Luci Power was among the first pharmacists in the United States to pressure her employer to take warnings about chemo handling coming out of Europe in the early 1980s seriously.
The alarm was triggered by a letter from Finnish researchers published in Lancet in 1979. That study found evidence of exposure in nurses preparing and administering chemo. Their urine contained higher amounts of chemo drugs than control groups.
"That was a landmark," said Power.
The Australians had already moved to publish some English-language guidelines. Power learned of them through a friend and colleague.
But when she asked for more protective equipment for her staff at the University of California, San Francisco, no one took her seriously, she said. She ended up creating makeshift "personal protective equipment" out of welder's masks and other scavenged pieces.
Then one day, a team from Cal-OSHA happened to be in the hospital monitoring an asbestos abatement project in a room adjacent to where Power and her staff were mixing chemo. The team used her room as a base, so they could observe the asbestos removal from a safe distance.
When they saw the pharmacy staff working behind bright red welders' face shields, they were horrified, she said. They started asking questions.
The Cal-OSHA inspectors spoke to the hospital administration, she said. "After that I had all kinds of money."
That experience launched Power on what would become a 30-year career trying to get safety regulations for all clinical environments to become standard.
Now a consultant who speaks nationally to workers about safe handling methods, she's frustrated by how many of those who routinely handle chemo continue to seem oblivious to their risks.
"Awareness is a problem," she said. "And we have a new generation of nurses, pharmacists, technicians, who did not go through the early 1980s (battle to develop safe handling guidelines)," she said. "They probably think the problem has been solved."