Many agents used for systemic anticancer therapy (SACT), which include chemotherapy drugs, monoclonal antibodies and other biological therapies, are known to be carcinogenic, teratogenic and mutagenic. Occupational exposure to SACT agents carries a proven risk of short- and long-term adverse health effects such as nausea, headaches, dizziness, hair loss, impaired fertility and cancer. The risk of contamination exists not only for staff who prepare or administer SACT agents, but also for those involved in transport, storage and waste disposal. In the UK, the handling of SACT agents is subject to a series of laws, regulations and guidelines. However, there are still inconsistencies in practice and a lack of awareness of the risks involved and need for training. The necessary preventive measures are not always in place and some staff remain exposed to cytotoxic agents. Furthermore, the risk of occupational exposure to SACT agents has intensified in recent years due to a significant increase in their use. This article prompts nurses to reflect on the health risks associated with handling SACT agents and the preventive and protective measures required.