Cancer nurses are being exposed to hazardous medicines linked to an increased risk of miscarriage and infertility because NHS trusts are failing to provide adequate personal protective equipment (PPE), an investigation by The Independent and Channel 4 News has found.
Inadequate protection for healthcare workers
Tens of thousands of healthcare workers administer toxic drugs such as chemotherapy and treatments for rheumatoid arthritis, HIV, and multiple sclerosis. However, most are routinely provided only with a plastic apron and gloves as protection, according to the investigation.
Nurses have reported suffering recurrent miscarriages, which they believe may be linked to working unprotected on cancer wards. Other staff have experienced hair loss, nausea, dizziness, and fatigue. Without adequate PPE, workers can be exposed to hazardous products through inhalation, contact with contaminated surfaces or spills, or absorption through the skin.
Guidance and regulatory gaps
In September 2025, the NHS West Midlands Cancer Alliance published guidance warning that inadequate control measures could cause miscarriage, birth defects, liver damage, abnormal cell formations, abdominal pain, nasal sores, and vomiting. Several studies have linked exposure to these drugs with infertility issues among healthcare workers.
In the United States, the Centres for Disease Control and Prevention issued an alert about the risks posed by these drugs to healthcare workers. However, UK guidelines allow NHS trusts to provide the bare minimum for workers. The Health and Safety Executive (HSE) is now being urged to review the evidence concerning health risks to staff.
Personal stories of affected nurses
Alison Simons, a cancer nurse of more than two decades, fears her miscarriages were linked to working without necessary protections. Beginning her career in the mid-1990s, she said: "When I was giving chemo, all we wore were plastic aprons and gloves to our wrists. I experienced three miscarriages, and at first, I didn't make any link between giving chemotherapy at all. In fact, it was my GP who said you give chemotherapy, don't you?"
Ms Simons, now a senior lecturer in applied cancer practice and a doctoral student at Birmingham City University, warned that despite knowing what safety measures should be implemented, many trusts are still not putting them in place. "It's particularly frustrating because we know there are things out there to protect us, and they're not being used. It does beg the question, are we not worth it?" she asked.
Samantha Toland, a nurse consultant in cancer care for 26 years and lead cancer therapy nurse at Worcestershire Acute Hospitals Trust, said: "I, too, experienced a miscarriage in between my two children, but didn't think anything of it... It was more when I started teaching; we both concluded that this was bigger than we thought it was."
Ms Toland noted that her current trust is very good on the matter, but in previous workplaces controls were lacking. She said: "I've had colleagues who have had multiple miscarriages, up to six or seven, and had to be off work for most of their pregnancy."
Survey reveals widespread inadequate protection
Professor Karen Campbell, a former president of the UK Oncology Nurse Society (UKONS), published a study last year revealing that 97% of 747 nurses surveyed were primarily given only plastic aprons when administering cancer drugs. Just 62% were given the correct gloves labelled for use in chemotherapy, while 53% were given general-purpose gloves. Professor Campbell, who has been a cancer nurse for 30 years, described this as an inadequate level of protection and said the UK falls behind countries such as the US, where staff are routinely given full surgical gowns, masks, and are double-gloved.
Of those who answered the survey, 161 reported health impacts such as headaches, hair loss, fatigue, skin irritation, nausea, dizziness, and miscarriage. Additionally, only 44% of staff said they consistently used closed system transfer devices, which are mechanically sealed and leak-proof containers for chemotherapy drugs designed to cut the risk of exposure.
Call for action
Professor Campbell said that despite evidence of the risks, authorities have been reluctant to standardise practice. "I think it's probably a very big can of worms to open up... My main fear is that the workforce is quite young, it's women, and they don't have much of a voice. You [ministers] have to protect your workers, [or] ultimately you won't have anybody working in the NHS... why would you let them suffer?" she said.
Labour MP Luke Akhurst, who received chemotherapy himself in 2009 and has raised the issue with ministers, said the government had a duty to protect workers. "This is about the NHS staff who are there for when you are really acutely ill, these are the people who are saving your life through cancer treatment, and none of us who have been for life-threatening illness would ever want the staff who are helping us to have their health damaged," he said.
The Royal College of Nursing (RCN) is calling on the HSE and government to implement minimum standards for the control of hazardous medicines. Current regulations require employers to ensure that exposure is as low as reasonably practical, but the RCN said the wording is subjective and has led to variations in how hospitals implement protections. It wants the standard changed to the lowest possible level, which would require stronger controls from employers.
Louise Church, health, safety and wellbeing senior national officer for the RCN, said: "The RCN recognises that these are vital treatments for patients, but what we want to see is that nurses and staff are properly protected when they are handling and caring for patients using these substances."
An NHS spokesperson said: "The safety of NHS staff is paramount, and NHS trusts have a duty in law to protect staff from being exposed to hazardous medicinal products – with clear regulations and guidance in place on the handling of these substances."
