Nurses routinely face the risk of direct exposure to hazardous drugs due to their key role in the administration of medication. Exposure can happen during all stages of administration: when spiking and unspiking at the bedside, when connecting and disconnecting syringes and tubing, through improper priming of IV tubing, wearing improper or no PPE, handling excreta and during disposal of used IV equipment.
Exposure to toxic drugs as droplets or vapor can occur through inhalation, skin contact, unintentional hand-to-mouth ingestion or accidental needle stick and sharps injuries. In wards, and especially oncology wards, unintentional exposure to
hazardous drugs poses a risk not only to nurses, but also to other hospital personnel, patients and their families, and the environment.
Studies show that nurses who handle antineoplastic drugs are exposed to the active ingredients. A recent study showed that 61% of wipe tests in hospital settings were positive for antineoplastics, with the highest concentrations on toilet floors, an IV pump and a waste bin cover.
Furthermore, nurses who work with antineoplastic drugs show more chromosomal aberrations and an increase in birth defects that appear to be related to frequency of use. In addition, there is an increased risk of spontaneous abortion with exposure to antineoplastic drugs. Additional acute effects of exposure to hazardous drugs include skin rashes and nausea, while chronic effects include infertility, leukemia and other cancers. In fact, a 2019 systematic review of 17 studies examining chromosomal damage related to hazardous drug exposure showed a significant association between hazardous exposure and increased chromosomal abnormalities.