Safe handling of Hazardous Materials

Toxic

Acutely harmful to health

Cytotoxic

acutely harmful to cells

Embryotoxic

Acutely harmful to embryos/foetuses

Mutagenic

Capable of changing genetic material

Carcinogenic

Capable of directly causing cancer

Teratogenic

Causes malformations in embryos/foetus

Harm vs Risk

• Harm - is an adverse outcome or impact.

• Risk - is the matrixed combination of severity & likelihood.

Define the terms:

• Biological

• Chemical

• Physical

• Psychosocial

In relation to hazardous materials

• Biological. Harmful organic substances, e.g. proteins or blood

• Chemical. Harmful inorganic substances, e.g. bleach, 5-FU

• Physical. Harmful environmental factors e.g. Pressure, noise, radiation, poor ergonomics and unsafe work areas

• Psychosocial. Not Bio/Chem/Phys but have an adverse effect on wellbeing, e.g. harassment, low control, workload & bad culture

Sign for cryogenic

Sign for Carcinogenic

Sign for biological

When are drugs classed and handled as hazardous?

If drugs meet one or more of the following criteria:

• Carcinogenicity

• Teratogenicity

• Reproductive toxicity

• Organ toxicity at low doses

• Genotoxicity (Older Cytotoxics)

HASWA

Helath and Safety at work act - 1974

PPEWR

Personal Protective equipment at work regulations - 1992

COSHH

Control of substances hazardous to health - 2002

Potential routes of exposure

• Ingestion (Consuming)

• Inhalation (Breathing)

• Dermal (Absorption through skin)

• Mucosal membranes (moist lining of organs & cavities)

• Percutaneous (needle puncture)

Personnel that would be affected by exposure

As well as these personnel, carers and relatives would be affected

• manufacture

• transport  

• stores

• reception

• dispensing

• administration

• nursing

Reproductive Risk

• increased risk of premature delivery

• longer time to conceive

• low birth weight

Latency periods

The latency period following exposure may be years

Which surfaces can be contaminated?

• Vial surface

• Product surface

• Work surface

All of these can be contaminted

Air contamination

Using containment exhausts can be contaminated as the recirculated air can sometimes have the contaminants

Hierarchy of Control

• assess risk

• eliminate (removing the exposure before it can occur)

• substitute (removing the exposure before it can occur)

• engineering control - change/adapt the environment

• admin controls - require someone to do something

• PPE

Using Substitution to manage risk

• Substitute powders with liquids

  • Removal of reconstitution step

• Substitute standard needles with

  • Luer-lock fittings

  • Vented needles

  • Compounding spikes

• Vials versus ampoules

Using engineering controls to manage risk

Based on two aspects:

• Product protection

• Operator protection (PPE)

General changes we do:

• Well designed rooms

  • Smooth, easy to clean surfaces and furniture

  • Environmental control

  • Minimal objects and storage within

Type of ventilated cabinet:

–LAFCs vs BSC vs isolators

–Positive or negative pressure

–Flexible vs rigid materials

Material decontamination

Administrative control to manage risks

• education and training

  • Only trained staff can handle hazardous materials

• procedures

  • clear and unambiguous written SOPs

  • minimum staff numbers to ensure safe working

• surveillance and supervision

  • adherence to safe handling to safe handling techniques

PPE

PPE is the final barrier between operators and hazards/products

Multiple light layers best as opposed to thick heavy layer which can impede movement and be uncomfortable

Decontamination

Removal

• Aqueous clean

• Detergent

• Validated method

Denaturation

• Biologics

• Bleach or alkaline agents

PPE Gloves

• Latex

• Vinyl - reduced barrier protection due to its susceptibility to tears, breakage and pinholes compared to latex.

• Nitrile - good tear resistance and chemical resistance although cost more than either latex or vinyl.

• Neoprene - comfort but is also more expensive than latex.

• Polyurethane - good comfort and tactile sensitivity as well as puncture, tear and abrasion resistance. However, expensive