Update on safe handling of hazardous drugs: the advice of experts

Questions related to the handling of hazardous drug products were discussed by a panel of pharmacy practitioners. The panel addressed the following issues: pharmacists' responsibilities for instructing patients, nurses, and physicians on safe handling of hazardous drug products; safe transport of hazardous drug products outside the hospital; disposal of hazardous drug products, items contaminated by these products, and body wastes of patients receiving these drugs; appropriate operation, venting, cleaning, decontamination, and recertification of biological safety cabinets (BSCs); the protective clothing and technique that should be used by workers in BSCs; monitoring the health of workers who handle hazardous drug products; pharmacy's potential liability for nonconformance to published guidelines; whether and how pharmacies that prepare few doses of hazardous drug products should comply with stringent guidelines geared to institutions that handle many doses of these products; and precautions for handling hazardous drug products for oral administration, caustic products, and vesicants. Safe limits for time and amount of exposure to hazardous drugs are unknown, but ASHP's revised Technical Assistance Bulletin on Handling Cytotoxic and Hazardous Drugs and current guidelines from the federal Occupational Health and Safety Administration provide guidance on precautions that should be observed.