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The health hazard for medical personnel handling carcinogenic, mutagenic and reprotoxic hazardous drugs is a major concern as they are not only classified as potentially carcinogenic, but also mutagenic (mutating genetic material) and reprotoxic (interfering with reproduction). 


Studies show that nurses exposed to cytotoxic drugs are twice as likely to miscarry and among health professionals exposed to hazardous drugs in Europe it is estimated that occupational exposure produces 17,185 incremental miscarriages each year. Occupational exposure also produces 10,108 more malformations in children each year in Europe.

The chemical risks are present during activities such as the preparation and administration of hazardous drugs, including cytotoxic drugs used to treat patients with cancer. According to EU-OSHA, these drugs represent the most dangerous chemical risk factors in healthcare and some of the most hazardous chemicals ever developed. Studies show that hospital workers who handle cytotoxic drugs are three times more likely to develop malignancy.  It is estimated that in Europe each year occupational exposure to hazardous drugs produces 2,220 new cases of leukemia alone which results in 1,467 additional deaths of health professionals each year.

Increased genetic damage has been demonstrated in nurses particularly in day hospital nurses, the group handling the highest amount of drugs during the administration process. As cancer often takes decades to emerge, a case of leukemia diagnosed in a nurse or in a pharmacist today might be the product of workplace exposures in the 1970s or the 1980s.

In 2017 the 1st Cytotoxic Exposure Management Conference was held at The Royal Marsden Cancer Hospital, London. Over the subsequent years new research studies have been undertaken, and there have been recently published guidance such as the ISOPP Standards for the Safe Handling of Cytotoxics (2022), the ETUI List of Hazardous Medicinal Products (2022) and most recently, the EU Commission's Guidance for the Safe Handling of Hazardous Medicinal Products published on 28th April 2023. It was therefore well overdue that a second International conference on the important topic of occupational health & safety when working with hazardous drugs and materials, took place. 


The Hazardous Drugs: Best Practice for Nurses and Healthcare Institutions was held at Wellcome Collection, London on April 21st 2023, attended by Clinical Governance Directors, Cancer Services Directors. Lead Cancer Nurses, Pharmacists and healthcare policy makers from across the EU and the UK and was supported by exhibiting companies at the forefront of healthcare hazardous drug safety. The expert speakers can be seen here.

It is our mission to raise awareness of the risks, guidance, studies and best practice for all nurses, pharmacists, healthcare workers, cleaners and porters working with or around hazardous drugs to ensure they have maximum protections and policies in place to ensure they are safe at work.

In 2024, the Hazardous Drugs: Best Practice conference will be held in Europe with date and venue to be confirmed.    Darren, Elke

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