HAZARDOUS DRUG EXPOSURES IN HEALTH CARE

Muti-channel infusion pump for delivery of chemotherapy

Health care workers who prepare or administer hazardous drugs (e.g., those used for cancer therapy, and some antiviral drugs, hormone agents, and bioengineered drugs) or who work in areas where these drugs are used may be exposed to these agents in the workplace. About 8 million U.S. healthcare workers are potentially exposed to hazardous drugs, including pharmacy and nursing personnel, physicians, operating room personnel, environmental services workers, workers in research laboratories, veterinary care workers, and shipping and receiving personnel.

It seems counter-intuitive that the health care industry, whose mission is the care of the sick, is itself a "high-hazard" industry for the workers it employs. In fact, published studies have shown that workplace exposures to hazardous drugs can cause both acute and chronic health effects such as skin rashes, adverse reproductive outcomes (including infertility, spontaneous abortions, and congenital malformations), and possibly leukemia and other cancers. The health risk depends on how much exposure a worker has to these drugs and how toxic they are. Workers can be protected from exposures to hazardous drugs through engineering and administrative controls, and proper protective equipment.

The National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention (CDC) has made updates to Appendix A in the NIOSH Alert: Preventing Occupational Exposure to Antineoplastic and Other Hazardous Drugs in Health Care Settings. This list includes drugs reviewed by NIOSH from June 2007 to December 2009. The current proposed additions and deletions to the list of hazardous drugs supersede the 2004 list and the 2010 list. Additional information for the 2012 update can be found at: Federal Register Notice.

If you have any questions regarding hazardous drugs please submit them to hazardousdrugs@cdc.gov.

Publications

NIOSH Alert: Preventing Occupational Exposures to Antineoplastic and other Hazardous Drugs in Healthcare Settings
DHHS (NIOSH) Publication No. 2004-165 (2004)
In this Alert, NIOSH presents a standard precautions or universal precautions approach to handling hazardous drugs safely: that is, NIOSH recommends that all hazardous drugs be handled as outlined in this Alert. Therefore, no attempt has been made to perform drug risk assessments or propose exposure limits. The area of new drug development is rapidly evolving as unique approaches are being taken to treat cancer and other serious diseases.

NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings 2012
DHHS (NIOSH) Publication No. 2012-150 (June 2012)

NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings 2010
DHHS (NIOSH) Publication No. 2010-167 (September 2010)

Workplace Solutions: Safe Handling of Hazardous Drugs for Veterinary Healthcare Workers
DHHS (NIOSH) Publication No. 2010-150 (June 2010)
Veterinary healthcare employees working where hazardous drugs are handled may face health risks. Many of these workers treat small companion animals (primarily cats and dogs), but also larger animals such as horses, with antineoplastic and other drugs that may be hazardous to humans.

Personal Protective Equipment for Health Care Workers Who Work with Hazardous Drugs
DHHS (NIOSH) Publication No. 2009-106 (2008)
Health care workers who handle hazardous drugs are at risk of skin rashes, cancer, and reproductive disorders. NIOSH recommends that employers provide appropriate personal protective equipment (PPE) to protect workers who handle hazardous drugs in the workplace.

Workplace Solutions: Medical Surveillance for Health Care Workers Exposed to Hazardous Drugs
DHHS (NIOSH) Publication No. 2007-117 (2007)
Health care workers who handle, prepare, or administer hazardous drugs may face risks to their own health such as skin rashes, cancer, and reproductive disorders.
En Español

Workplace Solutions: Preventing Worker Deaths and Injuries When Handling Micotil 300^®
DHHS (NIOSH) Publication No. 2007-124 (2007)
Livestock producers, veterinarians, and other workers may be exposed to the toxic hazards of the animal antibiotic Micotil 300® through needlestick injuries, skin cuts, puncture wounds, and contact with skin and mucous membranes.