Outpatient Chemotherapy Centers Pose Risk of Toxic Exposure for Nurses

A new study from the University of Michigan Comprehensive Cancer Center reports that nearly 17 in 100 nurses who work in outpatient chemotherapy infusion centers reported being exposed to the toxic drugs on their skin or eyes.

Approximately 84 in 100 chemotherapy sessions are delivered in outpatient facilities.

As published in BMJ Quality and Safety, the study surveyed 1,339 oncology nurses working in outpatient settings. “We have minimized needle stick incidents so that they are rare events that elicit a robust response from administrators,” said lead study author Christopher Friese, R.N., Ph.D., assistant professor at the U-M School of Nursing. “Nurses go immediately for evaluation and prophylactic treatment. But we don’t have that with chemotherapy exposure.”

Although safety guidelines for chemotherapy drug administration have been issued by organizations such as the National Institute for Occupational Safety and Health, they’re not mandatory.

As might be expected, the greater the oversight, the fewer the problems: Practices with more staffing and resources reported fewer exposures; those in which two or more nurses were required to verify chemotherapy orders – part of the study’s suggested guidelines – had fewer exposures.

Unlike needle sticks, when a specific virus is involved and preventive treatments can be given, it’s more difficult to link chemotherapy exposure to a direct health effect. So it’s more difficult for health-care systems to respond effectively.

The risks of unintentional chemotherapy exposure include impairment of the nervous and reproductive system, and a future risk of blood cancers.

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