April 27, 2023

New NIOSH Documents Address Hazardous Drugs in Healthcare Settings

Two new documents available from NIOSH address hazardous drugs in healthcare settings. Procedures for Developing the NIOSH List of Hazardous Drugs in Healthcare Settings outlines the methodology that NIOSH uses to add substances to its List of Hazardous Drugs in Healthcare Settings. The document also describes the process for requesting drugs’ removal from or placement on the list as well as how NIOSH recommends the list be used in healthcare and other settings. The second document, Managing Hazardous Drug Exposures: Information for Healthcare Settings, is intended to help employers establish workplace-specific risk management procedures for hazardous drugs. A Federal Register notice published today describes the development of these documents and discusses changes made in response to comments received regarding the draft versions made available for review by NIOSH in 2020.

The Procedures document can be used by healthcare facilities to examine new drugs and establish their own lists of hazardous drugs. It also makes clear that NIOSH’s hazardous drugs list is applicable in settings such as veterinary care clinics, drug research laboratories, retail pharmacies, and home healthcare agencies in addition to healthcare. Employers can use the Managing Hazardous Drug Exposures document as a starting point for developing facility-specific risk management plans. According to NIOSH, factors unique to each work setting can affect workers’ potential exposures from handling hazardous drugs. Among these factors are the frequency, duration, and magnitude of exposures as well as the presence or absence of exposure controls.

The NIOSH List of Hazardous Drugs in Healthcare Settings was previously known as the NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings. The list builds on a NIOSH alert from 2004 that warned healthcare employers and workers of the risks of working with hazardous drugs and discussed measures they could take to protect their health. NIOSH announced the retitling of the list in 2020, explaining in the Federal Register that “[m]any of the drugs currently used to fight cancer function differently than those previously used” and that “antineoplastic drugs are no longer all cytotoxic, genotoxic, and highly hazardous chemicals.” At that time, NIOSH also proposed reorganizing the list to group drugs by hazard instead of by their function. The 2020 list is available in draft form (PDF) from NIOSH, while the 2016 list remains the current update. The agency’s website states that its 2023 List of Hazardous Drugs in Healthcare Settings will be published to the NIOSH website once it’s been finalized.

For more information about hazardous drug exposures in healthcare, visit NIOSH’s website.