PPE and Engineering Controls
Personal protective equipment and engineering controls for preparing hazardous drugs
| Formulation | Activity | Double chemo-therapy gloves | Protective gown | Eye/face protection | Respiratory protection | Ventilated engineering control |
|---|---|---|---|---|---|---|
| All types of hazardous drugs | Receiving, unpacking, and placing in storage | No (single glove can be used, unless spills occur) | Yes, when spills and leaks occur | No | Yes, when spills and leaks occur | No |
| Tablets or capsules | Cutting, crushing, or manipulating tablets or capsules; handling uncoated tablets | Yes | Yes | No | Yes, it not done in a control device | Yes |
| Oral liquid drug or feeding tube | Compounding | Yes | Yes | Yes, if not done in a control device | Yes, if not done in a control device | Yes |
| Topical drug | Compounding | Yes | Yes | Yes, if not done in a control device | Yes, if not done in a control device | Yes, BSC or CACI (Note: carmustine and mustargen are volatile) |
| Subcutaneous/ intra-muscular injection from a vial |
Preparation (Withdrawing from vial) | Yes | Yes | Yes, if not done in a control device | Yes, if not done in a control device | Yes, BSC or CACI |
| Withdrawing and / or mixing intravenous or intramuscular solution from a vial or ampoule |
Compounding | Yes | Yes | No | No | Yes, BSC or CACI; use of CSTD recommended |
| Solution for irrigation | Compounding | Yes | Yes | Yes, if not done in a control device | Yes, if not done in a control device | Yes, BSC or CACI; use of CSTD recommended |
| Powder / solution for inhalation / aerosol treatment |
Compounding | Yes | Yes | Yes, if not done in a control device | Yes, if not done in a control device | Yes, BSC or CACI |
| Spills | Cleaning | Yes | Yes | Yes | Yes | N/A |
Source: NIOSH [2016]. NIOSH list of antineoplastic and other hazardous drugs in healthcare settings, 2016. By Connor TH, MacKenzie BA, DeBord DG, Trout DB, O’Callaghan JP. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication Number 2016-161 (Supersedes 2014-138).
Personal protective equipment and engineering controls for administering hazardous drugs
| Formulation | Activity | Double chemo-therapy gloves | Protective gown | Eye/face protection | Respiratory protection | Ventilated engineering control |
|---|---|---|---|---|---|---|
| Intact tablet or capsule | Administration from unit-dose package | No (single glove can be used) | No | No | No | N/A |
| Tablets or Capsules | Administration | No (single glove can be used) | No | Yes, if vomit or potential to spit up | No | N/A |
| Oral liquid drug or feeding tube | Administration | Yes | Yes | Yes, if vomit or potential to spit up | no | N/A |
| Topical drug | Administration | Yes | Yes | Yes, if liquid that could splash | Yes, if inhalation potential | N/A |
| Subcutaneous/ intra-muscular injection from a vial | Administration from prepared syringe | Yes | Yes | Yes, if liquid that could splash | no | N/A |
| Withdrawing and/ or mixing intravenous or intramuscular solution from a vial of ampoule | Administration of prepared solution | Yes | Yes | Yes, if liquid that could splash | no | N/A; CSTD required per USP 800 if the dosage from allows |
| Solution for irrigation | Administration (bladder, HIPEC, limb perfusion, etc.) | Yes | Yes | Yes | Yes | N/A |
| Powder/ solution for inhalation/ aerosol treatment | Powder/solution administration | Yes | Yes | Yes, if liquid that could splash | Yes, if inhalation potential | N/A |
| Aerosol adminsitration | Yes | Yes | Yes | Yes | Yes, when applicable | |
| Drugs and metabolites in body fluids | Disposal and cleaning | Yes | Yes | Yes, if liquid that could splash | Yes, if inhalation potential | N/A |
| Drug-contaminated waste | Disposal and cleaning | Yes | Yes | Yes, if liquid that could splash | Yes, if inhalation potential | N/A |
| Spills | Cleaning | Yes | Yes | Yes | Yes | N/A |
Source: NIOSH [2016]. NIOSH list of antineoplastic and other hazardous drugs in healthcare settings, 2016. By Connor TH, MacKenzie BA, DeBord DG, Trout DB, O’Callaghan JP. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication Number 2016-161 (Supersedes 2014-138).