Fórsa and the European Biosafety Network (EBN), along with the Hospital Pharmacists Association of Ireland (HPAI) and the National Association of Hospital Pharmacy Technicians (NAHPT), gathered on Tuesday January 30th to explore best practice around Hazardous Medicinal Products (HMPs) and other dangerous drugs. HMPs pose potential risks to healthcare workers across the board from manufacturing to administration, potentially causing health issues ranging from headaches to severe conditions like cancer.

Lively and engaged discussions echoed through Fórsa HQ at Éamonn Ceannt House as over 100 participants from across the Irish healthcare and social care sector came together for a day of dialogue among hospital pharmacists, pharmacy technicians, oncology nurses, occupational health specialists, and an eager audience. 

Ian Lindsley, Secretary of the European Biosafety Network unveiled survey results on Irish healthcare workers' awareness and engagement in preventive measures.  The results revealed that the majority of those using a list of HMPs, use the National Institute for Occupational Safety and Health (NOISH) list of hazardous drugs.  Ian highlighted how this is a list from the United States, dating from 2020, and therefore may not reflect the full range of HMPs used in Ireland. 

“So if your starting point is the NIOSH list, you may miss some of the substances that are only available in Europe or even specific to to Ireland,” he warned.

He described how less than half of the 480 survey respondents use a list of HMPs in their workplace. While almost 40% of respondents do not have a written policy for risk assessment or handling of HMPs and talked about safety data sheets and other labelling systems to protect workers.

“The vast majority of workplaces ought to be using one list or another,” Ian advised. “If you don't use a list, it makes it more difficult to know which drugs are hazardous, let alone to prevent exposure.”

Ian described how any legislative approach to HMPs needs to be backed up on the ground.  “At the end of the day, that needs to be enforced and it needs to be implemneted practically,” Ian said. “So, in the real world, I think it's organizations like Fórsa who are the ones who will have to lead the battle in terms of ensuring implementation of these legal measures.”

The packed panels and keynotes that followed saw Dr. Tony Mizo and Dr. Paul Sessink present insights into new European legislation, including an EU list of HMPs and guidelines on safe handling, with discussions on their practical implementation and transposition in Ireland. 

Dr Tony Muso, a senior researcher at the European Trade Union Institute, highlighted the frightening volume of workers that are exposed to HMPs.  He described how HMPs pose risks in obvious places like healthcare settings or the pharmaceutical industry and across the labour force.

Dr. Paul Sessink emphasised the importance of risk assessments around HMPs and the role employers have to play.

“Without the risk assessments, you can do nothing,” he said.  “The risk assessment enables the decisions you have to take on management training, exposure assessments, and health surveillance. It's actually the starting point. The key point of all the work related to exposure to Hazardous Medicinal Products is that the responsibility for the risk assessments lies with the employer.” 

Fórsa, along with the EBN, HPAI, and NAHPT, urged the Health Service Executive (HSE) to quickly update their 'Guideline on the Safe Handling of Cytotoxic Drugs.' This guideline hasn't been updated since February 2022 and needs to include the latest changes from the new EU Directive and related guidance on Hazardous Medicinal Products (HMPs). They also emphasized the importance of the Health and Safety Authority (HSA) stepping up inspections at healthcare facilities and manufacturing sites dealing with HMPs.

Linda Kelly, Fórsa national secretary said: “With the issue of exposure to hazardous medicinal products (HMPs) directly and indirectly impacting so many of our members, it is imperative that awareness of the risks is improved, and that we act now to prevent the damaging health effects that exposure to HMPs can have on the workforce. We are calling for preventive measures to be put in place to protect all workers potentially exposed to contamination. We must work holistically to ensure that all workers in health and social care are sufficiently protected when doing their jobs.

“The new EU Directive that includes HMPs for the first time must be transposed into Irish law by 5 April 2024. But the real work does not stop with changes to legislation or the implementation of new EU guidance; employers in Irish health and social care need to understand the risks of exposure to HMPs, implement controls and take immediate action to protect workers.”

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