This is an updated version of the 2014 publication. The current update (2016) adds 34 drugs, five of which have safe-handling recommendations from the manufacturers.

Hazardous drugs include those used for cancer chemotherapy, antiviral drugs, hormones, some bioengineered drugs, and other miscellaneous drugs. This document presents criteria and sources of information for determining whether a drug is hazardous. When a drug has been judged to be hazardous, the various precautions outlined in the Alert should be applied when handling that drug. Also included is a list of drugs that should be handled as hazardous.

Table 1 – drug meet one or more of the NIOSH criteria for a hazardous drug. In addition to many of these drugs being cytotoxic, the majority are hazardous to males or females who are actively trying to conceive, women who are pregnant or may become pregnant, and women who are breast feeding, because they may be present in breast milk.

Table 2 – drug meet one or more of the NIOSH criteria for a hazardous drug. Some of these drugs may represent an occupational hazard to males or females who are actively trying to conceive, women who are pregnant or may become pregnant, and women who are breast feeding, because they may be present in breast milk.

Table 3 – drug primarily meet the NIOSH criteria for reproductive hazards. They represent a potential occupational hazard to males or females who are actively trying to conceive, women who are pregnant or may become pregnant, and women who are breast feeding, as they may be present in breast milk.

Table 5 – provides some guidance on engineering controls and personal protective equipment (PPE) that applies to all listed drugs for some of the possible scenarios that may be encountered in healthcare settings where hazardous drugs are handled, but it cannot cover all possible situations.

Click on the image above or on the link for the full version of the NIOSH List of Antineoplastic & Other Hazardous Drugs in Healthcare Settings, 2016.

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Acknowledgement: Many thanks to Barbara MacKenzie for the information and updates.