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Hazardous therapy
Veterinary workplace exposure to chemotherapeutic agents creates health risks, could have regulatory implications


DVM360 MAGAZINE


Legal exposure

Still, despite the financial hurdle and lack of official oversight, veterinarians' handling practices have evolved, in many cases, to include impermeable gowns, gloves and biological safety cabinets. Still, safety measures need to go much further, experts contend.

Four years after the CDC's warning, human medicine faces lawsuits linking workers' exposure to diseases spanning everything from reproductive abnormalities and hearing loss to skin irritation and breast cancer. Although science still lacks hard evidence showing a connection between chemotherapy exposure and disease in occupational handlers, veterinary experts liken the profession's ham-fisted approach to safety to where the profession was nearly 15 years ago on radiation, when associations between exposure and cancer emerged to force regulations.

"These drugs cause DNA disruption, and in comparison to radiation, chemotherapy exposure has proven just as deadly," says Dr. G.G. Davidson, who claims the discovery of precancerous lesions on her bladder prompted the veterinarian pharmacist to crack down on her once "cavalier" approach to chemotherapy drug handling.

"It's a huge liability issue. If someone has a miscarriage in a veterinary practice, the owner will be hard-pressed to prove that he didn't contribute to that."

Dr. James F. Wilson agrees, although the lawyer and veterinarian consultant maintains that such legal battling could "be very costly and go on forever."

"I don't think any insurance would cover a practice owner in a case like this," he contends. "It might be immensely hard to prove an approximate cause of the illness, but such a lawsuit would likely expose a practice owner to financial hardship. It would certainly cost a lot to deal with this."

Research

Thomas O'Connor, a scientist with the CDC's National Institute of Occupational Safety & Health (NIOSH) says that while there's no strong evidence concerning occupational exposures, a soon-to-be-published study he conducted looked at workplace contamination in three human hospitals. The result: Half a dozen drugs were picked up in the urine of workers, including chemotherapy agents. Wipe samples and air samples revealed that pharmacy and patient areas were highly contaminated, posing dermal exposure risks to everyone encountering them.

O'Connor, who has researched chemotherapy drugs and the effects of such human carcinogens for 25 years, imagines that contamination in veterinary practices might prove much worse.

"Despite the safety protocols, these drugs were everywhere, on the counters and on the floors," he says. "In veterinary practices, I wouldn't guess that you wouldn't even have that level of safety, especially because technicians are mixing the same drugs that pharmacies handle for human hospitals. You also have animals urinating, and a lot of these drugs coming out in the urine. There's a real danger to people who want to be with their animals while they're being treated. It's got to be a fairly hazardous situation."


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Source: DVM360 MAGAZINE,
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