Each year, more than 8 million U.S. health care personnel are potentially exposed to hazardous drugs (HDs).  The risk is real and can lead to serious health issues for you and/or your staff such as skin rashes, adverse reproductive outcomes, leukemia and other cancers.  That’s why it’s critical for every person who comes in contact with HDs in the workplace to understand how to best avoid these risks.

The first step is determining which drugs are considered hazardous.  According to the National Institute for Occupational Safety and Health (NIOSH), a drug is considered hazardous if it exhibits one or more of the following characteristics:

  • Carcinogenicity
  • Teratogenicity or developmental toxicity
  • Reproductive toxicity
  • Genotoxicity
  • Organ toxicity at low doses
  • Structure and toxicity profiles of new drugs that mimic existing hazardous drugs

Once you have identified these drugs the next step is learning how to protect yourself from harm when you come in contact with them.

Handle with Care

Personal Protective Equipment PPE must be worn whenever HDs are handled. After use, all equipment should be considered contaminated and must be disposed of in accordance with all local, state, and federal regulations.

Eye and face protection:

  • Appropriate protection must be worn when there is a chance of a spill.
  • Face shields and goggles provide a full range of protection.

Respiratory protection:

  • Surgical masks do not provide respiratory protection.
  • Fit-tested NIOSH-certified N95 or higher respirator provides defense against particles.

Gowns must:

  • Be disposable
  • Resist permeability by HDs
  • Close in the back
  • Be long-sleeved
  • Have closed cuffs
  • Be seamless


  • Gloves should be worn for all HD handling.
  • All personnel administering chemotherapy must use two pairs of gloves.

Chemotherapy gloves must:

  • Meet American Society for Testing and Materials standard D6978
  • Be powder-free
  • Be sterile (outer gloves)
  • Be changed every 30 minutes

Hair, Shoe & Sleeve Covers:

  • Covers must be worn to help protect from HD residue.
  • When compounding, a second shoe cover must be used when entering the containment secondary engineering controls (C-SEC) and removed when leaving.
  • Hair, including beards and mustaches, must be covered.
  • Disposable sleeve covers may be used to protect areas of the arm that may come in contact with an HD.

When it comes to handling HDs in the workplace, it’s your job to protect yourself and your staff.  The best way to do that is to take the necessary precautions as outlined by USP <800> and make sure that they are being followed by everyone on a daily basis.  Remember, hazardous drugs can lead to serious health risks.  You can help avoid those risks by handling HDs with care.

For more information on how to remain compliant, check out our series of blogs on the USP General Chapter <800> on our website.  You can also download our free handbook.