Protection of workers from exposure to carcinogens or mutagens at work – CMD4

Speakers from the Stop Cancer at Work campaign and other experts gave presentations to the Employment  and Social Affairs Committee of the European Parliament alongside Employment Commissioner Schmit.  The exchange of views will be followed up by a vote in the European Parliament on 25 March 2021 on the amendments tabled by MEPs and will then move to the trilogue process with the European Council and Commission.

Commissioner Schmit committed to the protection of healthcare workers at the frontline but unfortunately the Commission’s independent study report on possible legislative options to prevent exposure to hazardous medicinal products (HMPs), which was due in June 2020, has been delayed but will be published soon.  He was persuaded by the danger of cancer treatments for healthcare workers exposed to HMPs and the Commission will provide a follow up on that subject and see what protection can be guaranteed.  On reprotoxins the priority will be to bring forward a limit value for lead and discussion is already taking place on asbestos and is moving forward on cobalt with social partners.  There is no limit to the number of substances that can be included in the CMD so it can go beyond the current target of 50.  He was not persuaded of the need for a fixed date for the update to benzene but he agreed that all workers should be guaranteed equal protection.

Tony Musu of ETUI said the unions campaign to Stop Cancer at Work had been running since 2016 with the objective of including in the CMD 50 substances with binding limit values but to date only 25 had been agreed.  The 6 trade union demands for CMD4 include the extension of the CMD to reprotoxins and the introduction of HMPs in Annex I of the CMD. In addition, a risk based methodology should be adopted to set binding OELs for carcinogens; binding OELs for cobalt and cobalt compounds; combined exposure in OEL implementation should be considered; and a mandatory revision of the BOEL for benzene.

Ian Lindsley of EBN spoke about the hundreds and thousands of healthcare workers, patients and carers who suffer and die each year from exposure to carcinogens, mutagens and reprotoxins. Inclusion of HMPs in the CMD, together with EU guidance, is supported by most Member States, workers, professionals, patients and employers in healthcare.  Legislation works to deliver change as it provides clarity and certainty and guidance alone will not and is by definition unenforceable.  There is no case for delaying legislation in CMD4 to await the development of guidance and there is a consensus for legislative change now. The European Commission’s long awaited study and report with the possible legislative option of including relevant groups of HMPs in Annex I of the CMD will provide the impact assessment and blueprint for that legislative change, supported by non-legislative guidance.

Lena Sharp of EONS said that cytotoxic drugs were the most often substance involved in medical errors, only four member states had swipe testing and in 7 nurses, not pharmacists, prepare hazardous medicinal products (HMPs).  In Sweden, even with the use of PPE and closed systems contamination was still prevalent.  As oncology nursing is not a recognised speciality there is no formal education and training so EONS is calling for legislation to include HMPs in the CMD together with mandatory education and monitoring of contamination.  The European Commission’s study team had seriously underestimated the risks of HMPs but the report is still not published.

Elke Schneider of EU-OSHA spoke about the huge scale of the problem of cancer at work with 120,000 deaths each year which are largely preventable and the agency has a number of initiatives to address the problem.  Matthieu Schuler of ANSES in France gave a presentation on their proposal to include 18 cytotoxic drugs in national legislation and to develop guidance and monitoring to prevent occupational exposure. 

Rebekah Smith of Business Europe said that there is no need for legislation in the CMD on either reprotoxins or HMPs and that the amendments proposed have a fundamental impact on the way that the CMD works.

Please see following link to view a recording of EMPL hearing on CMD revision on the 23rd February:

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