Background

Studies on cancer risk of oncology workers who handle hazardous drugs as part of patient care have only rarely been performed, primarily in Europe and during the 1990s. Published studies documented increases in cancer risks, but the designs were small and reflected handling practices of the time (Skov 1990, 1992). Currently, such studies cannot be performed in the U.S. because there is no national cancer registry and because the network of state registries typically do not obtain occupational data when documenting new cancer cases. Hence, the true impact on cancer risk in health professionals handling these drugs is unknown. 

The literature has suggested that adverse reproductive outcomes are linked to toxic exposures in the workplace, including antineoplastic drugs (Lawson, 2012; Connor, et. al., 2014). The biological mechanisms for these effects are known, but an accurate assessment of their occurrence is lacking. Indeed, there may well be an invisible excess of unknown risks going unrecognized.  This is because, in the U.S., we do not systematically link  health outcomes to the occupation and industry of the affected persons/person. This is why a registry is needed.

 A systematic registry of the exposure history and cancer experience of U.S. oncology workers handling these drugs is one of the last un-addressed research gaps needed to be filled.  We need to more accurately assess the impact and risk of occupational exposure and the efficacy of safety protections.

The aim of the Registry is to:

• Comprehensively characterize the demographics and exposure circumstances to hazardous anti-cancer drugs in this population of workers. 
• Assess the burden of health risks - cancer and adverse reproductive outcomes - which accrue to this group. 
• Advocate for and promote adoption of safety practices nationally, by engaging with professional organizations, public health agency partners and other stakeholders to conduct training events and policy forums to mitigate exposure risks.  

Registry Format

The registry consists of an electronic data base designed and maintained by epidemiology and occupational health registry staff at the University of Maryland School of Medicine Division of Occupational and Environmental Medicine.  Data for the registry is collected via a web-based survey from eligible participants with an occupational history of hazardous drug handling.  Participant self- reported cancer diagnoses will be validated against state-based cancer registries to ascertain the cancer experience in these participants.

Registry enrollment will accrue over time and, after realizing sufficient participants, the data will be queried to assess the cancer experience and other health questions of interest in these exposed workers. We foresee planning for a twenty-year horizon, at a minimum, to include contingencies for data retrieval and storage. Technical reports regarding the health status and cancer experience of participants will be prepared for publication by registry staff to inform future safe handling practice and policies.

Contact Us

Questions about the registry can be directed to the Primary Investigator: