Safe Handling of Cytotoxic Drugs


Safe Handling of Hazardous Drugs

Safe Handling of Hazardous Drugs – Protecting Healthcare Staff from Toxic Drugs

Many Suggestions are provided from past twenty years by healthcare providers and professionals on how to handle hazardous drugs. Studies showed that the exposure to hazardous drugs causes severe health conditions; especially healthcare workers are more prone to the exposure of these toxic drugs. However, nurses and doctors can avoid the exposure little bit if they take precautionary measures.  

But many people do not take the suggestions seriously; this is because of lack of understanding and lack of information on safe handling of hazardous drugs which helps protecting healthcare staff from toxic drugs.  It is very important to educate healthcare workers.  The healthcare organizations have to conduct special awareness programs especially to the workers who prepare and distribute the drugs to the cancer patients. This can be achieved if the healthcare organization can do the following methods:


• Conducting awareness programs and discussion on issues related to risks caused by hazardous drugs. 

• Educating hospital staff and making them understand how safe handling of hazardous drugs can help them prevent exposure.

• Alerting the hospital authorities and educating them on how to protect healthcare staff from toxic drugs.

• Make available of safe handling Guidelines, obstacles to implementing guidelines, current recommendation on healthcare settings, and etc.

Hazardous drugs are kind of drugs that cause a possible heath risk to hospital staff, which may get exposed at the time of preparation of the drug or administration the drug to cancer patient. Such toxic drugs need special handling because of their toxic compounds. While most cancer drugs are toxic such as cytotoxic drug, gancyclovir, etc.  Presently the term Hazardous is referred for antineoplastic or chemotherapy because it is the most comprehensive drug that causing risks to healthcare professionals.

Criteria for significant Hazardous Drugs: Drugs that fall under any of the following criteria must be considered as Hazardous:

- Carcinogenicity

- Developmental toxicity or Teratogenicity 

- Reproductive toxicity

- Genotoxicity

- Organ Toxicity at low-doses

- Toxicity or structure equal to drugs categorized as hazardous utilizing the above mentioned criteria.

Historical Perception

In World War I, the chemical called Nitrogen mustard was used as a chemical weapon. This chemical compound caused severe damages to the people who were exposed to the chemical; it caused lymph tissue and bone marrow regression in service men which were exposed to chemical product.  Therefore, the powerful chemical was used in a medicine to treat disease such as lymphoid malignancies.  This implementation is considered as the commencement of the modern era of Cancer Chemotherapy.  

In early 1950’s Radiation Therapy and Surgery were the major treatments for cancer. The NC (National Chemotherapy)program is a federal program  promoted in 1955,  supported the progress of new chemotherapy  compound. Due to the enhancement of technology and science, chemotherapy is now generally administered for the treatment of cancer-patients with both hematologic malignancies and sold tumors.  The United States FDA (Food and Drug Administration) approved eighty five drugs that were used in the treatment of cancer between 1949 and 1992, eighty five drugs in nest 8 years (1993-2000), and Thirty four drugs from 2001 to 2004.

OSHA Guidelines 

Occupation Safety and Health Administration (OSHA) published guidelines for the safe handling of hazardous drugs and described the usage of protective garments; safety equipment at work place can help the hospital staff prevent the exposure.   All nurses and pharmacists must understand the perspective of safety measurement and usage of closed system drug transfer devices can help them stop health risks caused by toxic drugs. 

Equashiled System evades the leakage of vapor droplets and offers complete aerosol protection when handling toxic drugs.  The Equashiled design confide on tightly-sealed double-membrane to supply connectors that stay dry and without any residue even with several entries by the jabs. An added advantage of Equashield is that the preset totally shielded needles reduce the risk for inadvertent stick injuries.