Get access to the exclusive HR Resources you need to succeed in 2018.
Sign up for free email newsletters and get more SHRM content delivered to your inbox.
Is your employee handbook keeping up with the changing world of work? With SHRM's Employee Handbook Builder get peace of mind that your handbook is up-to-date.
Build competencies, establish credibility and advance your career—while earning PDCs—at SHRM Seminars in 14 cities across the U.S. this fall.
Gain the skills you need to rise to the next level in your career. Jon us at SHRM's Leadership Development Forum, October 2-3 in Boston.
Members may download one copy of our sample forms and templates for your personal use within your organization. Please note that all such forms and policies should be reviewed by your legal counsel for compliance with applicable law, and should be modified to suit your organization’s culture, industry, and practices. Neither members nor non-members may reproduce such samples in any other way (e.g., to republish in a book or use for a commercial purpose) without SHRM’s permission. To request permission for specific items, click on the “reuse permissions” button on the page where you find the item.
Employers should conduct “medical surveillance” as part of a comprehensive safety program, according to the National Institute for Occupational Safety and Health (NIOSH).
The federal agency published an update Nov. 19, 2012, to its 2007 hazardous drugs exposure guidelines, emphasizing the establishment of medical surveillance for health care workers who prepare, administer or transport hazardous drugs or dispose of hazardous drug waste.
NIOSH dropped the recommendation of routine periodic laboratory testing on exposed workers, pointing to evidence that it is not very valuable. The agency still advocates initial baseline evaluations that include laboratory testing.
NIOSH emphasized that medical surveillance programs feature periodic reproductive and general health questionnaires, worker histories of drug handling, and follow-up plans for workers who show health changes suggesting toxicity or have had acute exposure to a hazardous drug.
Who Is Exposed to Hazardous Drugs?
In the United States, an estimated 8 million health care workers are potentially exposed to hazardous drugs or drug waste at their worksites, according to the U.S. Bureau of Labor Statistics.
Drugs are considered hazardous if studies in animals or humans show that they have the potential to cause cancer, reproductive toxicity, birth defects or damage to organs at low doses, NIOSH said. The following health care workers should be included in medical surveillance programs: nurses, pharmacists and pharmacy technicians, physicians and physician assistants, operating room personnel, home health care workers, veterinarians and veterinary technicians, environmental service workers (housekeeping, laundry, maintenance workers) and workers who ship, transport or receive hazardous drugs.
Exposure to hazardous drugs may occur through skin contact, inhalation, ingestion or injection. Workers may be exposed to hazardous drugs when they create aerosols, generate dust, clean up spills or touch contaminated surfaces when compounding, administering or disposing of hazardous drugs or patient waste.
Establishing a Medical Surveillance Program
Medical surveillance is a second line of defense, NIOSH said, enhancing the protection afforded by engineering controls, other administrative controls, work practice controls, personal protective equipment (PPE) and worker education about the hazards of the materials they work with or they may come into contact with in the course of their duties.
An effective surveillance program begins with a hazard identification program that is integrated with surveillance for disease or illness, NIOSH said.
Elements of a medical surveillance program for workers exposed to hazardous drugs should include the following:
Medical surveillance program results should be examined in aggregate for trends that may be a sign of health changes because of exposure to hazardous drugs, NIOSH said.
What If Workers Are Found to Be Exposed
If adverse health effects due to exposure are found as a result of the surveillance program, NIOSH advised the employer take the following actions:
Roy Maurer is an online editor/manager for SHRM.
Follow me on Twitter @SHRMRoy
SHRM OnlineSafety & Security page
You have successfully saved this page as a bookmark.
Please confirm that you want to proceed with deleting bookmark.
You have successfully removed bookmark.
Please log in as a SHRM member before saving bookmarks.
Please sign in as a SHRM member before saving bookmarks.
Please purchase a SHRM membership before saving bookmarks.
An error has occurred
Recommended for you
SHRM Seminars are coming to cities across the US this fall.
SHRM’s HR Vendor Directory contains over 10,000 companies