Chemotherapy is often considered a “necessary evil” in the fight against cancer. However, it may be more evil – and less necessary – than many patients realize. You probably already know that chemotherapy drugs cause severe side effects for cancer patients, but did you know they can also affect those who handle them? Recent studies, surveys, and government reports have revealed significant health risks among workers who are exposed to these toxic, potent drugs.
At Angeles Health, we look forward to a world in which gentler options are more accessible and chemotherapy is used as selectively as possible. Our functional oncology team already prioritizes this balance, but as we continue to learn more about the health risks of chemotherapy use and exposure, we hope more health providers will follow our lead.
Chemotherapy drugs are harmful for the very same reasons they’re helpful. Chemotherapy isn’t engineered to kill cancer cells specifically; it simply kills any cells that grow quickly. Hair, intestinal tract, and bone marrow cells are particularly susceptible because of their growth rate. Additionally, other body parts are also affected by the process of metabolizing, absorbing, and eliminating these drugs.
Even small concentrations of toxic chemotherapy drugs may have this effect on the nurses, pharmacists, and other healthcare workers who handle them. According to the Centers for Disease Control and Prevention (CDC), the short-term effects of occupational exposure to chemotherapy drugs include:
- Skin rashes
- Hair loss
- Cardiac toxicities
- Congenital abnormalities
- Spontaneous abortion
- Hearing impairment
The CDC also lists these long-term effects of chemotherapy treatment:
- Liver damage
- Kidney damage
- Bone marrow damage
- Lung damage
- Heart damage
- Temporary or permanent infertility
- Reproductive organ damage
That’s right; healthcare workers must face the ironic reality that treating a patient’s cancer could actually increase their own future cancer risks. The International Agency for Research on Cancer (IARC) classifies eleven chemotherapy drugs and two combination therapies as human carcinogens, and another 23 drugs are considered probable or possible carcinogens.
Toxic Effects on Nurses & Pharmacists
According to one recent study of oncology nurses, up to 17 percent of nurses come into direct contact with chemotherapy drugs while giving infusions in outpatient clinics. The CDC also found traces of chemotherapy drugs in the urine of pharmacy and hospital staff members, which showed that their bodies metabolized and eliminated detectable amounts of the drugs.
Nurses and pharmacists face the highest risks because they actually administer and prepare the drugs, making their exposure more direct and concentrated. However, other workers may also be at risk. According to the CDC, they include:
- Physicians who treat cancer patients
- Shipping and receiving personnel who handle drug shipments
- Operating room personnel
- Custodial staff
- Laundry workers
- Waste handlers
Hospitals, outpatient centers, and research laboratories should be places of healing, but because chemotherapy can be so destructive, they’re often toxic workplaces too.
No Precedent for Preventing Risks
If early intervention could prevent some of these health risks, the medical community hasn’t discovered or implemented it yet. Toxic chemotherapy exposure is often gradual, and even if an intravenous drug touches a worker’s eye or skin, they can’t take an antiviral pill to stop the absorption or toxic effects of that particular drug.
Unlike sudden workplace accidents with known health risks (such as “needlestick incidents”), there is no protocol in place for responding to contact with chemotherapy drugs. Ultimately, each worker’s health risks depend on two factors: the amount of exposure and the toxicity of the specific drug(s). Nurses and pharmacists face higher risks because they handle the drugs directly, but there are other forms of contact that increase health risks for workers. Hazard remnants of chemotherapy drugs may remain on clothing, medical equipment, patient waste, work surfaces, and even the air itself.
Reconsidering Workplace Safety Standards
Just as employers were once oblivious to the effects of secondhand smoke, modern hospitals don’t always take the precautions necessary to protect their personnel from toxic exposure. Protective gear and careful safety and sterilization procedures are crucial, and chemotherapy drugs have always come with serious safety warnings. However, it isn’t mandatory to follow them.
It’s important for healthcare professionals to take safety guidelines seriously in any case. In fact, the National Institute for Occupational Safety and Health (NIOSH) published a public health alert to raise awareness about the occupational hazards of chemotherapy and outline some of the best practices for prevention. Their occupational guidelines include disinfecting air and work surfaces, wearing protective gloves and gowns, and requiring two or more nurses to verify drug orders.
Is Chemotherapy Worth the Risks?
Of course, if chemotherapy exposure can hurt everyone from the nurse to the janitor, the effects on patients must be exponentially greater. Fortunately, there are alternative treatment options.
At Angeles Hospital, we know how devastating the effects of chemotherapy can be. Our functional oncology program includes therapies that use your own cells and biological functions to weaken cancer cells, and we are always looking for newer and safer ways to harness modern medicine without causing unnecessary harm.