The National Institute for Occupational Safety and Health (NIOSH) Alert: Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings was published in September 2004. Appendix A provided a sample list of major hazardous drugs. The 2004 list was updated in 2010. The latest update adds 26 drugs to the 2010 list. These additions are new drugs or existing drugs that had new warnings from 2007 to 2009. In addition, four drugs were removed from the 2010 list based on new information, two radioactive drugs were removed since their management is regulated by the Nuclear Regulatory Commission, and nine drugs were removed since they are currently unavailable in the United States.
The new drugs added as are follows: acitretin, ambrisentan, bendamustine HCl, cabergoline, carbamazepine, clonazepam, degarelix, dronedarone HCl, everolimus, ixabepilone, mycophenolic acid, nilotinib, oxcarbazepine, pazopanib HCl, phenoxybenzamine HCl, plerixafor, pralatrexate, romidepsin, televancin, temsirolimus, tetracycline HCl, valproic acid/divalproex Na, vigabatrin, ziprasidone HCl, and zoledronic acid.
The current active drugs deleted from the list are alemtuzumab, Interferon alfa 2a, interferon alfa 2b, and interferon alfa n3.
The radiopharmaceuticals being managed under the NRC regulations are ibritumomab tiuxetan and tositumomab.
Drugs currently not available in the US and therefore removed from the update list are dienestrol, interferon alfa n1, perphosphamide, piritrexim isethionate, plicamycin, prednumustine, raltitrexed, trimetrexate glucuronate and vindesine.
The purpose of the list is to highlight those drugs that could potentially be problematic if employees are exposed during receipt, handling, preparation, administration, or disposal. It is the responsibility of the organization to determine if the particular dosage form used and the manner in which the drug is handled actually pose such a threat. Each organization should use the list as a starting point from which to develop a customized list based on the practice setting. Generally speaking, solid dosage forms are not considered to pose an OSHA hazard unless they are split or crushed.
PharmEcology Services includes a separate NIOSH Hazardous Drug List in both PDF and Excel format as part of our Inventory Analysis package. For more information, please contact us at 877-247-7430 firstname.lastname@example.org.
The NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings 2012 may be accessed at http://www.cdc.gov/niosh/docs/2012-150/pdfs/2012-150.pdf.
If you have any additional questions about disposal of any pharmaceutical waste or if you have any questions about managing your pharmaceutical waste, please contact us at email@example.com, call us at 877-247-7430, or visit our web site at www.pharmecology.com.