In a letter sent to U.S. hospitals last week, the National Institute for Occupational Safety and Health (NIOSH), the Occupational Safety and Health Administration (OSHA), and The Joint Commission reminded hospital and health care employers that hazardous drugs such as antineoplastic drugs can pose serious job-related health risks to workers if proper precautions are not used in handling the drugs.

Drugs used for chemotherapy, antiviral treatments, hormone regimens, and other applications have potential for serious adverse occupational health effects, the agencies said. Irreversible effects from work-related exposures even at low levels, without taking appropriate precautions, can include cancer, reproductive and developmental problems, allergic reactions, and others.

"Potent therapy drugs can have great benefit for patients when used in proper regimens, where doses are controlled and risks are minimized. But they can also have serious consequences to the workers who handle, dispense, mix, apply, and dispose of them without proper controls and training," said NIOSH Director John Howard, M.D. "We are pleased to join with our partners to remind hospital employers that protecting the health of their employees is vitally important."

“Substances that present a potential health hazard to workers must be included in an employer's hazard communication program, and it should be readily available and accessible to all including temporary workers, contractors, and trainees, said David Michaels Ph.D., MPH, Assistant Secretary of Labor for OSHA. “We encourage employers to address safe drug handling by committing their management staff to taking a leadership role identifying and remediating hazards, offering employee training, and evaluating workplace injury and illness prevention programs for continuous improvement.”

“Protecting employees from the risks associated with handling hazardous drugs is a critical ingredient in creating a culture of safety in a health care organization,” said Paul M. Schyve, M.D., Senior Vice President Healthcare Improvement, The Joint Commission.

In their letter to hospital employers, NIOSH, OSHA, and The Joint Commission encouraged employers to:

• Commit their management staffs to taking a leadership role in worker safety and health.
• Offer opportunities for meaningful employee participation in efforts to identify and remediate hazards, develop and offer training, and evaluate the hospital's injury and illness program for continuous improvement.

A list of hazardous drugs can be found in a NIOSH document, "NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings, 2010" (www.cdc.gov/niosh/docs/2010-167/). The list was updated as part of an earlier document, "NIOSH Alert: Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Healthcare Settings," which provides guidance on protecting healthcare employees from hazardous exposures (www.cdc.gov/niosh/docs/2004-165/).

More information on identifying hazards, determining appropriate controls, and applying safe practices can be found in a NIOSH webpage on hazardous drug exposures in healthcare (www.cdc.gov/niosh/topics/hazdrug/) and an OSHA webpage on hazardous drug safety and health at www.cdc.gov/niosh.

With the Occupational Safety and Health Act of 1970 Congress created the Occupational Safety and Health Administration (OSHA) to ensure safe and healthful working conditions for working men and women by setting and enforcing standards and by providing training, outreach, education and assistance.

Founded in 1951, The Joint Commission seeks to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.