Amy Callahan, DNP featured in Oncology Nursing Forum


Factors Influencing Nurses’ Use of Hazardous Drug Safe-Handling Precautions

Hazardous drugs (HDs) are defined by the National Institute for Occupational
Safety and Health ([NIOSH], 2004) using one or more of
the following criteria: carcinogenicity, teratogenicity, reproductive
toxicity, genotoxicity, organ toxicity at low doses, and drugs that
mimic existing HDs in structure or toxicity. Most of the drugs that
match the HD description are cytotoxic antineoplastic agents; however, other
classes of drugs are included in this category, such as antivirals, antibiotics, and
hormones (NIOSH, 2004).

According to the Centers for Disease Control and Prevention ([CDC], 2012),
about 8 million healthcare providers in the United States work in environments
that could increase their risk of HD exposure. Exposure occurs via inhalation,
dermal absorption, ingestion, or contact with conjunctiva (NIOSH, 2004). HD
exposure risk occurs during drug-handling activities, such as administration,
preparation, and disposal of the drug and patient excreta (Polovich & Martin,
2011). Nurses working in oncology settings frequently handle chemotherapeutic
agents, making the nurses particularly vulnerable to exposure.

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