Occupational Health Hazards in the Medical Field Kim Chastain AB TECH April 24, 2012 Abstract Medical personnel come into contact with a complex variety of deadly toxins. Contact comes from industrial cleaners, sterilization products, radiation, medications, and mercury. Side effects of these toxic materials are known to lead to a variety of cancers, miscarriages, asthma, birth defects and metabolic syndromes. Government agencies have been negligent in protecting healthcare workers from exposures to these materials.
There has never been a government-funded study of these materials and their impact on health and the environment; however independent studies have shown higher rates of disease in healthcare professionals and their children. According to Environmental Working Group (2007), of the 82,000 chemicals in record only around one hundred and eighty have been tested. Thousands of pollutants can be found in any medical setting yet only six have government workplace safety standards.
Exposure standards fall to individual facilities to regulate, and vary wildly depending on facility understanding of these toxins. Continued training is recommended when new chemicals and equipment are changed. Healthcare facilities should also be tested on a yearly basis to identify areas of contamination to the employee and patient. Keywords Toxin, hazards, occupational disease In 1970 President Nixon and Congress instituted OSHA to create a safe working environment and NIOSH (The National Institute for Occupational Safety and Health) to research workplace hazards.
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While OSHA and NIOSH have clear guidelines for common biohazard procedures, almost nothing exists for chemical and toxin exposures. From doctors and nurses to janitors and mail delivery, anyone who comes into contact with these toxins is at risk. The nature of the nurse or doctors exposure is two fold; consumer contaminates from home and industrial contaminates from work. Illnesses reported by medical personnel range from chronic skin dermatitis and asthma to acute life threatening conditions; rare cancers, spontaneous abortions, metabolic syndromes and birth defects.
The importance of studying the multigenerational human impact of these contaminates is not only to help the lives of the medical employee, but would result in helping to determine the effects on the population as well. Individuals that work in health care should be aware of workplace exposure to hazardous materials found in the medical industry to better protect themselves. While the government plays catch up with science individuals must be proactive in learning about the dangers and what they can do to make their workplace safer. Locating the Danger
It is no surprise that toxins can be found in a medical setting. What does surprise experts is that there are not more regulations and education on how to handle them. There is no question of the impact that these contaminates have on medical personnel and their families. Environmental Working Group (EWG) conducted a survey in 2007 to examine exposure and its effects regarding nurses. Fifteen hundred nurses were asked in a survey to list exposure to eleven common toxins found in a medical setting and health problems seen in their children and themselves. The data is staggering.
Organizations around the world have conducted their own investigations into workplace exposure and have found the same results. The conclusion is a global pandemic of cancer, miscarriages and illness never before seen in any other workplace. Figure 1 (Environmental Working Group, 2007) An article by Carol Smith (2010) presents InvestigateWests examination into the regulations surrounding medication exposure regulations and chronicles the impact they pose by following the illness of pharmacist Sue Crump. Ms. Crump at the time of the interview was in the end stages of pancreatic cancer.
Crump had spent 23 years working in the medical industry mixing chemo drugs. InvestigateWest found that no government agency has any regulations on exposure to drugs; even those that OSHA has deemed as hazardous. OSHA defines hazardous drugs to knowingly cause cancer, birth defects and other illness. Thomas Conner, a researcher for the National Institute for Occupational Safety and Health has spent four decades studying chemo medications on personnel. He emphasizes that, “There is no other occupation population (that handles) so many known human carcinogens” (Lifesaving Drugs, Deadly Consequences, 2010, para. 1 ). Unlike the US, European countries have taken notice and placed stronger standards to protect its workers, and most have replaced most toxins with green chemicals. Two Danish studies have found “a significant increased risk of leukemia among oncology nurses and physicians” and extreme risks of multiple cancers for medical workers (A Silent Threat, 2010, para. 10). Concerned over the growing number of studies NIOSH issued an alert on the dangers of handling toxic drugs; however they are only recommendations and OSHA has no intent on making them regulatory.
According to the Environmental Working Groups Survey on Nurses (2007), starting with the Toxic Substance Control Act in 1976, “the EPA has not reviewed or even begun gathering safety data for more than eighty percent of the chemicals produced or imported in annual quantities exceeding ten thousand pounds” (The System is Broken, para. 4). This brings in to question the very nature of the agencies that have been put into place to protect its citizens. There seems to be no clear cut standard for how these government agencies handle the data and respond to the people or each other.
While each one clearly knows and verifies the existence of the dangers they do nothing about it. Common Toxins Anesthetic Gas Anesthesia is commonly used in dental and surgical procedures. Gases escape can from facemasks, tubes and even regulating machines that were created to control exposure. Although NIOSH has recommended exposure limits for many gases used it is primarily to protect the worker during the procedure. These gases have been found to increase neurological issues, lowered fertility in men and women, miscarriage and higher rates of birth defects in children; articulalry neurological complications. Medications According to EWG, the FDA has approved close to six thousand medications. Even in trace amounts these medications can pose serious effects. No study has ever been conducted to examine the hazard of combining medications in humans. Some chemo drugs are capable of damaging DNA and are known cause certain types of rare cancer. Antiretroviral drugs used for HIV treatment are even more dangerous to a developing fetus. Unnecessary exposure to medication has been linked to everything from skin rashes, asthma, cancer, infertility, and birth defects.
Latex and personal care products Latex is a common material used in gloves, catheters, and other plastics. Personal care items range from shampoo to shaving cream used by patients. Both were linked to asthma and allergies, ranging from mild reactions to life threatening anaphylaxes. Medical professionals have already been found to have to leave the job because of the seriousness of their allergies. Mercury containing devices Mercury can still be found in devices ranging from thermometers, blood pressure cuffs to non-medical devices, such as batteries and thermostats.
It is known to be extremely toxic to the brain and nervous system. Neurological disorders have been found to be higher in medical personnel than other occupations. Children born to nurses exposed during pregnancy have higher degrees of developmental delays and central nervous system diseases. Radiation Radiation can be found in medications and used in life saving medical devices. Imaging machines, such as MRI and CAT scans, have been shown to emit radiation even when protections are in place. Radiation exposure has been proven to cause an increased rate of miscarriage, cancer and birth defects. Sterilization
Ethylene oxide & Glutaraldehyde are chemicals used to sterilize anything that cannot be sterilized by steam. Whether the exposure was from the liquid form or spread through evaporation it has been linked allergies, anemia and severe migraines. Recommendations Although many of these contaminates are needed, immediate action should be taken place to insure the health of everyone who works near them. Rigorous standards for the handling of and the exposure to toxins; updated and complete profiles for chemicals and their affects on health and the environment; and investigations on healthcare personnel and their children’s lifeps.
Education should be as fast paced as chemical production. Healthcare facilities should have mandatory guidelines for replacing hazards with green alternatives when available and only extensively trained personnel allowed to handle them. Conclusions Since the inception of control and regulation of toxins and chemicals the government has banned production of only one chemical, and set very few exposure standards for personnel that are exposed to them. Its apparent in the data that what’s being done currently is not working.
No other workforce has been asked not only to risk their lives but the lives of their children as well. Bringing to mind the aftermath of 9/11, when the nation watched as military, medical personnel, police, FEMA, and firemen ran to act. Only this time no one seems to be watching. Families of medical workers, like Sue Crumb, have been left to wonder why nothing has been done. It has been reported that the nursing shortage is over but is expected to reemerge again by 2020 as the largest employed group of nurses retire.
If the healthcare industry continues to be a hazard to its staff one could only assume that the shortage will become worse. No one can deny that the current burden on the healthcare system is extreme. When our health care professionals begin to get sick the burden will become greater. By stepping forward now, patient and health professional together, perhaps we can save generations of lives from needless loss. References Brody, J. M. (2007). Improving Disclosure and Consent: "Is It Safe? ” New Ethics for Reporting Personal Exposures to Environmental Chemicals.
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