This document has been superseded and the new version can be found https://stacks.cdc.gov/view/cdc/175047 : NIOSH researchers conducted a field survey at Veterinary Hospital C in July 2017. The purpose of the site visit was to identify and evaluate hazardous drug engineering controls as well as to sample for potential surface contamination at the hospital. NIOSH researchers also observed and interacted with the hospital's veterinarians and staff to obtain information about the hazardous drug work practices, daily activities, and oncology treatment processes. A TSI VelociCalc(TM) Plus Model 9565-P thermal anemometer was used to measure air velocities at the face of the biological safety cabinet (BSC), while a Wizard Stick handheld smoke generator was used to visualize air movement inside and around the periphery of the hood. Both the qualitative and quantitative tests showed that the BSC was operating appropriately. The BSC's average face velocity measured (0.51 m/s [131 fpm]) which was above the minimum recommended face velocity of 0.51 m/s (100 fpm) for a Class II Type A2 BSC. A TSI Accubalance Plus Air Capture Hood Model 8373 was used to measure the supply (0.42 m3/s or 884 cfm) and exhaust (0.09 m3/s or 201 cfm) ventilation in the oncology department. The air changes per hour (ACH) of the oncology department was calculated to be 7, which is less than the required ACH (minimum 12 ACH) for an unclassified containment segregated compounding area. The presence of potential surface contamination was evaluated with wipe samples. These were collected in areas where the staff handled chemotherapy drugs within the oncology department. Wipe samples were also collected in less obvious places (i.e., telephone, door handles, floor of nearby restroom) to determine if current workplace safety practices at the hospital were adequate to prevent inadvertent contamination of these surfaces. Sampling and analytical procedures varied by the hazardous drug for which they would be evaluated (i.e., the analyte). In some cases, a single sample could be evaluated for more than one analyte simultaneously. Carboplatin, cyclophosphamide, lomustine, vincristine, mitoxantrone, and doxorubicin were the only hazardous drugs actually in use during the NIOSH visit. Sample analyses results revealed that 16 of 18 wipe samples submitted were non-detectable (ND) for toceranib, lomustine, and chlorambucil. Fifteen of 15 wipe samples, including a mop strand, submitted for N-methyldiethanolamine (MDEA) were positive (6.4 to 145 ng). Five of 5 wipe samples submitted for toceranib, chlorambucil, and lomustine were positive for only toceranib (0.042 to 0.14 ng). MDEA was monitored as a potential stable marker for the highly unstable antineoplastic drug mustargen as explained in the text. Four out of 9 samples submitted for carboplatin were positive (5.3 to 230,000 ng/sample). Twelve out of 36 samples submitted were positive for vincristine (10,000 ng/sample), methotrexate (5.3 to 480 ng/sample), cyclophosphamide (5.8 to 1,400 ng/sample), and doxorubicin (19,000 ng/sample) while simultaneously being ND for epirubicin. The ND determination means that contamination was either not present, or was present at levels below the detectable limit of the analytical method. In some cases, NIOSH researchers collected wipe samples on certain surfaces that were highly anticipated to contain drug contamination (e.g. suspected drug droplet at end of a CSTD connection). This strategy was done to verify the analytical methods' ability to detect drug contamination under the sampling, handling, shipping variables specific to this evaluation. These "known" contaminated samples were for carboplatin (230,000 ng/sample), vincristine (10,000 ng/sample), and doxorubicin (19,000 ng/sample). Although many of the wipe sample analytical results were ND, there is no safe level of exposure when handling hazardous drugs. The presence of the carboplatin, cyclophosphamide, toceranib, and MDEA contamination is a reminder that the patients themselves can be a source of exposure, even when the drugs are not being directly handled. The cyclophosphamide and methotrexate presence (on surfaces) serves as two reminders: (1) that hazardous drug contamination can sometimes linger despite cleaning efforts and (2) the detected contamination on desk and cabinet surfaces one might ordinarily think of as "safe", emphasizes the importance of proper work practices regarding the use of gloves and shoe covers, hand washing, and food/drink prohibitions within the hazardous drug handling environments. The detected contamination on the outside of the chemo transport bag serves as a reminder of the meticulous work practices required to avoid cross-contamination of surfaces expected to be "clean" as well as a reminder to treat all surfaces as potentially contaminated within the oncology treatment areas. Therefore, it is important to continue to use engineering controls (e.g., biological safety cabinets), supplementary controls (e.g., closed system drug-transfer devices), protective work practices (e.g., surface cleaning after every oncology patient, regardless of whether I.V. chemotherapy was administered), and personal protective equipment (e.g., gloves and gowns rated for chemotherapy protection, respirators, shoe covers, eye protection) to reduce unintentional exposures to the staff or pet owners. Additionally, the detection of drug contamination on the floor mop is a reminder that cleaning tools and supplies used in these areas should be dedicated for that purposes alone, and should not be used for cleaning of adjacent areas not expected to be exposed to hazardous drugs.