Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

PREAMBLE
In September 2004, the United States National Institute for Occupational Safety and Health (NIOSH) published an
alert recommending more stringent preventive measures for the preparation and handling of hazardous drugs. This
document quickly attracted attention in Quebec, where a number of institutions began questioning their preventive
measures. The AQESSS Montreal Prevention Committee, as well as a number of institutions and organizations,
have turned to the ASSTSAS for answers regarding medical and biological monitoring. In addition, some
institutions whose pharmacy departments were being remodelled or were about to undergo remodelling wished to
ensure the implementation of the proper measures, e.g. the type of pressure gradient required between the clean
room , the antechamber and the general pharmacy.
In 1995, the ASSTSAS – whose mission is to promote occupational health and safety in health and social services
institutions – had published a prevention guide in this regard, which it was planning to revise in 2005. Due to the
issuing of the NIOSH recommendations, this revision was completed earlier.
Following a review of the reference material and extensive work in collaboration with a university hospital
(CHUS) to assess the applicability of the NIOSH recommendations, the ASSTSAS felt it necessary to draw on the
expertise and assistance of other stakeholders to produce a prevention guide which would reflect the diversity of
the issues and points of view.
The Association thus formed a committee with mandate to produce a prevention guide for the safe handling of
hazardous drugs in Quebec health care institutions.
This committee included professionals and stakeholders from the health care network with expertise and an
interest in the hazardous drug issue. They have been introduced in a previous section. Some members were
included in this committee in view of their expertise, while others were delegated by organizations with an interest
in the issue (APES, AQATP, AQESSS, AQIO, CHQ, INSPQ, IRSST, MSSS). All of the members were asked to
confer with their peers and collaborators in their respective environments.
This guide sets out the Committee’s recommendations regarding how to safely handle hazardous drugs. It refers to
practices which may present a risk of exposure to those working closely with or at a distance from these drugs.
The recommendations contained in this guide are in keeping with the general recommendations of the majority of
recent guides published in North America, Europe and Australia. This guide does not claim to address every issue,
as some require further research. If necessary, updates will be published to supplement or clarify information
regarding some of these issues.
The measures proposed in this guide should be considered recommendations; they are not normative and are not
mandatory. Each workplace is to implement them based on its individual circumstances.
While the guide is primarily intended for health care workers, some recommendations apply to users of the health
care network and their families. These recommendations are intended to protect these individuals from direct
contact with sources of contamination and to ensure harmonization between institutional and home care. Patients
and families who are properly informed regarding hazardous practices will be able, in turn, to help protect
workers.
viii ASSTSAS PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS