One of the questions that ONS commonly receives in the clinical inbox (clinical@ons.org) is whether nurses who are pregnant, breastfeeding, or trying to conceive can safely administer or handle chemotherapy and other hazardous drugs.

Because one
 of ONS’s strategic plan goals relates to patient and staff safety, we’ve aligned with organizations such as the National Institute for Occupational Safety and Health (NIOSH) and the American Society of Health-System Pharmacists (ASHP) in producing a position statement (ONS, 2016) and publication (Polovich, 2011) focusing on safe handling.

ONS Perspective

Handling antineoplastics may result in reproductive risk, including structural defects in a fetus because of occupational exposure during pregnancy; adverse reproductive outcomes, including fetal loss, miscarriage, or spontaneous abortions; infertility; and preterm births and learning disabilities in offspring of nurses exposed during pregnancy. Although consistent and thorough use of primary engineering controls and personal protective equipment when handling hazardous drugs minimizes risk of occupational exposure, it does not eliminate it (Polovich, 2011). Because of the increased susceptibility for harm, an added level of protection is needed for nurses who are pregnant, breastfeeding, or actively trying to conceive.

Because of the increased susceptibility for harm, an added level of protection is needed for nurses who are pregnant, breastfeeding, or actively trying to conceive.

Male and female healthcare workers who handle chemotherapy, biotherapy, and other hazardous drugs are accountable to notify their employers about such situations or if they have other medical reasons to avoid exposure. Upon notification, employers should provide alternate duty that does not include the preparation or administration of hazardous drugs. Collaboration with the employee’s primary care and obstetrician/gynecologist should be part of the decision-making process (ASHP, 2006; Polovich, Olsen, & LeFebvre, 2014).

We often hear of concern with non-nursing personnel
such as ancillary staff. It is important to note that much of
the reproductive risk research has been done on healthcare personnel who prepare and/or administer chemotherapy. Although the risk of exposure appears to be lower with clinical activities not directly related to preparation and administration, risk still exists.

Ultimately, the responsibility lies with healthcare workers to inform their employer of their health condition and desire to perform alternate duties that do not involve handling hazardous drugs.

Do you have questions related to the clinical care of patients with cancer? Email clinical@ons.org to reach one of our clinical nurses on staff directly.

For more information about administering chemotherapy while pregnant, breastfeeding, or trying to conceive, watch the following educational presentation.

comments

Posted by edna colcol (n… (not verified) 4 years 6 months ago

Thanks...

Posted by Heidi Valdez, … (not verified) 4 years 5 months ago

Good, quick refresher.

Posted by Valerie (not verified) 2 weeks 5 days ago

How much of an increased risk? Where is the link to the data supporting this research? As a survivor and chemo RN, it is information I would like to see.

Posted by nancy (not verified) 1 week ago

including those who are trying to conceive is a huge issue for trying to staff an inpatient and infusion area. how much of a risk is it? where is the evidence?

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