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NIOSH Alert: Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings [report]
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2004/09/01
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Series: NIOSH Numbered Publications
[PDF-2.21 MB]
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Alternative Title:Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings [report]
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Description:Foreward: The purpose of this Alert is to increase awareness among health care workers and their employers about the health risks posed by working with hazardous drugs and to provide them with measures for protecting their health. Health care workers who prepare or administer hazardous drugs or who work in areas where these drugs are used may be exposed to these agents in the air or on work surfaces, contaminated clothing, medical equipment, patient excreta, and other surfaces. Studies have associated workplace exposures to hazardous drugs with health effects such as skin rashes and adverse reproductive outcomes (including infertility, spontaneous abortions, and congenital malformations) and possibly leukemia and other cancers. The health risk is influenced by the extent of the exposure and the potency and toxicity of the hazardous drug. To provide workers with the greatest protection, employers should (1) implement necessary administrative and engineering controls and (2) assure that workers use sound procedures for handling hazardous drugs and proper protective equipment. The Alert contains a list of drugs that should be handled as hazardous drugs. This Alert applies to all workers who handle hazardous drugs (for example, pharmacy and nursing personnel, physicians, operating room personnel, environmental services workers, workers in research laboratories, veterinary care workers, and shipping and receiving personnel). Although not all workers in these categories handle hazardous drugs, the number of exposed workers exceeds 5.5 million. The Alert does not apply to workers in the drug manufacturing sector. The production, distribution, and application of pharmaceutical medications are part of a rapidly growing field of patient therapy. New areas of pharmaceutical development will bring fundamental changes to methods for treating and preventing diseases. Both traditional medications and bioengineered drugs can be hazardous to health care workers who must handle them. This NIOSH Alert will help make workers and employers more aware of these hazards and provide the tools for preventing exposures.
Conclusions: Recent evidence in the Alert summarized in this Alert documents that worker exposure to hazardous drugs is a persistent problem. Although most air-sampling studies have not demonstrated significant airborne concentrations of these drugs, the sampling methods used in the past have come into question [Larson et al. 2003] and may not be a good indicator of contamination in the workplace. In all studies involving examination of surface wipe samples, researchers have determined that surface contamination of the workplace is common and widespread. Also, a number of recent studies have documented the excretion of several indicator drugs in the urine of health care workers. Results from studies indicate that worker exposure to hazardous drugs in health care facilities may result in adverse health effects. Appropriately designed studies have begun and are continuing to characterize the extent and nature of health hazards associated with these ongoing exposures. NIOSH is currently conducting studies to further identify potential sources of exposure and methods to reduce or eliminate worker exposure to these drugs. To minimize these potentially acute (short-term) and chronic (long-term) effects of exposure to hazardous drugs at work, NIOSH recommends that at a minimum, employers and health care workers follow the recommendations presented in this Alert.
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Pages in Document:58 pdf pages
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Contributor:Coyle, Barbara J.;Hammond, Duane R.;Leone, Melissa M.;Polovich, Marty;Sharpnack, Douglas D.;Hamilton, Anne C.;Becks, Vanessa;Afanuh, Susan;Weber, Jane;Allen, Andre;Votaw, Anne;Lewis, Teresa;
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NIOSHTIC Number:20025411
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NTIS Accession Number:PB2004-107262
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Citation:Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2004-165, 2004 Sep; :1-50
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Federal Fiscal Year:2004
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Peer Reviewed:False
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Resource Number:DHHS (NIOSH) Publication Number 2004-165
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