Every year more than 12.7 million healthcare workers in Europe, including 7.3 million nurses, are potentially exposed to carcinogenic, mutagenic and reprotoxic hazardous drugs. Studies show that hospital workers who handle cytotoxic drugs are three times more likely to develop malignancy and that nurses exposed to cytotoxic drugs are twice as likely to miscarry. The health hazard for handling these drugs is a significant concern as they are not only classified as potentially carcinogenic but also mutagenic (mutating genetic material) and reprotoxic (interfering with reproduction).
For HOSPEEM, it is particularly important to address handling techniques of hazardous medicinal products that are in line with national legislative specificities. While hospitals and healthcare employers are required to undertake risk assessments, it is clear that for example replacement of hazardous medicinal products is not an option for most cases, as patients still need these products for cancer and other treatments. Therefore, the Carcinogens and Mutagens Directive need to clarify the terminology “technically possible” as stipulated in Article 5 (2, 3) “employers shall ensure that the carcinogen or mutagen is, in so far as is technically possible, manufactured and used in a closed system. Where a closed system is not technically possible, the employer shall ensure that the level of exposure of workers is reduced to as low a level as is technically possible.”
HOSPEEM and EPSU call the European Commission to include in its CMD4 report or accept parliamentary amendments for the revision of the CMD in 2020-2021 that include hazardous drugs, including cytotoxic drugs, as a category in Appendix I. Healthcare workers and patients deserve to be protected by legislation now through measures that are legally binding for all the actors in healthcare, with the best possible systems of work, technology as well as education and training to avoid the risk of toxic and genetic damage and associated diseases resulting from exposure to hazardous drugs.
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