Pharmacists, pharmacy technicians:
• Handling drug-contaminated vials
• Reconstituting powdered or lyophilized drugs and further diluting either the reconstituted powder or concentrated liquid forms of hazardous drugs
• Expelling air from syringes filled with hazardous drugs
• Compounding HD powders into custom-dosage forms
• Transferring drug solution to IV bag or bottle
Pharmacists, pharmacy technicians, nursing personnel:
• Counting out individual, uncoated oral doses from multidose bottles
• Unit-dosing uncoated tablets in a unit-dose machine
• Crushing tablets or opening capsules to make oral liquid dose
• Opening ampoules
• Preparing topical drugs
Nursing personnel:
• Administering antineoplastic drugs by injection (intramuscular, subcutaneous or intravenous (IV)), by inhalation or by nasogastric tube
• Spiking the IV set into an HD-containing IV bag (without a closed system)
• Priming the IV set with a drug-containing solution at the administration location
• Connecting and disconnecting the IV set to an IV pump or patient
Nursing personnel, support staff, housekeeping personnel, laundry personnel:
• Handling body fluids or body-fluid-contaminated clothing, dressings, linens, bedpans, urinals and other materials
• Handling contaminated wastes generated at any step of the preparation or administration process
Pharmacists, pharmacy technicians, nursing personnel, housekeeping personnel, environmental services personnel:
• Contacting hazardous drugs present on drug vial exteriors, work surfaces, floors, and final drug products (bottles, bags, cassettes, and syringes)
• Handling unused antineoplastic drugs or antineoplastic drug-contaminated waste
• Decontaminating and cleaning drug preparation or clinical areas
• Cleaning hazardous drug spills
Physicians, nursing personnel, operating room personnel:
• Performing certain specialized hazardous drug administration procedures such as intraperitoneal
chemotherapy (in the operating room or other locations), bladder instillation, isolated limb perfusion
Support staff:
• Transporting hazardous [drugs] in the facility
Nursing personnel, housekeeping personnel, waste disposal personnel:
• Transporting hazardous waste containers
Pharmacists, pharmacy technicians, nursing personnel, housekeeping personnel:
• Removing and disposing of personal protective equipment after handling hazardous drugs or waste.
Source: National Institute for Occupational Safety and Health, Current Intelligence Bulletin (draft), Reproductive Risks Associated with Hazardous Drug Exposures in Healthcare Workers and Recommendations for Reducing Exposures, 2015.
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