“And so you have different kinds of hazards with the drugs that you’re using. That means that in the past, when a lot of oncology drugs, antineoplastic drugs used to treat cancer would have been added, you may see that a lot of oncology drugs either weren’t added or they’re added in a different place on the list than they were in the past. That’s due to some of the restructuring of the list we’ll probably talk about later,” Jerald L. Ovesen, PhD, pharmacologist at the National Institute for Occupational Safety and Health (NIOSH) and Centers for Disease Control and Prevention, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the latest update to the NIOSH list of hazardous drugs. 

Music Credit: “Fireflies and Stardust” by Kevin MacLeod 

Licensed under Creative Commons by Attribution 3.0  

Episode Notes  

• NCPD contact hours are not available for this episode. 
• ONS Podcast™ episodes:
  • Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs 

  • Episode 142: The How-To of Home Infusions

  • Episode 68: Empowering Healthcare Workers to Handle Hazardous Drugs
  • Episode 53: Home Care Nursing for Patients With Cancer
• ONS Voice articles:
  • Hazardous Drug Surface Contamination Prevails, Despite More Diligent PPE 
  • NIOSH Releases Its 2024 List of Hazardous Drugs 
  • No Place Like It: Home Care for Patients With Cancer 
  • What Is ONS’s Stance on Handling Chemotherapy While Pregnant, Breastfeeding, or Trying to Conceive? 
  • What You Wear Matters When It Comes to Safety 
• ONS book: Safe Handling of Hazardous Drugs (Fourth Edition) 
• ONS course: Safe Handling Basics 
• Clinical Journal of Oncology Nursing article: Safe Management of Chemotherapy in the Home 

• ONS Learning Library: Safe Handling of Hazardous Drugs 

• ONS Position Statement: Ensuring Healthcare Worker Safety When Handling Hazardous Drugs 
• National Institute for Occupational Safety and Health article: Managing Hazardous Drug Exposures: Information for Healthcare Settings 
• NIOSH List of Hazardous Drugs in Healthcare Settings, 2024 

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  

To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. 

To provide feedback or otherwise reach ONS about the podcast, email [email protected]. 

Highlights From This Episode 

“So we look for a carcinogenic hazard. So does this molecule, does this chemical, this drug, have the ability to increase the risk of cancer? A lot of the time that will also tie with genotoxic hazards, but not always. There are some drugs on the list that are carcinogenic through other mechanisms. Sometimes carcinogenicity can be related to hormone signals, can lead to increased risk of cancer. There’s some nuance there, but is it a carcinogenic hazard? That can get it onto the list. Is it a developmental and reproductive hazard?” TS 10:48 

“NIOSH can’t say what’s right for every situation, but some organizations have suggested further precautions such as temporary alternative duty for workers who are pregnant or are looking to become pregnant. NIOSH can’t say what’s best for any given facility, but other organizations have given some good suggestions you may want to look into.” TS 13:18 

“The list doesn’t really rank hazard. I know a lot of people have kind of treated it that way a lot of times. We don’t say that something is less hazardous if it’s only a developmental or reproductive hazard, because if you’re trying to have a child, then that’s an important hazard to you. And we don’t necessarily say something that’s carcinogenic is more hazardous.” TS 14:34 

“Some standard setting organizations have set standards for handling. Really in the oncology setting, particularly oncology pharmacy setting, it’s really changed how some of the handling happens there because some of the standards come out of the pharmacy world. And what’s happened there is some drugs that are oncology drugs, they might have been on table one before just because they were used in the treatment of cancer. They were antineoplastics, so they were on table one. Now, because they’re not identified as a potential carcinogen and they don’t have manufactured special handling information, they are now on table two.” TS 23:39 

“Occasionally, if a drug comes out and has manufacturer special handling information, we’ll go ahead and add it to the list. And since we won’t add it into the publication, we typically have a table on that page that puts that there. If a drug is reevaluated and we find that the hazard is not as bad as expected or it’s not a hazard, actually, and we can remove it from the list; sometimes we get new information and that happens.” TS 30:30