Background

“The EU needs to address more effectively the impact of the interaction of Occupational Health and Safety (OHS) with the environment and chemicals”, highlighted the European Commission in the results of the evaluation of the 2007-12 OHS strategy.

This recommendation is particularly imperative in the healthcare sector. While the majority of occupational hazards have been successfully addressed by legislation at the European and national level, much remains to be done when it comes to the exposure of healthcare workers to chemical risks during activities such as the preparation and administration of cytotoxic drugs used to treat patients with cancer. These drugs represent the most dangerous chemical risk factors in healthcare2 and some of the most hazardous chemicals ever developed.

The workplace exposure to dangerous drugs and the resulting health risks for healthcare personnel have been well known and documented for over four decades, since it first became a recognised safety risk in the United States in the 1970s. Nowadays, the challenge of protecting workers persists and is expanding, for a number of reasons. Firstly, the incident rate of cancer is steadily increasing and, in turn, the use of cytotoxic drugs used to treat cancers is growing, amplifying the exposure to healthcare professionals.

Secondly, the number and variety of healthcare workers potentially exposed to cytotoxic drugs is on the rise (e.g., professionals in immunology, rheumatology, nephrology and dermatology) because of the rapidly expanding use of these agents in non-oncology practices for treating non-malignant diseases.

Thirdly, recent studies have demonstrated a persistence of drug contamination on surfaces even though guidelines and recommendations for the safe handling of cytotoxic drugs have been issued and implemented by Member States to minimise the risk of occupational exposure. Moreover, contamination has been detected on work surfaces after recognised cleaning procedures are concluded.

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• Spain: Exposición laboral a citostáticos en el ámbito sanitario

• France : Guide de Recommendations de Dispositifs Médicaux

• UK: Guidance on Handling of Injectable Cytotoxic Drugs in Clinical Areas in NHS Hospitals in the UK