Health care workers at the Westlock Healthcare Centre have potentially been exposed to harmful cytotoxic medications without any kind of warning or a plan in place to minimize that exposure, according to the Alberta Union of Provincial Employees (AUPE).
Last week, AUPE filed five occupational health and safety complaints regarding health care workers’ exposure to cytotoxic medications at five facilities in Westlock, Vegreville, Cold Lake and Edmonton.
However, these complaints were actually based on 100 individual complaints received through the AUPE’s issue reporting process, which were spread fairly evenly among the five facilities, said AUPE vice president Carrie-Lynn Rusznak.
“Even though we’ve had 100 individual complaints filed, we can only file (OHS complaints) on the facilities,” said Rusznak, noting they continue to receive complaints from their members almost daily.
Cytotoxins are not a specific brand of medication, but rather a term that applies generally to medications that are harmful to cells.
There are a wide variety of cytotoxic medications, which are also known as antineoplastic agents. They’re primarily used in chemotherapy, but they’re also being used to treat a growing number of illnesses like rheumatoid and juvenile arthritis.
However, they also can cause side effects ranging from skin and eye irritations to vital organ damage to pregnancy-related health issues, such as birth defects. They’re also known to cause some forms of cancer, ironically.
Rusznak said health care staff providing day-to-day or hourly care to patients are potentially exposed to these medications, but many of these workers at least have access to a client chart and would know if a patient is on a cytotoxic medication.
“But we have a number of workers that aren’t necessarily privy to a client’s file or a client’s chart,” she said.
These include housekeeping and food services staff, who could potentially be exposed to cytotoxic medications through the bodily fluids — blood, urine and so forth — of patients using them, she said.
Rusznak said they also have heard that in some locations, nursing staff aren’t informed what plan or policies a facility has in place for dealing with a patient who is being treated with cytotoxins.
“They’re at a bit of a risk,” she said.
When asked further about the Westlock Healthcare Centre’s issues, Rusznak said that to her expectation, there is not a plan in place to directly education the staff on what the concerns are around cytotoxins.
Following the filing of AUPE’s complaints, Alberta Health Services (AHS) issued a statement saying the health and safety of staff is their top priority and they continue to ensure “their ongoing health, safety and wellness.”
The statement alludes to the fact that AUPE previously raised this issue in regards to other facilities back in April and June.
AHS Workplace and Safety conducted an investigation to determine the level of exposure and potential risk, but determined there was no exposure that could cause harm.
“We have no reason to believe that harmful exposures have occurred or that any staff member has experienced adverse health effects from exposure to cytotoxic medications,” the statement reads.
Despite the fact that no employee has reported any illness or adverse health effects from exposure to these cytotoxic medicastions, Workplace Health and Safety occupational health nurses have reached out to affected staff to hear their concerns, AHS stated.
Rusznak said they have raised alarm bells before about cytotoxins for some time now, adding that the dangers “aren’t anything new.” Nonetheless, some employers continue not to have any kind of plan or policies in place to reduce exposure to staff.
Others make no effort to educate staff so they know what the risks are when treating these patients. Ultimately, the AUPE wants employers to acknowledge these risks and put procedures in place to minimize the dangers from cytotoxins, she indicated.
“Own that, and let all the staff in the facility know, ‘We have client so-and-so who is being treated with these (medications). There is a risk of exposure.”
If there is a solid effort to educate staff about the hazards and what mitigation measures are in place, “there’s not a front-line staff out there that’s not going to listen to what the process is to protect them,” she said
Whether or not anything comes out of these new complaints remains to be seen, though AUPE insists there is an “escalation” in individual complaints about cytotoxins coming to them.
However, with cytotoxic medications becoming more frequently used, the issue isn’t going away.
“As we move into the future, we could find that there are more drugs out there that have a danger or a risk attached to them,” said Rusznak.
“We have to be able to have that … uncomfortable conversation about, ‘You have a patient on site using this medication. What is your plan to protect the front line workers?”
Rusznak said resolving this issue isn’t going to be a matter of “waving a magic wand.”
“I think it’s going to be a constant conversation that we have to keep having with employers to ensure that, from now on, there needs to be better communication and better education of what the risks are and how to protect yourself from the risk.”