Safe Handling of Hazardous Drugs

From


Recommendations for the safe handling of hazardous drugs have been available for more than twenty years. Evidence for continued risk of occupational exposure is abundant; however, nurses' use of the recommended precautions is not universal. This may be related to a lack of information or to a lack of serious concern for the potential hazards. This article includes a discussion of current issues related to handling hazardous drugs in the workplace and a review of the history of safe handling guidelines, current recommendations, and barriers to implementing guidelines in health care settings.


Hazardous drugs are drugs that pose a potential health risk to health care workers who may be exposed during preparation or administration. Such drugs require special handling because of their inherent toxicities. While most drugs are hazardous because they are cytotoxic, drugs from other categories are potentially harmful (such as the antiviral agent gancyclovir). Currently, the term "hazardous" is preferred over "chemotherapy" or "antineoplastic" because is it is more inclusive of drugs that present a risk


Drugs that meet one or more of the following criteria should be handled as hazardous:

• Carcinogenicity
• Teratogenicity or developmental toxicity
• Reproductive toxicity
• Organ toxicity at low doses
• Genotoxicity
• Structure or toxicity similar to drugs classified as hazardous using the above criteria

From Preventing Occupational Exposures To Antineoplastic And Other Hazardous Drugs In Healthcare Settings. (NIOSH, 2004)


Author

Martha (Marty) Polovich, MN, RN, AOCN
E-mail: marty.polovich@southernregional.org

Martha Polovich is an Oncology Clinical Nurse Specialist at Southern Regional Health System in the South suburban Atlanta area. She has been caring for persons with cancer and administering chemotherapy since 1980. Ms. Polovich has been a trainer and instructor trainer for the Oncology Nursing Society’s Cancer Chemotherapy Course since 1998. She is co-editor of the ONS publication Chemotherapy and Biotherapy Guidelines and Recommendations for Practice (2001) and editor of Safe Handling of Hazardous Drugs (2003).
Ms. Polovich represents the Oncology Nursing Society on the National Institute for Occupational Safety and Health (NIOSH) Hazardous Drug Safe Handling Working Group. She participated in the preparation of the NIOSH Alert "Reducing Occupational Exposure to Antineoplastic and Other Hazardous Drugs in Health Care Settings" which was published online in March 2004 and is available at: www.cdc.gov/niosh/docs/2004-HazDrugAlert/pdfs/2004-HazDrugAlert.pdf.