Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

2. RISKS RELATED TO THE USE OF HAZARDOUS DRUGS
Medication Circuit Steps Potentially Exposed Workers Potential Sources of Exposure to Hazardous Drugs
Transport and Storage
Following Preparation
(Chapter 9)
Administration of Drugs
(Chapter 10)
Pharmacy Department
workers (e.g. pharmacist,
clerk, pharmacy technician)
Outpatient clinic and patient
care unit workers (e.g. nurse,
patient service associate)
Transport workers (clerk, etc.)
Care unit, outpatient clinic and
home care workers, i.e.,
nurses, patient service
associates, physicians,
inhalation therapists
Pharmacists
Hygiene and sanitation
workers
Other patients and families of
patients
Patient Care Care unit / outpatient clinic /
home care workers (e.g. nurse,
(Chapter 11)
physician, inhalation therapist,
patient service associate)
Other patients, families of
patients
Hygiene and sanitation
workers
Biomedical engineering
workers
Breakage of a drug container due to a fall or other
cause (worker exposure and environmental
contamination due to the spread of liquids, powders or
aerosols or through the diffusion of vapours).
Direct contact with a drug container (as the outside of
the container may be contaminated).
Leaks or creation of aerosols when priming or
removing air from tubing, if this is not done in the
preparation cabinet;
Leaks or creation of aerosols during the connecting
and disconnecting of syringes and tubing from the
injection ports;
Contamination through contact with poorly-cleaned
drug bags, tubing or syringes during the preparation
step. The drug containers or drug preparation transport
trays may also be contaminated;
Inhalation of aerosols during aerosolized
administration (ribavirin, pentamidine);
Surface contamination (gloves, etc.) and inhalation of
particles when handling or crushing pills;
Contact contamination when applying creams or
ointments;
Accidents: needlesticks, breakage of drug containers,
spills;
Direct contact due to projections, splashing or vapour
inhalation during special procedures such as
hyperthermic intraoperative intraperitoneal
chemotherapy (HIIC) (operating room or intensive
care unit).
The body fluids of patients who have received
chemotherapy contain drug residues. Contact with
patient excreta, bedpans, sheets or wash water may be
a source of contamination.
2-8 ASSTSAS PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS