"The United States does not have a national cancer registry. We have a bunch of state registries. Some of those registries do collaborate and share information, but the issue is the registries that do exist typically do not report cancer by occupation. So, we cannot get our arms around the potential work-relatedness of the health outcome given the current way the state registries collect information. What we're trying to set up, is a way to make what is currently an invisible risk, visible," ONS member Melissa McDiarmid, MD, MPH, DABT, professor of medicine and epidemiology and public health director of the division of occupational and environmental medicine at the University of Maryland School of Medicine in Baltimore, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the University of Maryland School of Medicine Hazardous Drug Safety Center Exposure Registry.

Music Credit: "Fireflies and Stardust" by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0

Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by January 23, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge in the incidence of hazardous drug exposure and the tracking and reporting of healthcare worker exposures.

Episode Notes

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Highlights From This Episode

"We thought that in order to answer some of the unclear questions about health risk, we would set up an exposure registry, in this case, for oncology personnel who handle the drugs. This would then create a cohort that we could ask questions to. For example, we could try to characterize whether there is a cancer excess in this group. Or characterize the reproductive abnormalities in excess that people are experiencing." TS 6:21

"It's sort of counterintuitive that the healthcare industry, whose mission itself is care of the sick, is a high-hazard industry. We typically think about the risk as being from infectious diseases, and certainly we've all lived in our practice lifetime through some examples of that. Even before COVID-19, some of us were doing preparation for Ebola and that sort of thing. So, we're kind of used to that. But the hazards that you kind of grew up with, we've routinized or normalized handling group one, human carcinogens, which a number of these drugs are—it's just something we do every day. Well, it is, but we have to do it with respect and with care every day. And I think sometimes in that routineness of it, we have sort of lost sight of the vigilance that we need to maintain." TS 11:19

"It's very easy in the life cycle of a drug in an organization to do something that doesn't just impact you, but unknowingly, you've contaminated a surface for somebody who comes behind you. Who maybe doesn't have plastic protective equipment on because something that got contaminated shouldn't have been contaminated in the first place. If we could all be thinking of it as more of a team sport, especially in terms of safe handling, that our disposition and drug handling affects not just us and our health, but those of our colleagues." TS 24:47

"For the job history pieces, we ask what year you started, what year you stopped, and we ask about estimations of handling. So we'll be able to come up with either a duration or some kind of metric for the intensity and duration of your handling history, which will then permit us to sort the population who completed the survey into sort of low, medium, high. And we'll see whether the health outcomes that are being reported are influenced by that drug handling history." TS 27:45

Episode 399: National Hazardous Drug Exposure Registry