Hazardous Drugs: A Guide for Healthcare Workers

What are hazardous drugs?

Hazardous drugs are drugs that are potentially toxic to human organ systems or have the potential to cause fetal abnormalities. All chemotherapeutic agents are considered hazardous, as are some other medications such as gancyclovir and ribavirin. These drugs need to be handled safely in preparation, administration and disposal.

Where can I find information regarding the proper handling of these drugs?

The UMHHC Hazardous Drug Policy 05-03-022 specifies procedures for use in the preparation, administration and disposal of hazardous drugs, and outlines the provisions for training, hazard communication and medical surveillance. The policy also includes information about cleaning a hazardous drug spill.

What precautions can I take to minimize my exposure to hazardous drugs?

In addition to the specific procedures outlined in UMHHC Policy 05-03-022, some simple, common-sense precautions can minimize your exposure.

  • Always wear gloves when handling HD.
  • Use nonpowdered latex gloves.
  • Double gloving is the safest option if the contact will be prolonged.
  • If you are allergic to latex, nitrile (synthetic rubber) gloves are an alternative.
  • HD should be prepared under a safety hood to minimize inhalation.
  • Do not eat, drink, chew gum or store food in or near areas where HD are handled.
  • Wear eye and face protection in situations where splashing is possible.
  • Always refer to the policy when handling HD spills.
  • Be aware of the special handling required for body substances of patients receiving HD.

What should I do if I experience an acute exposure to HD, such as a splash or needlestick?

If you are splashed with HD or stuck with a clean needle that has had contact with HD, go to U-M OHS as soon as possible. You will be evaluated for the extent of the exposure; a physical exam and lab tests may be done, and follow-up will be arranged.

If U-M OHS is closed, go to the Emergency Department. If you have an exposure to a contaminated needle, of course, this should be treated as a body substance exposure and you should call (734) 764-8021 immediately.

What about working with HD if I am pregnant or attempting to conceive?

Concerns regarding pregnancy or reproductive issues should be discussed with your U-M OHS medical provider. The HD policy states that pregnant employees, if they desire, may be removed from handling HD. We can discuss with you the potential risks and ways to minimize exposure.

What can my employer do for me to minimize any negative effects from working with HD?

Your employer should ensure that you are properly trained to handle these drugs and that you consistently follow safe practices. In addition, the Health System offers medical surveillance for employees who work with HD.

Medical surveillance is the systematic collection of health data to prevent disease caused by exposure to hazardous substances. In the case of hazardous drugs, we offer medical surveillance for all workers potentially exposed to these substances.

These exams are used to identify any conditions that might make the worker more likely to experience effects from exposure and to identify any early signs of disease. In addition, we review the safe practices and make sure that each employee understands the policy and knows where to obtain information about safe handling of hazardous drugs.

What will a medical surveillance examination for HD include?

The visit will include a general health history, reproductive health history and an occupational history. A brief physical examination will focus on the organ systems that are most likely to be affected by exposure to HD. Laboratory testing may be offered.

The results of the exam will be reviewed with you. When the laboratory test results are available, U-M OHS will send you a copy of the results and indicate whether any follow-up is needed.

Your supervisor will receive a notice that you have completed the examination and whether there are restrictions related to your work with these HD. Your supervisor will not receive any confidential health information.

How can I make an appointment for an HD medical surveillance examination?

If you routinely prepare or administer hazardous drugs, ask your supervisor for a Hazardous Drug Medical Surveillance form. You and your supervisor should complete the form, which asks questions about your work with HD.

After you complete the form (or if you need to obtain one), call the U-M Occupational Health Services (734) 764-8021 for an appointment for a hazardous drugs medical surveillance exam. Take the completed Medical Surveillance Form with you when you go to U-M OHS for your appointment.