Nurses may face health risks from chemical exposure

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The very chemicals used to keep hospitals squeaky clean and to treat patients could be harmful to nurses who are exposed to them in their daily duties, according to a study released this week by an environmental group.Nurses are exposed to a wide range of chemicals on the job -- from heavy-duty cleaners and latex to chemotherapy drugs -- that could have long-term effects on their health and the health of their children, say researchers with the Environmental Working Group and Health Care Without Harm, based in Oakland, Calif., which coordinated an online survey of 1,500 nurses in the United States.But few regulations limit nurses' exposure to chemicals, and, in fact, most nurses have no idea that their work environment could be harmful, said Jane Houlihan, vice president of research for Environmental Working Group and an author of the study."As much as we rely on nurses to protect us when we're sick, we're not protecting nurses in return," Houlihan said. "They face a diverse range of exposures in the workplace that really could pose significant health risks."The survey was made available to nurses all over the country, and nurses with physical ailments and concerns about their working environment could have been more likely to participate in the survey, said Houlihan. But researchers hope the survey results will persuade national health officials to further study the exposure of nurses to chemicals and to develop regulations to limit it.The survey looked at nurses' exposure to 11 common health care chemicals, including gases used for anesthesia; hand disinfectants; cleaning agents; latex; medications such as chemotherapy and antiretroviral drugs; devices containing mercury; personal care products such as shampoo and soap; and chemicals used for sterilization.According to the survey results, nurses who were exposed regularly -- at least once a week -- to the chemicals had increased rates of cancer, asthma and miscarriages. Nurses who were pregnant when they were exposed to certain chemicals were more likely to have children with birth defects than nurses not exposed to the chemicals.Chemical exposure seemed to have an especially large impact on the rate of musculoskeletal defects in children of pregnant nurses. Nurses with frequent exposure to sterilizing agents and anesthetic gases were seven to nine times more likely to have children with musculoskeletal defects than their unexposed peers.The results could be overstated because of the informal nature of the survey, Houlihan said. But even if long-term exposure to chemicals isn't as harmful as the study shows, there's no question that it is unhealthy, nurses said. "The biggest problem I see is that nurses don't know they're being exposed," said Lisa Hartmayer, a registered nurse at University of California, San Francisco. "It's not like nurses are saying, 'I can't go to work because of chemical exposure.' It's more like they don't feel well, and they don't know why. I think the damage is being done quietly."Hartmayer said one of the most common complaints nurses have is related to sanitary wipes they're instructed to use to clean off devices such as blood pressure cuffs and stethoscopes. Nurses might use these wipes several times a day, she said, and many of her colleagues complain of headaches, watering eyes and runny noses every time they use them."Generally, we think the cleaner the better -- the cleaner something is, the safer it is. But that's not always the case," Hartmayer said. "We use everyday cleaners that have chemicals, there's soap we use on our hands. I don't believe there's strong enough research to tell us what happens with constant exposure."While government regulations are in place for a handful of chemicals common in medical facilities, the policies aren't strong enough and don't cover enough chemicals, said researchers and nurses."I know a woman who had eight miscarriages while she was working in health care," said Lauri Hoagland, a nurse practitioner at a Kaiser Permanente clinic in Napa. "There haven't been any studies, but if you work in health care, you know something's happening. There isn't enough information and there aren't enough rules for hospitals to follow."(E-mail Erin Allday at eallday(at)sfchronicle.com) (Distributed by Scripps Howard News Service, www.scrippsnews.com.)