NIOSH Publications on Hazardous Drugs

NIOSH Publications

Managing Hazardous Drug Exposures: Information for Healthcare Settings

DHHS (NIOSH) Publication No. 2023-130 (April 2023)

This document contains risk management information and a Table of Control Approaches describing some of the possible scenarios that workers may encounter in healthcare settings when handling hazardous drugs. The potential exposure of workers from handling a hazardous drug depends on several factors unique to each work setting. Such factors include: (1) the dosage form of the drug, (2) the routes of exposure, (3) the frequency, duration, and magnitude of exposure, (4) work practices, and (5) the presence or absence of any exposure controls such as engineering controls, administrative controls, or personal protective equipment. The National Institute for Occupational Safety and Health (NIOSH) encourages healthcare settings to conduct a facility-specific assessment to determine the most effective exposure control strategies for controlling the risks identified in the assessment.

Procedures for Developing the NIOSH List of Hazardous Drugs in Healthcare Settings

DHHS (NIOSH) Publication No, 2023-129 (April 2023)

This document lays out the methodology the National Institute for Occupational Safety and Health (NIOSH) uses to determine if a drug meets the criteria for placement on the NIOSH List of Hazardous Drugs in Healthcare Settings. It also sets forth the process parties can use to request that a drug be added to the list or reconsidered for removal or a different placement on the list.

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

DHHS (NIOSH) Publication No. 2016-161 (September 2016)

The National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention (CDC) has made updates to its list of hazardous drugs (2016). This list includes drugs reviewed by NIOSH from January 2012 to December 2013. The current proposed additions to the list of hazardous drugs supersede the 2004 list in the NIOSH Alert: Preventing Occupational Exposure to Antineoplastic and Other Hazardous Drugs in Health Care Settings and the 2014 list of hazardous drugs. The format for the 2014 list was revised to include three groups of hazardous drugs: (1) Antineoplastic drugs; (2) Non-antineoplastic hazardous drugs; and (3) Drugs with reproductive effects. The current update (2016) adds 34 drugs and includes a review of the 2004 list.

NIOSH Alert: Preventing Occupational Exposures to Antineoplastic and other Hazardous Drugs in Healthcare Settings

DHHS (NIOSH) Publication No. 2004-165 (2004)

In this Alert, NIOSH presents a standard precautions or universal precautions approach to handling hazardous drugs safely: that is, NIOSH recommends that all hazardous drugs be handled as outlined in this Alert. Therefore, no attempt has been made to perform drug risk assessments or propose exposure limits. The area of new drug development is rapidly evolving as unique approaches are being taken to treat cancer and other serious diseases.

Previous Hazardous Drug Lists

NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings, 2014 - DHHS (NIOSH) Publication No. 2014-138 (September 2014)

NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings 2012 - DHHS (NIOSH) Publication No. 2012-150 (June 2012)

NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings 2010 - DHHS (NIOSH) Publication No. 2010-167 (September 2010)

Workplace Solutions: Safe Handling of Hazardous Drugs for Veterinary Healthcare Workers

DHHS (NIOSH) Publication No. 2010-150 (June 2010)

Veterinary healthcare employees working where hazardous drugs are handled may face health risks. Many of these workers treat small companion animals (primarily cats and dogs), but also larger animals such as horses, with antineoplastic and other drugs that may be hazardous to humans.

Personal Protective Equipment for Health Care Workers Who Work with Hazardous Drugs

DHHS (NIOSH) Publication No. 2009-106 (2008)

Health care workers who handle hazardous drugs are at risk of skin rashes, cancer, and reproductive disorders. NIOSH recommends that employers provide appropriate personal protective equipment (PPE) to protect workers who handle hazardous drugs in the workplace.

Workplace Solutions: Medical Surveillance for Healthcare Workers Exposed to Hazardous Drugs

DHHS (NIOSH) Publication No. 2013-103 (2013) – supersedes 2007-117

Health care workers who handle, prepare, or administer hazardous drugs may face risks to their own health such as skin rashes, cancer, and reproductive disorders.

Workplace Solutions: Preventing Worker Deaths and Injuries When Handling Micotil 300®

DHHS (NIOSH) Publication No. 2007-124 (2007)

Livestock producers, veterinarians, and other workers may be exposed to the toxic hazards of the animal antibiotic Micotil 300® through needlestick injuries, skin cuts, puncture wounds, and contact with skin and mucous membranes.