Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

8. DRUG PREPARATION
8.3 Preventive Measures
8.3.1 Personal Protective Equipment RATING: +++
Wear proper protective equipment.
RECOMMENDATIONS
8.3.1.1 Workers (pharmacists or pharmacy technicians) must wear a cap, shoe covers, a
protective gown and two (2) pairs of gloves (see 4.1.7.7) to make sterile preparations of
hazardous drugs in preparation cabinets. A surgical mask may be used by workers with
a respiratory tract infection to reduce the risk of microbial contamination or if this is the
practice in the institution.
8.3.1.2 Upon completion of sterile manipulations, the outer pair of gloves must be removed
inside the preparation cabinet. Only the inner pair of gloves, next to the skin, must be
worn for the labeling, bagging and transfer from the sterile preparation cabinet.
8.3.1.3 Outside the sterile preparation room, workers must wear 1 pair of gloves (see 4.1.7.7) if
they come into contact with hazardous drug containers (e.g. workers removing syringes
from their plastic bag for an additional verification, additional labeling). However,
gloves are not required to handle the plastic bag.
APES, p. 5-6, 5-7 ♦ ASHP, p. 1178-1180, 1188 ♦ CSHP, Sections 8.2.4, 8.3.2 ♦ NIOSH, p. 12, 13 ♦
OPQ, Section 8
8.3.2 Organization of the Work RATING: +++
Organize the work to limit microbial and environmental contamination.
RECOMMENDATIONS
8.3.2.1 Preparation workers should cover the work surface with a disposable, absorbent, sterile,
plastic-backed cloth to absorb any liquid contamination that may occur during handling.
The cloth must not cover the front and rear grilles of the preparation cabinet. It should
be changed after 3.5 hours of continuous work or for a new batch of preparations (e.g. a
set of vials of a given drug) or in the event of a spill or contamination. The cloth must
be disposed of in a cytotoxic waste receptacle.
8.3.2.2 Workers must proceed in a way that does not adversely affect the cabinet’s
effectiveness in protecting against hazardous drug exposure:
‣ never permanently obstruct the air return grilles (e.g. by covering them with
material), to avoid disturbing the protective curtain of air;
‣ follow the manufacturer’s instructions regarding the minimum work distances inside
the cabinet; if there are no instructions from the manufacturer, work on a surface
more than 10 cm away from the front and rear grilles and 15 cm from the side walls
of the preparation cabinet;
‣ lower the protective window according to the manufacturer’s recommendations. To
protect the face and eyes of the worker, the bottom of the window should not be any
higher than the worker’s shoulders. The usual height of the opening is 20 cm.
8.3.2.3 Workers should proceed in a way that minimizes the risks of contamination:
‣ group the material required for a batch or preparation, to avoid having to frequently
enter and leave the preparation cabinet (as arm movements, particularly lateral
movements, break the protective curtain of air);
‣ limit the quantity of supplies and hazardous drugs in the cabinet, to avoid adversely
affecting the laminar flow and to facilitate regular cleaning of the work surface;
PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS ASSTSAS 8-3