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Hazardous Drug Safe Handling: An Expert Interview With Martha Polovich, MN, RN, AOCN

medscape-article

November 17, 2008 — Editor’s note: Eliminating exposure to hazardous drugs is an important safety goal, according to a presentation given at the Oncology Nursing Society (ONS) 9th Annual Institutes of Learning meeting, held from November 14 to November 16 in Seattle, Washington.

Health risks to nurses mixing and administering hazardous chemotherapeutic agents include acute symptoms and adverse reproductive outcomes.

To protect themselves from exposure, nurses can use several engineering controls that are currently available, including machines and equipment to isolate or contain hazardous drugs.

To learn more about safe handling of hazardous drugs, Medscape Nursing interviewed presenter Martha (Marty) Polovich, MN, RN, AOCN, associate director of clinical practice, Duke Oncology Network, Durham, North Carolina.

Medscape: What is the morbidity and mortality associated with handling of hazardous drugs?

Ms.

Polovich: It’s important to remember that handling hazardous drugs (HDs) does not equal exposure.

However, handling does put nurses and other healthcare workers at risk for exposure, particularly when they fail to use safe handling precautions.

Exposure to [HDs] is associated with adverse health effects.

Acute symptoms have been reported in nurses and pharmacists who were occupationally exposed to HDs.

These include hair loss, abdominal pain, nasal sores, contact dermatitis, allergic reactions, skin injury, and eye injury.

Adverse reproductive outcomes [also] have been identified in nurses and pharmacists working with HDs, including miscarriage, spontaneous abortions, fetal abnormalities, infertility, longer time to conception, preterm labor, preterm births, and learning disabilities in offspring of nurses exposed during pregnancy.

Consistent with the carcinogenic potential of 23 chemotherapy agents, there is an increased risk of cancer among occupationally exposed pharmacy technicians and nurses.

One recent study found that exposed nurses were significantly more likely to report a cancer diagnosis than unexposed nurses, and the nurses’ age at cancer diagnosis was younger than expected.

Medscape: Why is it important for staff, for patients, and for others in the healthcare environment that exposure to HDs be reduced or eliminated?

Ms.

Polovich: For patients with cancer, the benefits of treatment with chemotherapy outweigh the risks.

For healthcare workers, there are not benefits, just risk.

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