The EPA Publishes Draft Guidance On Best Management Practices for Health Care Facilities

    [released September 22, 2010]

    NIOSH, the National Institute for Occupational Safety and Health, has published an update to their 2004 alert: Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings. This latest update adds 21 drugs to Appendix A, the list of drugs considered hazardous. The additions are either new drugs or existing drugs that have had new warnings between 2004 and 2007.

    In this alert, NIOSH presents a standard approach to handling drugs safely, reviews the criteria for identifying hazardous drugs, describes how each organization should generate its own list of hazardous drugs, and presents the updated sample list of drugs that should be considered hazardous.

    The update adds the following nine chemotherapy drugs to the previous list published in the 2004 alert. These chemotherapy drugs include:

    • Bortizomib;
    • Clofarabine;
    • Dasatinib;
    • Decitibine;
    • Nelarabine;
    • Pemetrexed;
    • Sorafenib;
    • Sunitinib malate;
    • Vorinostat.

    In addition to identifying the above chemotherapy drugs, the update also added the following 12 drugs to the sample list of hazardous drugs:

    • Alefacept;
    • Bosentan;
    • Entecavir;
    • Lenalidomide;
    • Medroxyprogesterone acetate;
    • Palifermin;
    • Paroxetine HCl;
    • Pentetate calcium trisodium;
    • Rasagiline mesylate;
    • Risperidone;
    • Sirolimus;
    • Zonisamide

    The NIOSH alert also includes a reminder that the OSHA hazard communication standard requires employers to develop a hazard communication program for their unique workplace. An essential part of the program is the identification of all hazardous drugs a worker may encounter in the facility along with the posting of a list of hazardous drugs to ensure worker safety. The alert also stresses that hazardous drug evaluation is a continual process, indicating that the communication program should provide for an assessment of new drugs as they enter the workplace and, when appropriate, reassessment of existing drugs as new information becomes available.

    PharmEcology has updated the PharmE® Inventory Analysis and the PharmE Waste Wizard® to properly identify these drugs and similar drugs as potentially OSHA hazards in the workplace. Our Inventory Analysis program includes the OSHA Hazardous Drug Review specifically designed to help organizations identify any OSHA hazardous drugs in their environment. The Waste Wizard, which is updated weekly, is ideally suited to help organizations categorize new products as they receive them.

    To review the actual NIOSH update, go to NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings 2010.

    If you have any questions about how PharmEcology can help you identify your OSHA hazardous drugs or if you have any questions about managing your pharmaceutical waste, please contact us at, call us at 414-292-3959, or visit our web site at