by
Cheryl Coppola RN, MSN, OCN
As more
and more chemotherapy is given in outpatient clinics and
at home, it is extremely important that caregivers and
patients understand the risks and hazards that household
members may be exposed to. Chemotherapy can be given via
a portable infusion pump or in pill form. In both cases
it is possible for cancer drugs to unintentionally come
in contact with caregivers. When chemotherapy is given
in any form, the body must then get rid of it after it’s
done its job. This means that the drugs leave the body
in a patient’s stool and urine. It can also be present
in emesis.
Traces of chemotherapy drug may be found in and on
toilets, in disposable diapers or any clothing or
laundry that a person has soiled after having a
treatment. Cleaning the bathroom or handling body wastes
or soiled laundry can expose you to these chemotherapy
drugs. If you are handling infusion pumps or equipment,
flushing intravenous lines or handling chemotherapy
drugs in any form, traces of the drug can be present and
can be absorbed through the skin.
Cancer
nurses have long known that exposing themselves to
chemotherapy can be harmful to their health. That’s why
they follow strict standards published by the
Occupational Safety Health Administration (OSHA) and the
Oncology Nursing Society (ONS). These guidelines include
safeguarding against drugs that are found in the urine,
vomit and stool of chemotherapy patients. When you care
for someone who’s receiving treatment in the home or
outpatient clinic, you need to be careful about coming
in contact with chemotherapy and the patient’s body
fluids.
So what
types of risks should caregivers be aware of when a
patient gets chemotherapy at home or comes home
immediately after a treatment at the cancer clinic? When
a patient is given a treatment, the drug is present in
body fluids for 48 to 72 hours after the infusion or
treatment ends. With a home infusion pump, the drug can
be spilled if the tubing is accidentally disconnected.
When chemotherapy is spilled, it can be absorbed through
the skin or the vapors can be inhaled. Acute exposure to
body fluids or the chemotherapy drug itself can cause
rash, nausea and vomiting, dizziness, abdominal pain,
headache, nasal sores and allergic reactions. Exposure
over a longer period of time is associated with birth
defects, reproductive losses and cancer later in life.
If you
or a family member is currently receiving chemotherapy,
whether in the clinic or at home, it is strongly
recommended that precautions be followed in order to
keep household members safe:
- Patients may use
the toilet as usual, but close the lid
and flush twice. Be sure to wash hands with soap and
water.
- If a bedpan, commode or urinal is used, the caregiver
should wear gloves when emptying it. (Two pairs of
latex or nitrile gloves are recommended.) Rinse it well
with water and wash with soap and water at least once
per day. The same applies to basins used for
vomiting.
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