Handling Hazardous Drugs in a Healthcare Environment

Some medications that are helpful to patients are, unfortunately, harmful to the healthcare workers who are exposed to the drugs. The National Institute for Occupational Safety and Health (NIOSH) report that, "about 5.5 million U.S. health care workers are potentially exposed to hazardous drugs, such as pharmacy and nursing personnel, physicians, environmental services workers, workers in research laboratories, veterinary care workers, and shipping and receiving personnel."

Harmful chemicals include those used for cancer therapy, some antiviral drugs, hormone agents, and bioengineered drugs. Possible routes of exposure are by inhalation, ingestion (from hand to mouth), injection, and skin absorption.

Depending on the degree of exposure and the level of toxicity, there can be serious repercussions from workplace exposures, including "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."

Through administrative and engineering oversight, healthcare workers can protect themselves by using biological safety cabinets, reducing the quantity of contaminants around them, containing the contaminants at their source, decreasing the time that workers spend in contaminated areas by modifying work schedules, and by utilizing personal protective equipment (PPE) whenever possible.

NIOSH suggests these general guidelines for appropriate PPE use and care:Select specific respirators and protective clothing based on an assessment of your potential exposure to hazardous drugs.Understand the proper use and limitations of any selected PPE to ensure that it functions properly.Use care in donning and removing all items to prevent damage to PPE and to reduce the spread of contamination.Ensure that all PPE fits correctly and is constructed of materials that are appropriate for hazardous drug exposure.Donning and removal of PPE should follow local hospital procedures and the manufacturer's instructions.When disposing personal protective equipment, according to NIOSH, "consider all PPE worn when handling hazardous drugs as being contaminated with, at a minimum, trace quantities of hazardous drugs. And, contain and dispose of such PPE either as trace or bulk contaminated waste."http://www.cdc.gov/niosh/topics/hazdrug/ http://www.cdc.gov/niosh/docs/wp-solutions/2009-106/
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