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Page last reviewed: 01/21/2011
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Highlights |
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- Washington State Department of Labor & Industries Hazardous Drugs Rule. Adopted on January 3, 2012 and will take effect in stages beginning January 1, 2014.
- Work precautions for handling hazardous drugs highlighted by NIOSH, OSHA, Joint Commission. OSHA Trade News Release, (2011, April 7).
- Healthcare Wide Hazards - Hazardous Chemicals. OSHA Hospital eTool. Provides hazards and solutions for employee exposure to hazardous chemicals, such as pesticides, disinfectants, and hazardous drugs in the workplace.
- Pharmacy. Reviews safety and health topics related to hazardous drugs including drug handling, administration, storage, and disposal.
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Hazardous Drugs
Worker exposure to hazardous drugs has been identified by OSHA as a problem of increasing health concern. Preparation, administration, manufacturing, and disposal of hazardous medications may expose hundreds of thousands of workers, principally in healthcare facilities and the pharmaceutical industry, to potentially significant workplace levels of these chemicals. Antineoplastic cytotoxic medications, anesthetic agents, anti-viral agents, and others, have been identified as hazardous. These hazardous medications are capable of causing serious effects including cancer, organ toxicity, fertility problems, genetic damage, and birth defects.
Hazardous drugs are addressed in specific standards for the general industry.
Standards
This section highlights OSHA standards and standard interpretations (official letters of interpretation of the standards) and State standards related to hazardous drugs.
OSHA
Note: Several states and territories have OSHA-approved State Plans and have adopted their own standards and enforcement policies. For the most part, these States adopt standards that are identical to Federal OSHA. However, some States have adopted different standards applicable to this topic or may have different enforcement policies.
General Industry (29 CFR 1910)
- 1910.1020, Access to employee exposure and medical records. OSHA requires the reporting of employee exposure to hazardous medications, and allows access to these records by employees.
- 1910.1200, Hazard communication. Includes the coverage of drugs and pharmaceuticals in the non-manufacturing sector. Requires any drugs posing a health hazard (with the exception of those in solid, final form for direct administration to the patient, i.e., tablets or pills) be included on lists of hazardous chemicals to which employees are exposed. In compliance with this standard all personnel involved in any aspect of the handling of covered hazardous medications must receive information and training to appraise them of the hazards in the work area. [related topic page]
Standard Interpretations
State
Note: These are NOT OSHA regulations. However, they do provide guidance from their originating organizations related to worker
protection.
- Hazardous Drugs Rule. Washington State Department of Labor & Industries. Adopted on January 3, 2012 and will take effect in stages beginning January 1, 2014.
Hazards and Solutions
The following references aid in recognizing and controlling hazards associated with hazardous drugs in the workplace.
Hazard Recognition
- NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings 2012 [672 KB PDF, 20 pages]. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2012-150, (2012).
- Yodaiken RE, and D. Bennett."OSHA Work-Practice Guidelines for Personnel Dealing with Cytotoxic (Antineoplastic) Drugs." American Journal of Hospital Pharmacy 43.5(1986, May): 1193-204. Reviews the short and long-term hazards known to be associated with cytotoxic (antineoplastic) drugs and work-practice guidelines that can limit exposure to workers. [For updated and expanded information see "Controlling Occupational Exposure to Hazardous Drugs" below.]
- OSHA Technical Manual (OTM). OSHA Directive TED 01-00-015 [TED 1-0.15A], (1999, January 20).
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Occupational Exposure to Antineoplastic Agents. National Institute for Occupational Safety and Health (NIOSH) Workplace Safety and Health Topic.
- Preventing Occupational Exposure to Antineoplastic and Other Hazardous Drugs in Health Care Settings: Appendix A - Drugs Considered Hazardous [4 MB PDF, 58 pages]. US Department of Health and Human Services (DHHS), National Institute of Occupational Health and Safety (NIOSH) Publication No. 2004-165, (2004, September). Provides an annually updated list of drugs considered hazardous.
- NIOSH Warns: Nitrous Oxide Continues to Threaten Health Care Workers. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 94-118, (1994, June 14). NIOSH has issued a warning to medical, dental, and veterinary professionals who work with nitrous oxide (N2O). The Institute warns that even with preventive measures such as scavenging systems in place these workers may be at risk for serious health effects due to their exposure.
- Guidelines for Protecting the Safety and Health of Health Care Workers. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 88-119, (1988, September). Addresses the risks that nurses and pharmacists face from contact with pharmaceuticals.
- Drugs. US Food and Drug Administration (FDA).
Possible Solutions
- Safe Handling of Hazardous Drugs for Veterinary Healthcare Workers [678 KB PDF, 4 pages]. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2010-150, (2010, June).
- Occupational Exposure to Antineoplastic Agents. National Institute for Occupational Safety and Health (NIOSH) Safety and Health Topic.
- NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings 2010 [747 KB PDF, 16 pages]. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2010-167, (2010, September). This update adds 21 drugs to the original list in the 2004 Alert. These additions are new drugs or existing drugs that had new warnings from 2004 to 2007.
- Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings [4 MB PDF, 58 pages]. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 2004-165, (2004, September). Provides health care workers and employers with measures for minimizing exposure to hazardous drugs.
- National Occupational Research Agenda (NORA) - Celebrating NORA, 1996-2006. National Institute for Occupational Safety and Health (NIOSH). NIOSH has formed NORA to examine how to minimize worker exposure to hazardous drugs used in the healthcare industry.
- OSHA Technical Manual (OTM). OSHA Directive TED 01-00-015 [TED 1-0.15A], (1999, January 20).
- Controlling Exposures to Nitrous Oxide During Anesthetic Administration. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 94-100, (1996, August 5). Provides occupational exposure limits, guidelines for minimizing worker exposure, engineering controls, and maintenance procedures.
Additional Information
Related Safety and Health Topics Pages
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