[MCOH-EH] Chemotherapy/Biotherapy reproductive hazards and staffing policy

[Rozman, John M]

I would appreciate a copy, Dr. Mitchell.

Thank you






John M. Rozman, CNP, MS, MPH
Nurse Practitioner
Employee Occupational Health
Allina Health
800 E. 28th Street
MS15002
Minneapolis, MN 55407

john.rozman at allina.com<mailto:john.rozman at allina.com>

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From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Dr Amber H Mitchell
Sent: Wednesday, May 18, 2016 10:07 AM
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Chemotherapy/Biotherapy reproductive hazards and staffing policy

USP<800> will be implemented in July 2018 based on a combination of guidance from ONS, ASHP, NIOSH, OSHA and others.  For the first time, it covers all healthcare workers with potential exposure to hazardous drugs at any point; compounding, crushing, administering, disposing, transporting, etc.

This chapter applies to all healthcare personnel who handle HD preparations and all entities which store, prepare, transport, or administer HDs (e.g., pharmacies, hospitals and other healthcare institutions, patient treatment clinics, physicians' practice facilities, or veterinarians' offices). Personnel who may potentially be exposed to HDs include, but are not limited to: pharmacists, pharmacy technicians, nurses, physicians, physician assistants, home healthcare workers, veterinarians, and veterinary technicians.
See section on Medical Surveillance lines 666 and on: http://www.usp.org/sites/default/files/usp_pdf/EN/m7808_pre-post.pdf

Here is an example of an action plan (see number 2 below) that may be useful developed by Dr. Marty Polovich and her colleagues.  We just presented it to ONS a few weeks ago at their annual conference in San Antonio.  I'd be happy to send the entire presentation (under separate cover) to anyone who would like it.


Specific Requirement


Action Steps


Target Date


Responsible Person


Resources Needed

1.Designate a person to oversee USP<800> compliance

*Develop position description
*Request applicants
*Identify training/ education needs
*Identify education source


September 2016


John Smith


XX Committee

Fees: Education/ training

2.Personnel of reproductive capability confirm understanding of risk in writing

*Develop policy
*Develop form
*Develop training/ education plan
*Implement policy


December 2016


Susan Jones


Employee Health

XX Committee



Amber Hogan Mitchell, DrPH, MPH, CPH
President | Executive Director
International Safety Center
PH: +1.713.816.0013
EM: amber.mitchell at internationalsafetycenter.org<mailto:amber.mitchell at internationalsafetycenter.org>
Web: www.internationalsafetycenter.org<http://www.internationalsafetycenter.org>


From: <Swift>, Melanie Swift <melanie.swift at Vanderbilt.Edu<mailto:melanie.swift at Vanderbilt.Edu>>
Reply-To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Date: Wednesday, May 18, 2016 at 9:20 AM
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] Chemotherapy/Biotherapy reproductive hazards and staffing policy

Fundamentally you need a comprehensive program in place that protects all workers and prevents exposure for everyone. We have training, work practices, and PPE in place to protect everyone from exposure, regardless of pregnancy status. Because studies in healthcare workers have shown that biomarkers for cytotoxic drugs in urine correlate directly with measures of environmental contamination, we have a program of routine environmental surveillance with surface wipes to detect trace chemotherapeutic agents. This demonstrates that we have good controls in place and are not having contamination. Staff members who are pregnant may still request a temporary reassignment. These requests are considered through the usual channels for accommodation requests, and may be granted if feasible. This is more for peace of mind than a concern that pregnant women are unsafe in the current environment, given the comprehensive protections in place.


Melanie Swift, MD
Director, Vanderbilt Occupational Health Clinic
http://occupationalhealth.vanderbilt.edu

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Wendy Stephenson
Sent: Wednesday, May 18, 2016 8:11 AM
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Subject: [MCOH-EH] Chemotherapy/Biotherapy reproductive hazards and staffing policy



I'm reaching out to the group on behalf of one of our member hospitals to find out how other organizations handle the chemotherapy / biotherapy reproductive hazards and staffing of pregnant, conceiving, and/or breastfeeding staff members.  Specifically, what policy or procedure is in place for accommodation or "opting out".  The issue has recently come up due to adoption of the Lippincott manual online and the more obvious messaging about the hazards with administering drugs of various sorts (not just chemo).




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