Safe Handling of Hazardous Drugs

The following table provides a description and examples for each type of control.
Type of Control Description Examples
Elimination
Substitution
Engineering
controls
Administrative
controls
PPE
Elimination of hazardous drugs
from the workplace is not typically
possible because these drugs may
be the only treatment available.
Substitution includes using
a drug that is less hazardous,
either because of the form it is
administered in or its toxicological
properties (provided it is just as
effective at treating the patient).
Engineering controls protect
workers by physically changing
the work environment to minimize
exposure to hazardous drugs.
Administrative controls aim
to reduce exposure in the work
environment by changing how
work is carried out.
PPE controls exposure at the point
of the individual worker. It is last in
the hierarchy of controls because
it requires the most activity and
is the least effective means of
limiting worker exposure. PPE will
often have to be worn despite the
presence of other control methods.
••
Removing unneeded hazardous
drugs from the workplace
••
Having drugs delivered in a form
that is ready to administer
••
Eliminating the number of times
hazardous drugs are handled
••
Using a form of hazardous drugs
that has a lower risk of exposure
to workers, such as tablets instead
of IV infusions (if clinically
appropriate)
••
Using an appropriate biological
safety cabinet
••
Having negative pressure
preparation rooms or anterooms
••
Using closed-system transfer
devices
••
Regular hand washing
••
Implementing an effective
cleaning routine
••
Protective reassignment
••
Developing and implementing
safe work procedures
••
Chemotherapy-tested gloves
••
Chemotherapy-tested gowns
••
Respirators
••
Eye and face protection
••
Footwear and shoe covers
Best Practices for the Safe Handling of Hazardous Drugs 21