Safe Handling of Hazardous Drugs

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Introduction

Guidelines for the safe handling of hazardous drugs have been available for nearly 20 years. Although the recommended guidelines have not changed significantly during that time, the information related to the potential for occupational exposure has changed. Evidence of contamination in healthcare work environments with hazardous drugs has been reported in the occupational health literature since the early 1990s. This information regarding potential health risks, considered together with the fact that nearly six million healthcare workers handle hazardous drugs (U.S. Department of Commerce, 1999), points to the need to focus on safe handling education for nurses.

This module is in its third edition. One change in this edition is the use of the term "hazardous" rather than "cytotoxic" when referring to drugs that require special handling. Not all drugs that should be handled as hazardous are cytotoxic (such as the genotoxic biologic agent interferon); thus, the term "hazardous" is more inclusive and appropriate (American Society of Health-System Pharmacists [ASHP], 1990).

The earlier editions of the module were written in outline form, whereas this edition reads more like a book. The format allows for a more thorough discussion of the content. Several new tables and figures are included to summarize the important points that are described in more detail in the text.

the module is based on the recommendations of the Oncology Nursing Society (ONS), the Occupational Safety and Health Administration (OSHA), and ASHP. Our intent is to help to translate the recommendations into practice for nurses who administer hazardous drugs in the care of patients. More importantly, nurses are invited to critically examine their work practices in order to identify activities that might result in exposure and to change practices that might put them and their colleagues at risk.