CoSHH and the Use of Cytotoxic Drugs

Published Date: 22nd November 2010

This article focuses on the hazards associated with cytotoxic drugs and looks at the precautions to take when handling them. It will be of particular interest to those working in areas such as hospitals, oncology units, hospices and care homes etc.

Cytotoxic drugs are extensively used in the treatment of cancer. They have the ability to prevent the growth of tumours by interfering with cell division. However, they not only affect tumour cells but may also damage normal cells. As a result, they can produce substantial side effects in patients or others exposed. Concerns have been raised as to the risks to health care workers involved in the preparation and administration of cytotoxic drugs.

For the most part, cytotoxic drugs are hazardous substances, according to the Control of Substances Hazardous to Health (CoSHH) legislation. A few are deemed to be carcinogenic and hence are subject to Appendix 1 of the CoSHH Approved Code of Practice (ACoP) which gives further guidance on the control of carcinogenic substances. Under CoSHH regulations, employers have a legal responsibility to assess the risks arising from employees handling cytotoxic drugs plus anybody else who could be impacted by this kind of work, and to take sufficient measures to protect their health.

The first precaution to take is to assess the risk. Identify which cytotoxic drugs are handled and what the possible harmful effects on health are. Decide who might be harmed from exposure to the drugs and how this could happen, for example, leakage of the drugs during preparation. The next step is to determine how likely that cytotoxic drugs could cause ill health and decide if existing controls are sufficient or if more should be done. Keep a record of the findings from the CoSHH risk assessment and review annually as well as when any significant changes occur throughout the year.

It is imperative that exposure to the drugs is controlled. Keep all drugs stored in a lockable safety cabinet and ensure when in use that exposure is controlled at source. Wear appropriate personal protective equipment (PPE) such as gloves when handling cytotoxic drugs.

Other more specific control measures contained within the CoSHH assessment will include organising work to reduce the quantities of drugs used, the number of employees exposed and keeping the duration of exposure to a minimum. Use good hygiene practices and ensure all staff are trained in the handling of cytotoxic drugs. Staff need to be aware of the risks of contamination and the precautions they should take when dealing with spillages etc. Health records should also be kept for staff.

If you are unsure if your company has an obligation to comply with the CoSHH regulations or you are unsure if any CoSHH hazards exist in your organisation, please call our free confidential H&S helpline or download our free CoSHH information pack. Please read 'What next?' below.

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