Occupational risk in health care and research

BACKGROUND: Working in the health care and research sectors has been linked to various hazards. METHODS: Studies published in the peer-reviewed literature that are pertinent to the exposures or diseases relevant to these fields were reviewed. RESULTS: The most important exposures include infectious agents, formaldehyde, anesthetic agents, antineoplastic drugs, and ethylene oxide. The best-documented evidence is that of infectious risk primarily among clinical personnel. Monitoring studies of persons occupationally exposed to anesthetics clearly demonstrate behavioral effects, possible risk of reproductive problems, as well as cytogenetic effects of unknown significance. The latter two impairments are also observed among those exposed to antineoplastic drugs and ethylene oxide. Exposure to formaldehyde appears to be associated with nasopharyngeal tumors. Whereas increased risk of cancer of certain sites, particularly the brain and lymphohematopoietic system, is found among research and health care personnel, no specific exposure has been linked to these neoplasms. CONCLUSIONS: Although some results are inconsistent, continued environmental and biological monitoring will allow better assessment of exposures and of implemented protection measures.