"Why do I need to protect myself from something I don't see?" This dialogue is present in the episodes of the dramatic Chernobyl series, produced by HBO and nominated for an Emmy, which portrays the lives of brave and heroic people who tried to mitigate the damage caused by the Chernobyl nuclear power plant, in the accident that occurred on April 25, 1986.
The Chernobyl catastrophe was stratospheric, but to some extent it makes us think that, unfortunately, we cannot specify whether, in the environment, there are chemical agents that permeate us or not. of the accident and who did not die immediately after the disaster, died a few years later, mostly due to respiratory failure, leukemia and other types of cancer. Thanks to technological advances in the last 20 years, the level of protection offered to workers working in hazardous chemical environments is increasingly more effective than it once was. There are hundreds of articles that highlight the risks and various literature cited by the NIOSH (National Institute for Occupational Safety and Health), the American agency responsible for researching and producing recommendations on work-related injuries and illnesses.
The need for more protection and, consequently, prevention in occupational exposure to antineoplastic drugs and dangerous drugs is highlighted by NIOSH. The evidence confirmed by the compiled studies brings reports that professionals of this practice, sooner or later, may suffer rashes, infertility, spontaneous abortion, birth defects, leukemia and even other types of cancer.
As we are not talking about anything new for cancer pharmacists so far, thinking about Brazilian practice, in May 2018, Fundacentro (Jorge Duprat Figueiredo Safety and Occupational Medicine Foundation) published the technical report on Unhealthy Exposure to Chemotherapics. Antineoplastics. The author of the technical opinion of Fundacentro, Érica Lui Rei n hardt, a researcher at the Chemical Agents Service of the Coordination of Occupational Hygiene, presented a bibliographic review that recognizes the need for more safety for professionals who handle antineoplastic agents.
“There is a proven risk in this work activity. And, when it comes to more security, society needs to start looking first for the implementation of all available protection resources, including the newest ones ”, he mentions. According to her, this report was requested by the Ministry of Labor of the previous government to permeate a possible standardization or readjustment in the payment of unhealthiness to the professionals of the class.
“All professionals need a good salary. They also need the employer to provide the best protection for the job. The simple discussion of more or less money for unhealthiness will not protect this professional from developing cancer in the future. And it is this protection that is worthwhile in the long run ”, says Érica, bringing the health of the worker to the focus of the discussion.
As the CLT is not specific about which agents are harmful or not, the Ministry of Labor started to establish Regulatory Norms over the years. In this case, of the antineoplastic chemotherapeutics, characterized as chemical agents, there is no clear provision in NR 15 for framing the unhealthy or any specification for mandatory more protection for workers.
According to lawyer Bruna Caroline Ribeiro de Moura Mafioleti, from the Pansieri Campos Advogados office, the characterization of unhealthy activity occurs when employees are exposed to agents harmful to health, above the tolerance limits set due to the nature and intensity of the agent and the time of exposure to its effects, pursuant to art. 189, of the CLT, making it possible to eliminate or at least neutralize unhealthiness by adopting measures that keep the work environment within tolerance limits.
“The big question is that there is no in-depth scientific study that attests to the amount of an antineoplastic substance and how long this exposure is needed for a person to develop cancer. Thus, I believe that if there are more complete and resistant mechanisms for supplying PPE (Individual Protection Equipment), as is the case with closed system connectors, added to the caution in handling these drugs, it is possible that there is an alignment of unhealthy ”, says the lawyer, pointing out that the certainty is that no existing PPE fulfills the role of eliminating all risk of contamination to the worker.
It is important to remember that closed system devices are not PPE. By definition, PPE is what the worker wears on his own body, providing protection that is exclusively individual. These connectors are not used on the worker's body and protect several workers.
Until the publication of this report, we were unable to obtain a response from the Ministry of Economy, whose body is responsible for the former functions of the Ministry of Labor, regarding the positioning of the body before the publication of Fundacentro's technical opinion.
According to the Pharmacy Council, a working group has been working since 2015 for the Tripartite Commission to amend NR 15.
