Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

1. INTRODUCTION
1.2 Terminology and Guiding Principles
1.2.1 Terminology
Hazardous Drugs – In this guide, the term “hazardous drug” is used to describe all of the drugs on the list
included in the NIOSH recommendations. Theses drugs are deemed hazardous because, due to their effects, they
pose a danger to workers. The NIOSH list will be used for the purposes of this guide.
Must, should, may –This document is only a guide; its recommendations have no legal or normative value. The
measures proposed must be considered recommendations only. Most are described using the term “should”.
When a recommendation is supported by a law, regulation or standard, the term “must” is used.
In addition, in some cases, the term “may” is used with respect to a measure which is “recommended”, but whose
implementation may vary according to local circumstances.
Glossary – A glossary defines the main terms found in this guide (Appendix 1). The words in italics refer to the
glossary.
1.2.2 Guiding Principles
The Committee members have adopted guiding principles to direct the decision-making process when
recommendations are based on incomplete knowledge or when a consensus was difficult to reach. These
principles are based on the Cadre de référence en gestion des risques pour la santé dans le réseau québécois de la
santé publique (Guidelines for Risk Management in the Quebec Public Health Network) developed by the Institut
national de santé publique (National Public Health Institute) (INSPQ, 2003). The guiding principles underpin the
Committee’s orientation in its choice of recommendations. Four principles have been retained in the Committee’s
recommendations.
1.2.2.1 Priority: The Protection of Human Health
Health is seen from a global standpoint, encompassing the concepts of maintaining and improving public health
and safety and disease prevention. Our first concern was for the protection of those working directly with
hazardous drugs, as well as for the protection of the patients and their families. The guide thus places a high
priority on the protection of human health. While aware that other concerns (for example, economic) may come
into play, the role of the Committee is not to plead the case of other considerations. We have, however, taken
these concerns into account as much as possible, without jeopardizing the protection of health.
1.2.2.2 Scientific Rigor
The recommendations must be based on the best evidence and knowledge available, must be supported by the
scientific opinions of experts in all of the relevant disciplines and must be the result of a structured, systematic
approach.
1.2.2.3 Prudent Practice
The principle of prudent practice has been applied, i.e., that preventive measures be taken when there is
reasonable evidence to indicate that the situation may have significant harmful effects on health – even when the
scientific evidence is not conclusive and there is continuing uncertainty.
For example, there are no known values regarding the limits of safe exposure to a hazardous drug. This
uncertainty requires the application of the principle of prudent practice, i.e., the recommendation of preventive
measures to minimize exposure to hazardous drugs to the greatest extent possible, in keeping with the provisions
of occupational health and safety regulations regarding products suspected of being carcinogenic.
1.2.2.4 Management
The Committee focused on strengthening the ability of individuals and organizations to make informed decisions
regarding the management of the risks related to hazardous drugs. This is the reason for this prevention guide, i.e.,
to provide stakeholders with all of the information required to exercise their judgment in an informed manner.
PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS ASSTSAS 1-3