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Examining Chemo Drugs’ Potential Threats to Health Care Workers

August 5, 2010 at 12:00 AM EDT
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As a part of NewsHour Connect, which showcases some of the best public broadcasting reporting from around the country, Enrique Cerna of KCTS in Seattle reports on the dangers that chemotherapy drugs could pose to healthcare workers who handle them.

RAY SUAREZ: For those stations not taking a pledge break the News Hour continues now with a story from a new project we call NewsHour Connect. That’s where we showcase the best of public broadcasting from around the country.

Tonight, the dangers chemotherapy drugs may pose for health care workers who handle them.

Our report was produced by KCTS Seattle in partnership with Investigate West, a nonprofit news organization.

The reporter is Enrique Cerna.

ENRIQUE CERNA: Sue Crump spent more than 23 years as a pharmacist working at Seattle area hospitals and health facilities.

She was a mixer who prepared chemotherapy drugs for cancer patients.

SUE CRUMP: She loved that idea that you know, these medications were helping people and saving people.

ENRIQUE CERNA: But after a life as a practitioner, Sue was suddenly the patient.

FEMALE: She was diagnosed May first, 2008. She went in for a CAT scan and that’s when they found the tumor on her pancreas.

SUE CRUMP: By the time I was diagnosed, I had already lost quite a bit of weight. By then, it’s incurable.

ENRIQUE CERNA: For Sue and her family, the diagnosis was doubly alarming.

FEMALE: She was talking to a friend that she worked with back in the ’70s and the friend said, ” Welcome to the club.” And my mom said. “What do you mean welcome to the club?” And she said — basically listed off all the people my mom worked with at the time, had had cancer of some kind.

ENRIQUE CERNA: Sue realized that many of those former co-workers had worked with or near chemotherapy drugs. She wondered if the life saving drugs she prepared for years was the cause of her cancer.

SUE CRUMP: Just hearing one of my friends after another was coming down with either some very rare, exotic bizarre disease, brain tumors, sarcoidosis, arrhythmias or cancer.

ENRIQUE CERNA: Carol Smith is a reporter for Investigate West.

CAROL SMITH: We think of them as medicines. And they’re good things and they help patients, clearly. But they’re also toxins and there’s a need for worker protections.

SETH EISENBERG: As we know that most of these drugs, or many of them I should say, are carcinogenic, which is this bizarre irony that you’re treating cancer with a drug that can cause cancer.

ENRIQUE CERNA: Seth Eisenberg is a nurse wit the Seattle Cancer Care Alliance. He’s also a safety advocate and travels the country advising health care workers about safe drug handling. Eisenberg says there are multiple problems with chemo drugs.

First, even a small amount is dangerous. A drop or even vapors.

This video from the University of Utah shows how vapors can escape during the mixing process. Second, Eisenberg says when there is a spill, chemo drugs are difficult to clean and don’t go away.

SETH EISENBERG: It may dry up, it may evaporate, it may turn into a powder, it may get tracked on your shoes, you may track it down the hallway, you may track it into the nurses’ lounge, you may track it into your car, you may even take it home with you but it won’t go away.

ENRIQUE CERNA: Finally, the risk from chemo drugs is long term.

SETH EISENBERG: And it’d be like taking a couple drags of a cigarette at a party. You’re not going to get lung cancer from that but we worry about somebody smoking for 20 years.

ENRIQUE CERNA: Back in the ’70s and ’80s when Sue Crump was mixing, there was little awareness of the risk. And few precautions were taken.

By the early 1980s, awareness began to grow. A stream of studies, mostly out of Europe, began to link chemo exposure to health problems including miscarriages and some cancers.

In the mid-’80s with evidence growing, the National Institute of Occupational Safety and Health, a division of the Centers for Disease Control, began formulating guidelines for the safe handling of chemotherapy drugs.

But NIOSH is not a regulating agency. That job falls to OSHA, the Occupational Safety and Health Administration. Surprisingly, Investigate West discovered that while OSHA classifies chemotherapy agents as hazardous drugs, there are no regulations that deal specifically with the handling of chemotherapy drugs.

In a statement responding to the story, OSHA told us that although this is an important safety and health issue, OSHA has not considered a standard to specifically address hazardous drugs in the health care setting.

Unfortunately, OSHA doesn’t have the resources to issue standards covering every safety and health hazard facing workers.

RAY SUAREZ: Sue Crump died last September at the age of 55.

For a link to our full story, go to the website:

Editor’s note: an earlier version of this transcript misspelled Enrique Cerna’s name.