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Pharmacist: The risks and solutions

As a pharmacist, your role involves dispensing medications, providing patient counseling, and ensuring the safe and effective use of pharmaceuticals. While your primary focus is on patient care and medication management, it’s important to be aware of potential occupational hazards, including those associated with the handling of medications and exposure to certain substances.

In the pharmaceutical setting, exposure to various drugs and chemicals is inherent to your daily tasks. While many medications are safe when used as directed, some pharmaceutical compounds may pose potential health risks, including carcinogenic properties.

Continuous exposure to these substances, whether through handling, inhalation, or skin contact, may contribute to long-term health issues, including an increased risk of certain types of cancers. To safeguard your well-being and that of your colleagues, it is crucial to implement safety measures and adhere to best practices.

Proper ventilation in pharmacy areas and the adoption of engineering controls, such as fume hoods, can help minimize exposure to airborne contaminants. Additionally, strict adherence to protocols for handling, storage, and disposal of medications is essential to mitigate risks. Protective measures for pharmacists may include the use of personal protective equipment (PPE) such as gloves and masks when handling certain medications.

Note: The CarcCheck is based on data collected for the EU. Therefore, uses of a substance might not be of equal relevance in all member states. The CarcCheck indicates were a carcinogen can potentially be involved or released; exposure potential will also vary in different sectors. Only the risk assessment will show whether this is the case in a real workplace or in a user situation.

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Pharmacist: The risks and solutions

As a pharmacist, your role involves dispensing medications, providing patient counseling, and ensuring the safe and effective use of pharmaceuticals. While your primary focus is on patient care and medication management, it’s important to be aware of potential occupational hazards, including those associated with the handling of medications and exposure to certain substances.

In the pharmaceutical setting, exposure to various drugs and chemicals is inherent to your daily tasks. While many medications are safe when used as directed, some pharmaceutical compounds may pose potential health risks, including carcinogenic properties.

Continuous exposure to these substances, whether through handling, inhalation, or skin contact, may contribute to long-term health issues, including an increased risk of certain types of cancers. To safeguard your well-being and that of your colleagues, it is crucial to implement safety measures and adhere to best practices.

Proper ventilation in pharmacy areas and the adoption of engineering controls, such as fume hoods, can help minimize exposure to airborne contaminants. Additionally, strict adherence to protocols for handling, storage, and disposal of medications is essential to mitigate risks. Protective measures for pharmacists may include the use of personal protective equipment (PPE) such as gloves and masks when handling certain medications.

Note: The CarcCheck is based on data collected for the EU. Therefore, uses of a substance might not be of equal relevance in all member states. The CarcCheck indicates were a carcinogen can potentially be involved or released; exposure potential will also vary in different sectors. Only the risk assessment will show whether this is the case in a real workplace or in a user situation.

Which carcinogen(s) are present?

As Pharmacist, the following (process-generated) carcinogens could be a potential risk for your health.

Can the carcinogen(s) or process(es) be replaced?

Substitution is the first and top prevention measure to avoid exposure to carcinogens. The following substances or processes are considered safer alternatives for these carcinogens or represent less exposure potential.

Are technical prevention measures in place?

Technical measures have to be used first, when substitution was not possible. The first technical measure of choice is the use of a closed, encapsulated system. Various possibilities and technical solutions are available that might be suitable to reduce exposure to as low as technically possible. These risk reduction measures vary in their effectiveness and need to be assessed for your working environment individually. 

Are organisational prevention measures in place?

Organisational measures can support your exposure reduction strategy. Organisational measures must be used only when substitution was not possible, and all technical measures have been exhausted. Various organisational measures are available that might be suitable to reduce exposure. These risk reduction measures vary in their effectiveness and need to be assessed for your working environment individually.
 
Furthermore, the following list provides you with general or organisational targeted solutions provided by others within your occupation/branch.

Are limit values in place?

Limit values for carcinogens are one mean to assess the exposure situation and to assess whether minimum requirements are met, or further risk reduction strategies have to be applied. The links provided above can support assessment whether technical and organisational measures have been sufficiently exhausted to minimise exposure. Please be aware that you can also assess internal exposure by biomonitoring.

Independent whether there is an European limit value in place or not, it is mandatory to minimise exposure to carcinogens as low as technically achievable. Please refer to your national legislation how to comply with minimisations duties.

As Pharmacist, the following (process-generated) carcinogens could be a potential risk for your health and the following EU limit values are in place.

Is exposure determined?

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If you come to the conclusion that exposure is likely, there are multiple options to assess your exposure situation.

Descriptions by the occupational prevention organisation or insurances, in practice approved control guidance sheets, REACH exposure scenarios or exposure modelling are further and eligible sources that help assessing the exposure situation as well as by comparing workplace situations. This must be documented in the risk assessment. Finally, if these methods do not allow for a conclusive exposure assessment, exposure measurements with the help of your respective insurance organisation or an external company can be performed.

Furthermore, you might want to check exposure data sources compiled here.

Is personal protective equipment provided?

You should be aware that personal protection equipment (PPE) should be used only after technical and organisational measures have been used to reduce exposure as much as possible.

Furthermore, there are strict rules for the use of PPE. For respiratory protection equipment (RPE), the filter class needs to fit the purpose, the size of the mask needs to fit the individual worker, maximal wearing time needs to be defined and workers need training for correctly equipping/un-equipping RPE.

For dermal protective equipment, adequate glove material and size needs to be assessed. Commonly, there are very rare situation when handling carcinogens, that PPE is not necessary to fulfil minimisation duties. When you decide to not use PPE, this has to be well-documented.

Furthermore, the following list provides you with solutions provided by others:

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Further duties and additional helpful measures

Ensuring the well-being of your employees is further guaranteed by certain duties laid down in the Carcinogens, Mutagens and Reprotoxicants Directive (CMRD). Additionally, other measures have a positive impact on workplace safety and workers health by boosting awareness of all involved actors.

The following list provides support for these important aspects. However, national requirements might deviate from the Directive and therefore, please consult with your national authorities about regulatory requirements for hazardous substances:

  • Performing a risk assessment is mandatory.
  • Instructing and training before workers start a task is mandatory.
  • Documentation of tasks involving carcinogens is mandatory.
  • Offering medical surveillance is mandatory.
  • Organising the chemicals within a substance inventory is regarded as very helpful.
  • Getting ‘external expertise’ from occupational physician or safety experts is regarded as very helpful.

Your well-being is further guaranteed by certain duties of your employer laid down in the Carcinogens, Mutagens and Reprotoxicants Directive (CMRD). However, it is also important that you act according to i.e. workplace instructions.

  • Performing a risk assessment is mandatory for your employer and serves to identify all potential health risks and install countermeasures to prevent or reduce these risks.
  • You have to be instructed and trained before you start a task. Repetition of training and adaption of operational instructions help you to stay alert to the risks.
  • Should you ever experience health problems that might be work-related even after changing the company or retirement, the documentation duty for tasks involving carcinogens will ensure that you receive recognition for an occupational disease.
  • Offering medical surveillance to you is your employers duty and serves to inform you about potential health risks related to your task.
  • Please be aware that cooperation with your employer is your duty as well. Workplace and personal hygiene protocols (for example, do not carry work clothes home) are one key factor to ensure your health and that of your family and should be followed at any time.