NIOSH Hazardous List: Safeguarding Healthcare Workers

Are you putting your healthcare workers at risk? The NIOSH hazardous list is a comprehensive resource for healthcare facilities to identify, assess, and manage potential hazards associated with medications and chemicals. By understanding the components of the list, its implications, and the steps involved in developing a facility-specific list, healthcare professionals can create safer work environments and protect the health of both workers and patients.

What Is The NIOSH Hazardous List?

The National Institute for Occupational Safety and Health (NIOSH) hazardous list is an in-depth guidance or catalog of medications and chemicals that pose potential health risks to healthcare workers during handling, preparation, or administration. These substances can affect healthcare workers’ health due to their toxicity. 

The list includes drugs from various therapeutic classes, such as:

• Chemotherapeutic agents: Used to treat cancer.
• Hormones: Including corticosteroids and thyroid medications.
• Immunosuppressants: Used mainly to prevent organ rejection.
• Antimicrobials: Antibiotics, antifungals, and antivirals.
• And other medications.

The NIOSH hazardous drug list is updated periodically to reflect new scientific evidence and emerging health concerns. It serves as a valuable resource for healthcare facilities, safety professionals, and workers to identify potential hazards, assess risks, and implement appropriate safety measures to protect themselves from exposure.

What Is A Hazardous Drug According To NIOSH?

NIOSH defines a hazardous drug as any substance that, when handled or administered, can potentially cause adverse health effects. Although these drugs are approved for use in humans by the FDA’s Center for Drug Evaluation and Research (CDER), they have one or more toxicity criteria of the following, in humans, animal models, or in vitro systems:

• Carcinogenicity; The ability to cause cancer.
• Developmental toxicity (including teratogenicity); The ability to cause birth defects.
•  Reproductive toxicity; The ability to harm the reproductive system.
• Genotoxicity; The ability to damage DNA.
• Organ toxicity at low doses; The ability to target specific organs or systems.
• Structure and toxicity profile similar to existing hazardous drugs.

What Are The Main NIOSH Hazardous List Groups?

The NIOSH hazardous drug list is a vital resource for healthcare workers to identify and manage potential hazards associated with medications and chemicals. This list is divided into five main tables:

• Antineoplastic drugs, including those with the manufacturer’s safe-handling guidance (MSHG): This table includes chemotherapy drugs, which are often highly toxic and can cause severe side effects.
                  (Read: Navigating Chemotherapy Compounding Guidelines)
• Non-antineoplastic drugs that meet one or more of the NIOSH criteria for a hazardous drug, including those with the manufacturer’s safe-handling guidance (MSHG): This table contains drugs that are not used to treat cancer but are defined as hazardous drugs according to NIOSH.
• Non-antineoplastic drugs that primarily have adverse reproductive effects: This includes drugs that have been identified as mainly having the potential to harm the reproductive system.
• Drugs that were deleted from the previous edition: This table lists drugs that have been removed from the NIOSH hazardous list due to changes in scientific evidence or other factors.
• Personal protective equipment and engineering controls for working with hazardous drugs in healthcare settings: It provides recommendations for personal protective equipment (PPE) that should be used when handling hazardous drugs.

By understanding and utilizing the NIOSH hazardous drug list, healthcare facilities can create safer and healthier work environments for their employees and patients.

Why Is The NIOSH Hazardous List So Important?

The development of the NIOSH hazardous list is crucial for ensuring the safety and health of healthcare workers exposed to potentially harmful medications and chemicals as we mentioned earlier. This comprehensive list is important for:

• Hazard Identification And Risk Assessment:

The list helps healthcare facilities identify substances that pose risks to workers’ health, allowing for targeted risk assessment and prevention measures. Also, by understanding the severity of hazards associated with different drugs, facilities can prioritize risk mitigation efforts and allocate resources effectively.

• Safe Handling And Administration:

This list guides the development of safe handling and administration procedures, minimizing the risk of exposure and accidental spills. So, facilities can implement engineering controls, such as fume hoods, ventilated cabinets, and personal protective equipment (PPE), to reduce exposure to hazardous drugs.

• Employee Training And Education:

It helps educate healthcare workers about the potential hazards associated with the drugs they handle, fostering a culture of safety and awareness. Facilities also can develop targeted training programs to equip workers with this knowledge and skills.

• Regulatory Compliance:

The NIOSH hazardous drug list aligns with various regulatory standards and guidelines, ensuring that healthcare facilities comply with relevant laws and regulations. By adhering to the list, facilities demonstrate their commitment to worker safety and can mitigate potential legal liabilities.

• Protecting Public Health:

By safeguarding healthcare workers from exposure to hazardous drugs, the list helps prevent occupational illnesses and protect public health. A healthy workforce is essential for providing quality patient care.

That’s how the NIOSH hazardous list serves as a valuable resource for ensuring the safety and health of both: healthcare workers and patients.

DIY Updated Hazardous Drug List!

While the NIOSH hazardous list provides a valuable foundation, the new drugs are introduced at a faster pace than updates to the NIOSH list. So, it’s crucial for facilities to develop and maintain their own up-to-date hazardous drug list (HDL). This ensures that your facility is equipped with the most current information to identify and manage potential hazards.

You can create a comprehensive and accurate facility-specific HDL that helps protect the health and safety of your healthcare workers by regularly reviewing and updating it based on:

• The drug package insert and manufacturer special handling information (MSHI).
• FDA drug safety labeling changes.
•  Safety data sheets (SDSs) provide information about the drug’s molecular properties.
• National Toxicology Program (NTP) and the International Agency for research on cancer (IARC) information on a drug’s carcinogenic potential.
• NTP’s Center for the evaluation of risks to Human Reproduction (CERHR) and the Office of Health Assessment and Translation (OHAT) information on reproductive toxicity, teratogenicity, or developmental toxicity.
• Published peer-reviewed scientific literature for any studies on the drug’s hazard potential.

Take proactive steps to implement the guidelines outlined above and protect your employees through an updated HDL that safeguards their lives.

Conclusion

Don’t wait for an incident to happen. Protecting your healthcare workers from exposure to hazardous drugs is a moral obligation. The NIOSH hazardous list provides the tools you need to fulfill this responsibility and create a safer, more compassionate workplace.

To ensure comprehensive protection, consider developing your own facility-specific HDL. By investing in the safety of your employees, you’re not only complying with regulations but also reaping the benefits of a healthier, more productive workforce.

Learn more about NIOSH hazardous list through our Comprehensive Chemotherapy Compounding & Handling Certification Program.