Independent research organisation MindMetre, which regularly addresses patient and healthcare worker safety across Europe, has produced a second study on oncology nurse safety, specifically analysing the level of activity by UK NHS Trusts in monitoring environmental contamination by hazardous cytotoxic drugs.

MindMetre’s original report identified that an increasingly wide body of commentators are raising the issue of hazardous drug chemical exposure risk for oncology nurses which can result in symptoms ranging from hair loss to high rates of miscarriage or even foetal abnormalities.

The research concluded that risk is well governed at the drug preparation stage, but possibly not yet properly mitigated in administration procedures.

A further focus on monitoring and management of risk was therefore recommended.

An assessment of the current situation on environmental contamination by such hazardous cytotoxic drugs was the logical next step.

MindMetre Research conducted a series of requests under the Freedom of Information Act (2000) amongst NHS Trusts enquiring about current practice regarding risk assessments, environmental contamination monitoring and staff health surveillance in oncology and chemotherapy day units.

The research found a general lack of awareness of the need to monitor contamination at day ward level – even on a one-off basis to establish an evidential starting point.

By contrast, in the U.S. the risk of contamination is considered so high that NIOSH (National Institute of Occupational Safety and Health) has specifically stated that procedures to reduce exposure, such as closed transfer systems and procedures, should be used, suggesting Europe should turn its attention to this under-analysed aspect of healthcare worker safety.

Specifically, the research found that the vast majority of English NHS Trusts were not conducting regular environmental monitoring (in the form of surface wipe-tests) within cancer day units to detect possible chemical contamination from hazardous drugs.

This explains the lack of surveillance data, leading to an inability to estimate actual levels of contamination in UK cancer day wards.

However, the research did also find that a pioneering minority of Trusts are aware of the risk of contamination on the ward, to the extent that they have specific measures in place to monitor that risk. 

7% of Trusts carry out regular oncology nursing staff surveillance, or are planning on introducing such screening programmes. 

And a forward-thinking 10% of Trusts state that they are using closed/sealed systems to prevent exposure of cytotoxic drugs to staff, or have near-term plans in place to introduce such systems.

Paul Lindsell, Managing Director of MindMetre Research, notes: “This research clearly shows that the risk associated with environmental contamination in cancer day wards is largely under-addressed by NHS Trusts, even though previous research by MindMetre along with a host of other commentators indicate that nurses regularly administering chemotherapy drugs are at risk of developing serious health problems.

“Audits and regular testing for levels of toxicity in the ward could help to identify risk areas and significantly reduce risk to these specialist healthcare workers. Moreover, the cost of conducting such a periodic contamination test is estimated to be less than £ 2,000 per unit. It therefore becomes morally imperative to make testing for environmental contamination mandatory in order to mitigate potential occupational risk which cannot be tackled unless Trusts begin to monitor their levels of contamination.”

Source: MindMetre