Although antineoplastic drugs primarily used in chemotherapy are a known hazard to reproductive health, 9% of pregnant nurses polled said they never wear gloves when administering the medications, the National Institute for Occupational Safety and Health (NIOSH) reports.

In another breach of recommended personal protective equipment (PPE), 38% of pregnant nurses said they never wear gowns while administering the drugs. Seven percent of pregnant nurses reported giving these drugs during the second trimester of pregnancy. The troubling findings come from one of the few studies to look at pregnant nurses and administration of hazardous drugs.1

“We really wanted to see if pregnant nurses are aware of the reproductive risks of working with antineoplastic drugs, and if they are getting the message that they need to use protective gloves and gowns,” says Christina Lawson, PhD, a NIOSH epidemiologist and lead author of the study.

The researchers could not determine whether the reported practices represented an education gap or other factors.

“We can look to previous studies to hypothesize the reasons,” Lawson says.

One prior study of nonpregnant workers administering the drugs found that the most frequent reason for not wearing gloves was that “skin exposure was minimal.”2 Reasons given for not wearing gowns included they were not provided by employer, not part of policy, or that other workers did not wear them.

This is particularly concerning because these hazardous drugs are no longer limited to oncology, as they are being administered in dermatology, neurology, and other specialties.

NIOSH reports that roughly a dozen antineoplastic drugs are human carcinogens and an equal amount are “probable” carcinogens. Given the long-term cancer risk, failure to wear PPE to administer the drugs poses risk to all workers. Lawson and colleagues found that 12% of nonpregnant nurses did not wear gloves when administering antineoplastic drugs. Likewise, 42% never used gowns.

The findings underscore the clear need to raise awareness, something employee health professionals may want to consider at their facilities by reviewing PPE policies.

“One of the reasons we wanted to publish this in the American Journal of Nursing — as opposed to a scientific [research] journal — was to get the word out and raise more awareness among nurses,” Lawson says.

The study, which assessed PPE by pregnant and nonpregnant nurses who administer antineoplastic drugs, used data from the Nurses’ Health Study.

“It takes a multipronged approach to raise awareness among employers and employees from many different avenues — including training, providing the gloves and gowns, and emphasizing the importance of protecting nurses and other healthcare workers,” Lawson says.

REFERENCES

  1. Lawson, Christina C. Johnson, C. Antineoplastic Drug Administration by Pregnant and Nonpregnant Nurses: An Exploration of the Use of Protective Gloves and Gowns. Am J Nurs 2019;(1):28–35.
  2. Boiano JM, et al. Adherence to safe handling guidelines by health care workers who administer antineoplastic drugs. J Occup Environ Hyg 2014;(11):728–740.