Received: 7 July 2020 | Revised: 16 September 2020 | Accepted: 18 September 2020 DOI: 10.1002/ajim.23192 BRIEF REPORT Occupational exposures to hazardous chemicals and agents among healthcare workers in Bhutan Rajni Rai MPH 1 | Sonia El‐Zaemey PhD 1 | Nidup Dorji PhD 2 | Lin Fritschi PhD 1 1 School of Public Health, Curtin University, Bentley, Western Australia, Australia 2 Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan Correspondence Rajni Rai MPH, School of Public Health, Curtin University, Kent St, Bentley, WA 6102, Australia. Email: rajni.rai@postgrad.curtin.edu.au Funding information Australian Government Research Training Program Scholarship Abstract Background: Occupational exposures to hazardous chemicals among healthcare workers can result in long‐term adverse health outcomes. Research on such ex- posures from low‐ and middle‐income countries is limited. The aim of this study was to estimate the prevalence of exposures to a range of chemicals used in healthcare settings among Bhutanese healthcare workers. Methods: A cross‐sectional study was conducted among healthcare workers (n = 370) working in three hospitals in the western region of Bhutan. Demographic and occupational information was collected, and exposures to asthmagens, carci- nogens, ototoxic and other agents were assessed using a web‐based tool. The prevalence of exposure to these chemicals was calculated and the circumstances resulting in such exposures were examined. Results: The prevalence of exposure to one or more asthmagen, carcinogen, and ototoxic agent was 98.7%, 28.1%, and 7.6%, respectively; and was 6.2% for anesthetic gases and 2.2% for antineoplastic drugs. The most common exposures were to latex, and cleaning and disinfecting agents in the asthmagens group; formaldehyde in the carcinogens group; and p‐xylene among ototoxic agents. The circumstances resulting in exposures were using latex gloves, using bleach and chlorhexidine for cleaning, using formaldehyde as a disinfectant and in the laboratory, and using p‐xylene in the laboratory. Conclusions: The results indicate that a large proportion of Bhutanese healthcare workers are occupationally exposed to chemicals linked to chronic diseases, with exposure prevalence higher than in high‐income countries. The study provides in- formation that can be used to formulate policies and to implement control measures to protect healthcare workers. KEYWORDS developing country, hazardous chemicals, healthcare workers, occupational exposures, prevalence 1 | INTRODUCTION Healthcare workers are occupationally exposed to a wide range of hazardous chemicals that can result in long‐term adverse health effects. 1 Exposures to cleaning and disinfecting agents and latex have been associated with occupational asthma among healthcare workers. 2 Ethylene oxide, antineoplastic drugs, and formaldehyde have been linked to cancers such as hematological, breast, and nasopharyngeal cancers. 3–5 Exposures to anesthetic gases and antineoplastic drugs have been associated with an increased risk of spontaneous abortions and congenital anomalies. 4,6 Am J Ind Med. 2020;1–7. wileyonlinelibrary.com/journal/ajim © 2020 Wiley Periodicals LLC | 1