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NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings, 2016

NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings, 2016
Sept 2016
DHHS (NIOSH) Publication Number 2016-161 (Supersedes 2014-138)
Preview image for Numbered Publication 2016-161

The NIOSH List of Hazardous Drugs in Healthcare Settings is a tool designed to assist healthcare workers and employers in identifying which drugs routinely handled by employees are considered by NIOSH to be hazardous drugs.

The NIOSH Alert: Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings (NIOSH Pub No 2004-165) was first published in 2004. The document identified a sample list of major hazardous drugs. The list was compiled from information provided by four institutions that had generated lists of hazardous drugs for their respective institutions, as well as a list from the Pharmaceutical Research and Manufacturers of America). The 2004 list was updated in 2010, 2012 and 2014, 2016 and 2024. Some of the updates include:

  • The 2010 update (NIOSH Pub No 2010—167) added 21 drugs to the original list in the 2004 Alert. Additional information for the 2010 update can be found at Peer review and public comment.
  • The 2014 update (NIOSH Pub No 2014—138) added 27 drugs and includes a review of the 2004 list and the consequent removal of 12 drugs that did not meet the NIOSH criteria for hazardous drugs.
  • The 2016 update (NIOSH Pub No 2016—161) added 34 drugs and includes a review of the 2004 list. This list includes drugs reviewed by NIOSH from January 2012 to December 2013. Additional information for the 2016 update can be found at Federal Register Notice.
  • The 2024 update (NIOSH Pub No 2025—103) added 25 drugs, 12 with manufacturer’s special handling information, and removed 7 drugs.

To obtain a copy of the 2010, 2014 or 2016 versions please contact CDC Info 1-800-CDC-INFO (1-800-232-4636)|TTY: 1-888-232-6348 l cdc.gov/info.

 

Notice

May 9, 2023
The manufacturers of trabectedin (Yondelis®), inotuzumab ozogamicin (Besponsa™), polatuzumab vedotin (Polivy™), enfortumab vedotin (Padcev™), trastuzumab deruxtecan (Enhertu®), sacituzumab govitecan (Trodelvy™), loncastuximab tesirine (Zynlonta™), melphalan flufenamide (Pepaxto®), belantamab mafodotin (Blenrep), and tisotumab vedotin-tftv (Tivdak™) recommend that they be handled as hazardous drugs. Therefore, NIOSH considers these drugs to be included in Table 1 of the NIOSH list of hazardous drugs. For additional information, see the package inserts for these drugs.

NIOSH list of hazardous drugs
Drug AHFS Classification Links Date Approved
trabectedin (Yondelis®) 10:00 Antineoplastic Agents DailyMed October 23, 2015
inotuzumab ozogamicin (Besponsa™) 10:00 Antineoplastic Agents DailyMed August 17, 2017
polatuzumab vedotin (Polivy™) 10:00 Antineoplastic Agents DailyMed June 10, 2019
enfortumab vedotin (Padcev™) 10:00 Antineoplastic Agents DailyMed December 18,2019
trastuzumab deruxtecan  (Enhertu®) 10:00 Antineoplastic Agents DailyMed December 20, 2019
sacituzumab govitecan (Trodelvy™) 10:00 Antineoplastic Agents DailyMed May 12, 2020
Loncastuximab tesirine (Zynlonta™) 10:00 Antineoplastic Agents DailyMed May 28, 2021
melphalan flufenamide (Pepaxto®) 10:00 Antineoplastic Agents DailyMed May 28, 2021
belantamab mafodotin (Blenrep) 10:00 Antineoplastic Agents DailyMed May 28, 2021
tisotumab vedotin-tftv (Tivdak™) 10:00 Antineoplastic Agents DailyMed March 23, 2022
lurbinectedin (Zepzelca®) 10:00 Antineoplastic Agents DailyMed May 9, 2023
mirvetuximab soravtansine (ElahereTM) 10:00 Antineoplastic Agents DailyMed May 9, 2023

January 10th, 2019
NIOSH has determined it is unlikely that risperidone (Risperidal®) poses a carcinogenic, reproductive, or developmental hazard to workers in a healthcare setting and is no longer considered a hazardous drug by NIOSH.

January 10th, 2019
NIOSH has determined it is unlikely that paliperidone (Invega®) poses a carcinogenic, reproductive or developmental hazard to workers in a healthcare setting and is no longer considered a hazardous drug by NIOSH.

April 12, 2017
NIOSH has determined that telavancin (VIBATIV®) does not meet the NIOSH definition of a hazardous drug and is no longer considered a hazardous drug by NIOSH.