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Protecting cancer carers: reducing the risk of hazardous drugs in oncology
by Devex Editor
15 February 2021
More than half of all hazardous drugs are products used to treat cancer. Potential side effects include hair loss, infertility, and miscarriages. Oncology nurses on the front-line are at high risk, so how should they be better protected?
More than half of all hazardous drugs are products used to treat cancer, with potential effects ranging from hair loss to infertility, miscarriages, and increased risk of leukemia. Over the past 20 years, professional societies have published recommended practices for the safe handling of chemotherapy drugs, but oncology nurses in low-resource settings continue to be exposed to these formidably toxic drugs every day. This risk might increase in some facilities as personal protective equipment, or PPE, is being diverted to fight COVID-19.
5 common hazardous drugs
Source: American Cancer Society
Globally, new cancer diagnoses are expected to grow from 19.3 million in 2020 to 30.2 million in 2040, and the steepest increases will take place in low- and middle-income countries, or LMICs.
That, and global efforts to scale-up cancer control across LMICs are bringing the health and safety of oncology nurses to the fore.
“Many nurses in LMICs are rightfully terrified of handling chemotherapy due to a lack of training and protection,” said Julia Challinor, nurse and secretary general of the International Society of Paediatric Oncology, or SIOP. Often, oncology nursing is not recognized as a specialization, meaning health workers handle hazardous drugs without any knowledge of how to do it safely.
New cancer diagnoses are expected to grow significantly between 2020 and 2040.
2020
2040
International standards recommend a combination of hazard controls in order of preference. Biological safety cabinets and closed system drug transfer devices offer significant protection, followed by adequate work practices such as having clinical pharmacists prepare the drugs and using suitable PPE. “In low-resource countries, where the more costly engineering solutions such as biological safety cabinets may be prohibitively expensive, there is necessarily an overreliance on the other elements,” notes a monograph by the Pan American Health Organization.
“[D]edicated areas for hazardous drug storage and compounding, restricting access to these areas, meticulously adhering to work practices that minimize … contamination, together with … training are the most reasonable set of alternatives to the internationally recognized best-practices,” the publication continues, adding that many facilities are far from complying with these measures.
Preparing a hazardous drug infusion (with the BD Texium™ System)
Photo: BD