potential long-term side effects of exposure to chemo

8/7/2019 Potential Long-Term Side Effects of Exposure to Chemo

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Potential-capable of being but not yet in existence;having possibility

Side Effect- an effect of a drug other than those desired. Exposure- the degree of exposure to hazardous

antineoplastic agents after a healthcare workersinadvertent occupational contact with chemotherapy

drugs during the preparation, administration, and/ordisposal process.

Chemo drugs-drugs are used to treat malignancies,cancerous growths


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Chemo Drugs Reconstitution

Chemo Drugs Packing

Spiking IV line on the Chemo IV bottle


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Giving Chemo Bolus

Chemo spillage and leakDisposal of Chemo IV bottle

Removing bed linens contaminated with patients body fluids andwaste post chemo


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The International Agency for Research on

Cancer (IARC) in Lyon, France has evaluated

900 agents for their potential to cause cancerin humans.


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The degree of internal antineoplasticchemotherapeutic exposure reflects

1. quantity of drug uptake

2. the metabolism of the drug in the body3. evidence of cellular manipulation after an

accidental exposure with cytotoxic agentsduring the handling process.


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HOST(Healthcare workers)

AGENT(Chemotherapy Agents)

ENVIRONMENT


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Acute Symptoms

Reproductive and developmental effects

Genetic Effects Cancer Development


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increased prevalence of infertility

noted a relationship between ectopic

pregnancies and occupational exposure the incidence of fetal loss and the degree of

occupational exposure

spontaneous abortions, preterm deliveries,

and small-for-gestation-age births


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potential chromosomal aberrations


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increased risk of malignancy

Leukemia


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Occupational exposure from hazardous drugs

may pose a significant risk to healthcare

workers. There is a need to break the chain of

occupational exposure by implementing safetyrecommendations that can prevent or reduce

exposure and minimize potential adverseeffects.


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HOST(Healthcare workers)

AGENT(Chemotherapy Agents)

ENVIRONMENT

Personal protectiveequipment (the use of

protective gloves,gowns, respiratory

protection, and eye

protection)

Compliance?

Health Monitoring

Training and educationprograms;

availability of material

safety data sheets;established workpractices, policies

Engineering controls (the use of biologicalsafety cabinets,

Proper ventilation/exhaust)


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Additional incentives for health care workers

i.e. hazard pay, health insurance benefits,

medical surveillanceBecause these RISKS are real and hazardouseffects could happen in the future (we dont know,

we only pray they wont), and because our noblejobs require us to face these risks in order to serveour patients, we really need to protect ourselves,and we hope our hospital would continue

protecting us too.


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Martin, Susan.The adverse health effects of occupational exposure tohazardous drugs. Community Oncology. September-October 2005,Volume 2, Number 5.

Valanis B, Vollmer W, Labuhn K, Glass A. Acute symptoms associated with

antineoplastic drug handling among nurses. Cancer Nurs 1993;16:288295.

Saurel-Cubizolles M. Ectopic pregnancy and occupational exposure toantineoplastic drugs. Lancet1993;34:11691171.

Valanis B, Vollmer W, Steele P.Occupational exposure to antineoplasticagents: self reported miscarriage and stillbirths among nurses and

pharmacists.J Occup Environ Med1999;41:632638.Stucker I, Caillard J, Collin R, Poyen D, Hemon D. Risk of spontaneous

abortion among nurses handling antineoplastic drugs. Scand J WorkEnviron Health 1990;17:133138.


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SkovT, Maarup B,Olsen J, Rorth M, Winthereik H, Lynge E. Leukaemia andreproductive outcome among nurses handling drugs.Br J Ind Med1992;49:855861.

Meirow D, Schiff E. Appraisal of chemotherapy effects on reproductiveoutcome according to animal studies and clinical data.J NatlCancer Inst

Monogr2005;34:2125.Dranitsaris G, Johnson M, Poirier S, et al. Are health care providers who work

with cancer drugs at an increased risk for toxic events? A systematicreview and meta-analysis of the literature.J Oncol Pharm Pract2005;11:6978.

SelevanSG, Lindbohm ML, Hornung RW, Hemminki K. A study of

occupational exposure to antineoplastic drugs and fetal loss in nurses. NEngl J Med1985;313:11731178.

Stcker I, Caillard JF, Collin R, et al. Risk of spontaneous abortion amongnurses handling antineoplastic drugs. Scand J Work Environ Health1990;16:102107.


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Hemminki K, Kyyrnen P, Lindbohm ML. Spontaneous abortions andmalformations in the offspring of nurses exposed to anesthetic gases,cytostatic drugs, and other potential hazards in hospitals, based onregistered information of outcome.J Epidemiol Community Health

1985;39:141147.Peelen S, Roeleveld N, Heederik D, et al.Toxic Effects on Reproduction in

Hospital Personnel. Reproductie-toxische effecten bijziekenhuispersonel.Netherlands: Elsevier; 1999.

Valanis B, Vollmer WM, Steele P.Occupational exposure to antineoplasticagents: self-reported miscarriages and stillbirths among nurses and

pharmacists.J Occup Environ Med1999;41: 632638.Zhao SF, Zhang XC, Wang QF, BaoYS.The effects of occupational exposure

of female nurses to antineoplasic drugs on pregnancy outcome andembryonic development. Teratology1996;53:94.

potential long-term side effects of exposure to chemo

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