Rennes (AFP)
Retired nurses and caregivers, they have cared for cancer patients in Rennes all their lives, before contracting the disease.
Exposed to ionizing radiation and to the chemotherapy drugs they were handling, they demanded compensation and recognition of an occupational disease.
"In the years 1970-1980, we prepared chemotherapy with bare hands on the bench, without a hood to suck toxic fumes, without a mask and even without gloves, while today the nurses are dressed like cosmonauts", testifies Colette (the first names are changed), 70 years old, former nurse at the Center for the fight against cancer Eugène-Marquis (CEM) in Rennes, a private non-profit establishment.
"Sometimes the glass syringes would leak, the patients would tear off their chemotherapy drip or vomit on us. We had it everywhere. We were losing our hair, our eyes were hurting, our head hurts", adds Irene, 80, suffering from colon cancer, which, like three other former colleagues, presented an application for recognition of occupational disease.
The caregivers also had to administer radioactive iodine-based treatments, handle radium needles, and quantify urine soaked with radioactivity.
“Some patients were walking around with needles that spit out radioactivity. We were told to act quickly but no one warned that it could be so dangerous,” says Thérèse, 71, who is fighting ovarian cancer.
"There were no leaded rooms like today. The patients were 15 per room, it radiated everywhere and we only had a lead apron as protection", adds the former nurse who mentions simple "red ribbons" hung on the door handles to warn of the presence of radiation.
- "Not contagious" -
When questioned, the deputy director of the establishment Pascal Briot admits that a "red ribbon" as a measure of protection now seems "surreal".
"There is no question of denying the words of these people. I am simply showing my astonishment because at the time I was a caregiver in other establishments and I never noticed any deficiency", he explains .
An internal survey of doctors at the time "did not reveal any anomaly".
"The chemos were not prepared as today in isolators in the central pharmacy but in the departments by nurses, in compliance with the protection standards of the time," continues Mr. Briot.
Sylvie Heuveline, SUD union representative, identified seven employees who had miscarriages or gave birth to malformed babies between the end of 1970 and the beginning of 1980, like a baby born with a half heart.
"The effects of these therapies were probably not fully identified," she comments, citing "optional" protections in the 1980s. However, working conditions improved during this time, according to her, with the move into a new building.
Between 1980 and 2017, 25 employees with cancer were identified by one of the applicants, Marie-Pierre Sénéchal, a former nurse who died at 71 in November from double cancer.
"We were robbed of our lives. We were told that cancer was not contagious, so no risk," she testified in writing.
None of the four former caregivers of Eugène-Marquis has yet obtained recognition as an occupational disease, according to the Support Collective for Pesticide Victims of the West which assists them and for whom recognition is "a question of social justice in the face of to a locked medical environment ".
“Between 2013 and 2017, 1,840 occupational cancers were recognized on average per year, or 0.5% of new cancer cases”, indicates a report from the Health Insurance.
"80% are linked to asbestos and 95% are recognized in the tables of occupational diseases".
However, none of the cancers of Breton caregivers appears in these tables.
It is therefore up to the victims to demonstrate that their pathology is directly linked to their work and that occupational exposure has played an "essential" role in the onset of the disease.
In fact, certain cytotoxic drugs (used in chemotherapy, editor's note) are classified as "certain carcinogens" by the International Agency for Research on Cancer (IARC).
"The first IARC classifications date back to the 1980s. When we look at the pathologies for which a causal link is established with exposure to these carcinogens, we are mainly dealing with leukaemias, there is generally no causal link established with d 'other cancers,' underlines Béatrice Fervers, oncologist at the Léon-Bérard Center in Lyon.
Despite the scientific recognition of their carcinogenic nature, none of the cytotoxics appear in the European regulation which lists the substances "mutagenic and reprotoxic carcinogenic chemicals" (CMR) because they are considered as drugs.
However, it is this regulation that is required in the labor code.
In addition, "there are few epidemiological studies on the carcinogenic risk constituted by anticancer drugs for caregivers, while this concerns most hospital services", underlines Antoine Villa, toxicologist and occupational physician in Marseille.
It also regrets the absence of "toxicological reference value above which we know that there is an excess unacceptable risk of cancer".
- "Contamination" -
And if caregivers are exposed to much lower doses than patients, they can be exposed for decades.
According to the INRS (National Institute for Research and Safety), exposures continue today: in a study published in 2018, traces of anticancer drugs were found in the urine of 53% of the 250 hospital staff monitored.
Samples collected from doorknobs, sheets, etc. also revealed "frequent contamination".
Anticancer drugs present "risks that are all the more worrying (...) as knowledge is still insufficient to assess with certainty the long-term impact", warn the authors.
In Europe, discussions are underway to include chemotherapy drugs in the European directive "Carcinogens and mutagens".
Handling them "can lead to errors, spills, needle stick injuries and contamination which present obvious health risks," said the European Trade Union Institute.
In France, ANSES (National Health Security Agency) proposed in October to introduce 18 anticancer substances in carcinogens listed by the labor code.
"This will have consequences on the obligations of employers in terms of protection and prevention because it is part of the regulations", explains Henri Bastos, director of occupational health at ANSES, even if the entry in the tables of occupational diseases no is according to him "not on the agenda".
A situation deplored by Annie Thébaud-Mony, Honorary Research Director at Inserm.
"Due to the lack of epidemiological studies, these cancers are not taken into account, especially since it can take several decades between exposure and their occurrence", she recalls.
And even with studies, "it is a question of probabilities which do not lead to a certain demonstration".
According to this specialist in occupational cancers, on the other hand, it is "impossible" to argue that carcinogens have played no role in triggering the disease.
© 2021 AFP