Tens of thousands of NHS cancer nurses are routinely exposed to toxic chemotherapy and other hazardous drugs—yet many are given only basic plastic aprons and gloves as protection, a new investigation reveals. The inadequate personal protective equipment (PPE) has left staff at heightened risk of miscarriage, infertility, and a range of serious health issues, according to a survey of 747 UK cancer nurses and firsthand accounts from frontline workers.
The risks are well-documented: exposure to chemotherapy and drugs used to treat conditions like rheumatoid arthritis, HIV, and multiple sclerosis can cause miscarriage, birth defects, liver damage, and long-term infertility. Last September, the NHS West Midlands Cancer Alliance itself warned that “inadequate control measures” could lead to these particularly outcomes. Yet, despite global alerts—including from the US Centers for Disease Control and Prevention—UK guidelines continue to allow NHS trusts to provide what amounts to the “bare minimum” in protective gear.
For Alison Simons, a cancer nurse with more than two decades of experience, the consequences hit close to home. She suffered three miscarriages during her career, only later realizing her years of administering chemotherapy with little more than a plastic apron and wrist-length gloves may have played a role. “When I was giving chemo, all we wore were plastic aprons and gloves to our wrists,” she recalls. “I experienced three miscarriages, and at first, I didn’t make any link between giving chemotherapy at all. It was my GP who said, ‘You give chemotherapy, don’t you?’”
Simons is now a senior lecturer and doctoral student at Birmingham City University, where she continues to advocate for change. “We know We find things out there to protect us, and they’re not being used,” she says. “It does beg the question: are we not worth it?”
Exposure and Health Risks: What the Data Shows
A peer-reviewed survey of 747 UK cancer nurses, published in March 2025, found that 97% reported using only plastic aprons as their primary PPE when administering cytotoxic drugs. Just 62% were provided with gloves specifically labeled for chemotherapy use, while 53% received general-purpose gloves—far below the standards recommended by occupational safety experts. Of those surveyed, 161 nurses reported experiencing health impacts directly linked to their work, including headaches, hair loss, fatigue, skin irritation, nausea, dizziness, and miscarriage.
Samantha Toland, a nurse consultant in cancer care for 26 years and lead cancer therapy nurse at Worcestershire Acute Hospitals Trust, echoes these concerns. She too experienced a miscarriage between her two children, and has seen colleagues endure multiple miscarriages—some as many as six or seven—due to inadequate protections. “The concern is that nurses are not getting the level of protection they should have,” Toland says. “There’s that feeling when you know there are things that could help, and nobody seems to be putting those into place.”
Why Are Protections So Inadequate?
Experts say the UK’s approach to protecting cancer nurses lags behind international standards. In the US, healthcare workers are routinely provided with full surgical gowns, masks, and double-gloving. Here, the current UK regulations require exposure to hazardous substances to be “as low as reasonably practical”—a standard that critics argue is too vague and open to interpretation. The Royal College of Nursing (RCN) has called for this to be strengthened to “the lowest possible level,” arguing that the current wording has led to wide variations in how hospitals implement protections.
Professor Karen Campbell, a former president of the UK Oncology Nurse Society and associate professor in cancer nursing, has spent decades advocating for safer practices. Her survey results underscore the gap between what is known and what is done. “The risks posed by these medicines have been known for decades,” she says. “But the consequences are more visible now because of the growing number of people undergoing cancer treatment. It’s particularly frustrating because we know there are things out there to protect us, and they’re not being used.”
What Are the Solutions—and Who Is Pushing for Change?
One proven solution is the use of “closed system transfer devices” (CSTDs)—mechanically sealed, leak-proof containers for chemotherapy drugs. These devices significantly reduce the risk of exposure during both preparation and administration. However, only 44% of nurses in the survey reported consistently using CSTDs. The RCN and other professional bodies are urging the Health and Safety Executive (HSE) and government to mandate stronger controls, including the adoption of CSTDs and more robust PPE standards.
Labour MP Luke Akehurst, who received chemotherapy himself in 2009, has raised the issue with ministers. “This represents about the NHS staff who are there for when you are really acutely ill,” he says. “These are the people who are saving your life through cancer treatment, and none of us who have been through life-threatening illness would ever want the staff who are helping us to have their health damaged.”
An NHS spokesperson acknowledged the duty to protect staff but noted that trusts have clear legal obligations and guidance in place. A government spokesperson added that the HSE is actively reviewing the evidence and considering whether further action or clearer guidance is needed.
Next Steps: What’s Happening Now?
The HSE is currently reviewing the evidence presented by professional bodies and staff concerns. While no immediate changes have been announced, the RCN and other advocates are pressing for a swift response. The next critical checkpoint will be the outcome of the HSE’s review, which could lead to updated national guidelines or even new regulations to ensure all NHS trusts provide the highest level of protection for their staff.
For now, the call to action is clear: nurses and their unions are demanding that the government and NHS take immediate steps to implement minimum standards for the control of hazardous medicines. As Professor Campbell warns, “You have to protect your workers, or ultimately you won’t have anybody working in the NHS.”
Have you or someone you know experienced similar issues in the NHS? Share your story in the comments below or on our social media channels. Together, we can push for the change that cancer nurses—and all healthcare workers—deserve.
