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https://ntp.niehs.nih.gov/go/OECCAAHO

Occupational Exposure to Cancer Chemotherapy Agents and Adverse Health Outcomes

patient's hand receiving treatment for cancer

Many cancer chemotherapy agents have toxic properties that can lead to secondary cancers in patients receiving treatment for cancer and are known to cause DNA damage and adverse pregnancy outcomes (e.g., fetal loss, congenital malformations). Occupational exposure to these agents was first documented in the 1970s and continues to occur, despite the issuance of safe handling guidelines in 1980s. While occupational exposure likely occurs at lower levels than those administered to patients or laboratory animals, the duration of occupational exposure is longer and may involve multiple chemotherapy agents.

As a follow-up to the NTP Monograph on Developmental Effects and Pregnancy Outcomes Associated with Use of Cancer Chemotherapy Agents During Pregnancy, OHAT conducted a systematic review of the published studies of occupational exposure to cancer chemotherapy agents and adverse health effects in humans. In addition, this systematic review also summarized the prevalence and levels of cancer chemotherapy agents detected in the workplace.

NTP concluded that there is a moderate level of evidence that occupational exposure to chemotherapy agents is associated with increased incidence of spontaneous abortion, and genetic toxicity. Regarding exposure to these agents, NTP observed that detectable levels of cancer chemotherapy agents continue to be reported in worker’s urine and blood samples and in the work environment. However, some studies suggested that the levels of exposure have decreased over time with the use of exposure protection equipment and implementation of safe handling guidelines.

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