Necessary Drugs, Unnecessary Consequences: An Intervention to Protect Healthcare Workers from Exposure to Chemotherapy

University of Minnesota Ph.D. dissertation. June 2016. Major: Environmental Health. Advisor: Patricia McGovern. 1 computer file (PDF); xiii, 197 pages.According to the American Cancer Society, nearly 1 in 2 people in the United States will develop cancer in their lifetime. Chemotherapy, prepared by pharmacists and given by nurses, is often part of their treatment. While necessary for patients with cancer, chemotherapy poses an unnecessary risk of serious, negative health effects to workers. Eight million health care workers per year are potentially exposed to chemotherapy, putting them at risk of exposure to agents that are known to be reproductive toxicants and probable carcinogens. Safety precautions that could reduce their exposure are neither required nor universal and barriers to their use have been identified. The purpose of this study was to develop and test a worksite intervention to protect healthcare workers who handle chemotherapy from work-related exposures to them. All nurses and pharmacy staff from a university hospital and outpatient clinic (N=163) were invited to participate. A self-report survey measured workplace and individual factors, such as perceived risk and workplace safety climate. The associations between these factors and Personal Protective Equipment (PPE) use were measured. Wipe samples tested for surface contamination with chemotherapy. An intervention was developed with worker input. PPE use was lower than recommended and improved slightly post-intervention. Self-efficacy and perceived risk increased on the posttest. Chemotherapeutic residue was found in several areas, including places in which PPE was not required. Awareness of safe handling precautions improved post intervention. The unit worked was an important predictor of safety climate and PPE use on the pretest but less so following the intervention. Involving staff in developing an intervention for safety ensures that changes made will be efficient. Units that implemented workflow changes had decreased contamination. Work-site analysis is important to identify specific, tailored interventions that will improve chemotherapy safety