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 presentations.

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Posted by edna colcol (n… (not verified) 5 years 2 months ago

Thanks...

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Posted by Heidi Valdez, … (not verified) 5 years 1 month ago

Good, quick refresher.

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Posted by Valerie (not verified) 8 months 1 week 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.

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Posted by nancy (not verified) 8 months 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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Posted by sharon parker (not verified) 7 months ago

i just want to share light on my experience about me giving birth to my first child after marriage, shout it loud, go out and reach others who have not heard of it was what got on my mind after i saw the result of my pregnancy test i did which was positive. mother iya basira is really doing a great works within and outside just try it and you will testify just as i am testifying now, i have this infection that lead to womb blockage and there was no hope at all the hospital i went said nothing but that there on hope for 4 years that i have waited no child then i came across mother iya basira recommended to me by my sister and she is a wonderful native herbalist who told me she can do it but i was scared because she was a lady but since i had no child i have to comply with how she will help with her powerful medicine and i carried my child in three weeks in contact with her and using her herbs, just try it and see your time to celebrate has come for women who seek permanent solution to their giving birth problem . you can reach mother iya her facebook page https://www.facebook.com/native.iyabasira and her email address is nativeiyabasira@yahoo.com

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Posted by Kathleen Wiley (not verified) 6 months 3 weeks ago

Thank you all for your comments. I am one of the Oncology Clinical Specialists with ONS. I noticed your request for references on the dangers of handling chemotherapy while pregnant, breastfeeding, or trying to conceive, and the recommendations for alternate duties for these nurses not involving hazardous drugs. The two podcasts that are associated with this article list many references including NIOSH, ASHP, and CDC and peer reviewed journals. There is a slide at the end of both with an inclusive reference list. ONS bases our position on these standards from professional organizations. I can offer think link from the CDC https://www.osha.gov/dts/osta/otm/otm_vi/otm_vi_2.html#3, that offers some data as well. I would refer you to the ONS publications Chemotherapy/Biotherapy Guidelines as well as Safe Handling of Hazardous Drugs. Hope this helps, but if you have any other specific requests, feel free to contact clinical@ons.org

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Posted by Arlene Heer RN… (not verified) 3 months 3 weeks ago

I carried my third child while working on an Oncology Unit. I was offered a different floor to work on, but chose to stay. My baby was a very healthy 9lb boy with no issues. I have known many RNs that chose to stay on their Unit and continue to administer Chemo throughout their pregnancies. I have also known of Pharmacists who mix the chemo stay on board without ill effects. There are dangers everywhere in healthcare, not just Oncology. Be careful!

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