has led to the untimely death of many medical practitioners.
It is quite difficult to trace the cancer of an individual to a particular source of exposure. This is one of the reasons why the efforts of the safety advocates to establish a more effective set of regulations have been annulled. A study being carried out in the United States, for ten years now, by the U.S Centers for Disease Control confirmed that chemo is still contaminating the workstations in which it is used. It was discovered that it was found in the urine of those that handled it, even with the application of safety precautions.
Chemotherapy agents have been classified as precarious drugs by the Occupational Safety and Health Association (OSHA). They are also referred to as hazardous drugs, and can be defined as drugs that are known or suspected to lead to cancer, birth defects, miscarriages, and some other serious health consequences. The problem now is that OSHA does not have a regulatory body or authority to enforce safety practices with penalties of fines and sanctions of defaulters. All that have is the general duty clause that gives them the ability to caution an employer that allows something wrong according to their definition. This clause has only been used once, for the past ten years!
Does exposure to little quantities have effects?
The chemotherapy drug was designed in a way to be toxic no matter how minute the quantity is, and also to be easily absorbed too. Three decades ago, pharmacists did not use protective covering like gloves. There was no reason to think to prompt the use of protective clothing. The chemo back then came in vials, and was to be transferred into plastic bags. Most of the time, the chemo agents would spill on their garments and the countertops. All that was done in situations like this was to wipe it away with a towel. As if this was not dangerous enough, there were also situations in which a pharmacist would experience a cut, gotten from handling other drugs. Other drugs came in ampoules and were to be squirted out. Filing of the neck and snapping it open often lead to cuts most times, and exposed the pharmacists to different drugs.
Now, if they had the knowledge that we have today, they would have found a way to protect themselves. But it was not taken seriously, and did not feel like a big deal. Exposure to the drugs, and even chemo, did not feel relevant. They felt like the quantity entering the body through the cut was insignificant. The thing is, this insignificant quantity kept entering the body over the years and caused a menace they never dreamed of.
Has this situation been a big threat?
Numerous studies have shown evidences of contamination in the workplace where chemotherapy was administered and prepared. More research also proved the presence of the chemo agents in the urine and blood of the nurses and other medical practitioners who handled them. The Danish epidemiologist used a cancer registry than ran from the 1940s to the 1980s to report the enlarged risk of occurrence of leukemia in oncology nurses and medical practitioners. Another recent Danish study on over 90 thousand nurses uncovered an increased risk of breast, brain, thyroid and nervous system cancers.
The chemo agents have been known to be difficult to clean. When dispersed in the air or plain surfaces, they become invisible and very hard to clean completely. The problem arising is that they are long lasting, they spread easily and have the ability to cause genetic damages. Traces have been found in the garbage cans, on door knobs, on floors and any other place that the chemo agents have been taken to.
It is now evident to say that this menace has neither been a big threat nor a little one. It is more convenient and proper to describe it as a silent threat, all this while. There has been little or no attention from the government in response to this “threat”, and there have been urges from concerned bodies that safety clothing like double-gloving, chemo gowns, ventilation hoods, face shield, respirators and a sophisticated closed-system are to be used.
Safety in preparing chemo?
There has been evolution of safety practices over the years, and there are now special areas for mixing chemo today. These areas are restricted to chemo purposes only. There are also protective equipment for use in protecting against chemo; such as special gowns, sleeves and gloves to prevent the chemo from spreading.
Safety advocates are concerned about the nurses in smaller clinics, where awareness and top-quality equipment are not as high and available respectively. Since there was a specification that there are about two million workers involved in mixing and dispensing chemo. These numbers are predicted to grow in correlation with the increase in cancer patients as the years go by. It is predicted that the number of cancer patients would climb up to about 50 percent in the next 10 years. This is alarming because more people would be required to prepare chemo and administer it to the increasing number of patients over the years.
It is a fact that fewer healthcare workers would risk their lives if they had a sound understanding of the risks involved in preparing and administering chemo. Most people still don’t take it seriously.