In September 2004, the United States National Institute for Occupational Safety and Health (NIOSH) published an alert recommending more stringent preventive measures for the preparation and handling of hazardous drugs. This document quickly attracted attention in Quebec, where a number of institutions began questioning their preventive measures. The AQESSS Montreal Prevention Committee, as well as a number of institutions and organizations, have turned to the ASSTSAS for answers regarding medical and biological monitoring. In addition, some institutions whose pharmacy departments were being remodelled or were about to undergo remodelling wished to ensure the implementation of the proper measures, e.g. the type of pressure gradient required between the clean room , the antechamber and the general pharmacy.
In 1995, the ASSTSAS – whose mission is to promote occupational health and safety in health and social services institutions – had published a prevention guide in this regard, which it was planning to revise in 2005. Due to the issuing of the NIOSH recommendations, this revision was completed earlier.
Following a review of the reference material and extensive work in collaboration with a university hospital (CHUS) to assess the applicability of the NIOSH recommendations, the ASSTSAS felt it necessary to draw on the expertise and assistance of other stakeholders to produce a prevention guide which would reflect the diversity of the issues and points of view.
The Association thus formed a committee with mandate to produce a prevention guide for the safe handling of hazardous drugs in Quebec health care institutions.
This committee included professionals and stakeholders from the health care network with expertise and an interest in the hazardous drug issue. They have been introduced in a previous section. Some members were included in this committee in view of their expertise, while others were delegated by organizations with an interest in the issue (APES, AQATP, AQESSS, AQIO, CHQ, INSPQ, IRSST, MSSS). All of the members were asked to confer with their peers and collaborators in their respective environments.
This guide sets out the Committee’s recommendations regarding how to safely handle hazardous drugs. It refers to practices which may present a risk of exposure to those working closely with or at a distance from these drugs. The recommendations contained in this guide are in keeping with the general recommendations of the majority of recent guides published in North America, Europe and Australia.
This guide does not claim to address every issue, as some require further research. If necessary, updates will be published to supplement or clarify information regarding some of these issues.
The measures proposed in this guide should be considered recommendations; they are not normative and are not mandatory. Each workplace is to implement them based on its individual circumstances.
While the guide is primarily intended for health care workers, some recommendations apply to users of the health care network and their families. These recommendations are intended to protect these individuals from direct contact with sources of contamination and to ensure harmonization between institutional and home care. Patients and families who are properly informed regarding hazardous practices will be able, in turn, to help protect workers.
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