Sunday, June 25, 2006

ASHP Guidelines on Handling Hazardous Drugs

Developed by the ASHP Council on Professional Affairs and approved by the ASHP Board of Directors on January 12, 2006

In 1990, the American Society of Health-System Pharmacists (ASHP) published its revised Technical Assistance Bulletin (TAB) on handling cytotoxic and hazardous drugs. The information and recommendations contained in that document were current to June 1988. Continuing reports of workplace contamination and concerns for health care worker safety prompted the Occupational Safety and Health Administration (OSHA) to issue new guidelines on controlling occupational exposure to hazardous drugs in 1995. In 2004, the National Institute for Occupational Safety and Health (NIOSH) issued the “NIOSH Alert: Preventing Occupational Exposure to Antineoplastic and Other Hazardous Drugs in Health Care Settings.

The following ASHP Guidelines on Handling Hazardous Drugs include information from these recommendations and are current to 2004.

The purpose of these guidelines is to
(1) update the reader on new and continuing concerns for health care workers handling hazardous drugs and
(2) provide information on recommendations, including those regarding equipment, that have been developed since the publication of the previous TAB.

Because studies have shown that contamination occurs in many settings, these guidelines should be implemented wherever hazardous drugs are received, stored, prepared, administered, or disposed. Comprehensive reviews of the literature covering anecdotal and case reports of surface contamination, worker contamination, and risk assessment are available from OSHA, NIOSH, and individual authors. The primary goal of this document is to provide recommendations for the safe handling of hazardous drugs.

These guidelines represent the recommendations of many groups and individuals who have worked tirelessly over decades to reduce the potential harmful effects of hazardous drugs on health care workers.

The research available to date, as well as the opinions of thought leaders in this area, is reflected in the guidelines. Where possible, recommendations are evidence based. In the absence of published data, professional judgment, experience, and common sense have been used.

You can download the complete Guidelines from the address:

The ASHP Guidelines on Handling Hazardous Drugs together with the Quality Standards for Oncology Pharmacy Services (QUAPOS3, ESOP - European Society of Oncology Pharmacy - ( are the necessary documents for every Hospital Pharmacists.