Managing the Risks of Employee Exposure to Hazardous Drugs

September 1, 2010 | Healthcare Risk, Quality, & Safety Guidance


Healthcare workers may be exposed to antineoplastic drugs—drugs used to treat cancer patients—and other hazardous drugs in the air or on work surfaces, clothing, medical equipment, and patient waste. Workers exposed to hazardous drugs may develop acute effects, such as rashes; chronic effects, such as reproductive problems; or possibly cancer. Exposure risks can be reduced by ensuring that the necessary engineering and administrative controls are used and by employing proper procedures and using proper personal protective equipment (PPE) when handling hazardous drugs. (NIOSH “Preventing”)

A hazardous drug is defined by the Occupational Safety and Health Administration’s (OSHA) hazard communication standard as “any chemical which is a physical hazard or a health hazard.” A health hazard is defined as a chemical for which there exists substantial statistical evidence that the chemical may cause acute or chronic health effects in exposed employees. (OSHA “Hazard”)

Drugs that are classified as hazardous exhibit one or more of the following characteristics in humans or animals (NIOSH “Preventing”):

This Risk Analysis discusses the various issues related to protecting healthcare workers from hazardous drugs. Specifically, the following topics are addressed:

Pharmacists who prepare antineoplastic agents (i.e., cancer chemotherapy drugs, cytotoxic drugs) and nurses who prepare or administer these drugs are the two occupational groups who have the greatest risk of exposure to such agents. Physicians and operating room (OR) personnel may also be exposed when treating patients who are being treated with these drugs. Additionally, hospital staff—including shipping and receiving staff, custodial workers, laundry workers, waste handlers—as well as workers in veterinary practices where hazardous drugs are used all have exposure risks. (NIOSH...

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