Illness in Nurses Linked to Hazardous Materials on the Job

The results were released online today by the Environmental Working Group, the American Nurses Association, Health Care Without Harm, the Environmental Health Education Center at the University of Maryland School of Nursing.

The survey included 1,500 nurses from all 50 states. It was detailed and is the first of its kind, but it was not a controlled, statistically designed study.

"Nurses are exposed daily to scores of different toxic chemicals and other hazardous materials whose cumulative health risks have never been studied," said Jane Houlihan, vice president for research at nonprofit Environmental Working Group.

"Nurses ingest, touch or breathe residues of any number of these potentially harmful substances as they care for patients, day after day and face potential but unstudied health problems as a result," she said.

Every day, nurses confront low-level but repeated exposures to mixtures of hazardous materials that include residues from medications, anesthetic gases, sterilizing and disinfecting chemicals, radiation, latex, cleaning chemicals, hand and skin disinfection products, and even mercury escaping from broken medical equipment.

Analysis of survey data shows that nurses' reported exposures during pregnancy to hazardous drugs, housekeeping chemicals, anesthetic gases, and disinfecting and sterilizing agents are associated with increased incidence of birth defects among their children.

Children born to nurses reporting high exposures to these chemicals - at least once a week for nine months - were up to twice as likely to be born with a congenital defect than children born to nurses with low or no exposures to these agents, and up to nine times more likely to suffer from musculoskeletal defects at birth.

Of the hundreds of compounds in these exposure categories, for only one has the government set standards specifically to restrict nurses' exposures - the sterilizing agent ethylene oxide.

There are no workplace safety standards to protect nurses from the combined effects of these exposures on their health.

"This survey is a call to action for nurses to demand the use of safer products and protective measures to control exposures to hazardous agents in the workplace," said Anna Gilmore Hall, RN, executive director of Health Care Without Harm, an international coalition working to reduce the environmental impact of the health care sector.

Nurses exposed to hazardous chemicals on the job are at greater risk of adverse heath effects. (Photo courtesy AORN)

The government does restrict allowable radiation doses for pregnant nurses, but monitoring is infrequent, equipment can be faulty, and only the state of California mandates that the lowest possible effective doses be used for patients' X-rays and CT scans.

The Centers for Disease Control proposed a National Occupational Exposure Survey for the health care industry in 2002, but to date, no such survey has been conducted.

"For many of the toxic chemicals in hospitals there are safer alternatives or safer processes. We must make these healthier choices for the sake of our patients, nurses and all hospital employees," said Barbara Sattler, RN, DrPH, FAAN, professor and director of the Environmental Health Education Center at the University of Maryland School of Nursing.

Nurses reporting high exposures to medications of any type reported a 14 percent increase in cancer incidence relative to nurses with low or no exposure. High exposure was defined as at least once a week for at least 10 years.

For the nurses reporting high exposure to antineoplastic drugs used in chemotherapy to kill cancer cells, this jumped to an over 40 percent increase in cancer incidence relative to nurses with low or no exposure. In addition, nurses with high exposures to radiation disclosed a 20 percent higher incidence of breast cancer.

American Nurses Association President Rebecca Patton, MSN, RN, CNOR, said, "We are pleased to work with our partners to bring attention to the growing concern over chemical exposures in the workplace, and ANA will continue its efforts on behalf of the nursing profession to create healthier working environments."

The American Nurses Association is the only full-service professional organization representing the interests of the nation's 2.9 million registered nurses.

View the survey results at: http://www.ewg.org/reports/nursesurvey

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