Chemotherapy Safety: How the New Regulations Affect Veterinarians
Hazardous drugs (HDs) which include all antineoplastic agents can pose serious health risks to healthcare workers when not handled appropriately. Despite numerous published guidelines, there have been no enforceable standards to minimize the risk of potential exposure. In February 2016, USP Chapter was published and outlines the practice and quality standards of safe handling of hazardous drugs. When USP goes into effect on December 1, 2019, these standards will become enforceable and all health care facilities including veterinary practices will be required to comply with these standards. USP is organized into 18 sections that outline the training and responsibilities of personnel handling HDs, development of a hazards communication program and standard operating procedures (SOP), necessary engineering and facility controls, appropriate use of personal protective equipment (PPE), standards for specific situations involving the handling of HDs (receiving, labelling, packaging, transportation, disposal, compounding, administration, deactivating, decontamination, cleaning, disinfecting and spill control), medical surveillance and environmental quality and control. There are specific requirements for the design of a facility including having a separate negative pressure room for handling HDs that is externally vented and has an appropriate air exchange. There must be an externally vented Class II BSC within this room. Personal protective equipment including chemotherapy gloves, gowns, shoe covers, head and hair covers, face shields and goggles and respirators will also be required depending on the specific task. The use of a closed system transfer device will be required for the administration of antineoplastic agents. Additional requirements will be written SOPs for all aspects of handling HDs, training for all personnel that work with HDs, development of a hazards communication program and designation of a person to oversee all aspects of an HD program. Environmental sampling for HD residue and the development of a medical surveillance program for workers is recommended but not required. It is important for veterinarians to understand the new standards as any veterinary practice that administers antineoplastic agents will expected to comply with these standards regardless of the how frequently they handle these agents.
- Upon completion, the participant will be able to summarize the standards for safe handling hazardous drugs in USP Chapter <800> and analyze how this may impact their own work practices.
- Upon completion, the participant will be able to describe what the appropriate engineering controls are for safe handling of hazardous drugs including the design of the physical plant, the use of a biologic safety cabinet and the use of a closed system transfer device.
- Upon completion, the participant will be able to identify what types of personal protective equipment are available for safe handling of hazardous drugs and which types are required for specific tasks.