GUIDELINES & REGULATIONS

What is a CSTD? Does USP 800 require the use of CSTD’s for compounding HD’s? Does USP 800 require the use of CSTD’s for administering HD’s? Why do nurses need to use a CSTD when administering chemo?

What were we asked to look at?

NHS Forth Valley asked us to review the evidence on the effectiveness of closed-system transfer-devices (CSTDs) in reducing the risk of exposure to hazardous anti-cancer drug treatments in healthcare professionals (all relevant staff groups including pharmacy, nursing and cleaning staff), patients and their visitors.

Xavier Guardino Solá, Gracia Rosell Farrás, Míriam Galisteo Manzanares

Los citostáticos son sustancias citotóxicas diseñadas y utilizadas para causar disfunción celular, inhibiendo el crecimiento de las células cancerosas mediante la alteración del metabolismo y el bloqueo de la división y la reproducción celular, por lo que se utilizan preferentemente

The National Institute for Occupational Safety and Health (NIOSH) requests assistance in preventing occupational exposures to antineoplastic drugs (drugs used to treat cancer) and other hazardous drugs in health care settings. Healthcare workers who work with or near hazardous drugs may suffer from skin rashes, infertility, miscarriage, birth defects, and possibly leukemia or other cancers.

Introducción: Desde el principio, se planteó como objetivo principal del grupo de trabajo la elaboración de una guía en la que se pudiese justificar la necesidad de revisión de la Orden 22 de abril de 1992 de la Comunidad de Madrid, normativa vigente en la actualidad, pero que no contempla la minimización de los riesgos de exposición debida a los cambios y mejoras técnicas de los últimos veinte años en materia de seguridad y salud de los trabajadores expuestos a agentes citostáticos.

This guide provides practical advice to PCBUs and workers on how to prevent or minimise the risks to health associated with handling cytotoxic drugs and related waste within health care establishments, community settings and veterinary practices. It will assist in the development and implementation of safe systems work of that are consistent with the…

Préambule :

Ces recommandations concernent les dispositifs médicaux destinés à la préparation et à l’administration parentérale des médicaments cytotoxiques et par extension à tout médicament présentant des risques toxiques pour le personnel et l’environnement.

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.

“The EU needs to address more effectively the impact of the interaction of Occupational Health and Safety (OHS) with the environment and chemicals”, highlighted the European Commission in the results of the evaluation of the 2007-12 OHS strategy.

This recommendation is particularly imperative in the healthcare sector. While the majority of occupational hazards have been successfully addressed by legislation at the European and national level, much remains to be done when it comes to the exposure of healthcare workers to chemical risks during activities such as the preparation and administration of cytotoxic drugs used to treat patients with cancer.