The toxicity of antineoplastic drugs in patients has been well-known since their introduction in the 1940s and 1950s. Because most antineoplastic medications have nonselective mechanisms of action, these agents affect noncancerous cells as well as cancerous cells, resulting in numerous adverse effects. When secondary cancers began to develop in patients treated with these drugs, concern was raised that healthcare workers also could be at risk for harmful effects from antineoplastic agents as a result of occupational exposure. In addition to the capability of many of the antineoplastic drugs of causing cancer, acute illnesses, and organ toxicity, evidence points to teratogenic and adverse reproductive outcomes in patients exposed to these agents. In current practice, antineoplastic medications are administered under controlled regimens that are designed to optimize benefits to patients while minimizing the risk for adverse effects. The safety of the patient is the primary focus. However, these procedures may result in job-related exposure of healthcare workers who are involved in patient treatment and related activities, such as storage, transportation, and disposal of the drugs. Awareness of the possible adverse health effects in workers during the 1980s prompted several organizations, including the Occupational Safety and Health Administration (OSHA),[3] the Oncology Nursing Society (ONS), and the American Society of Hospital Pharmacists (ASHP, now the American Society of Health-System Pharmacists) to issue safe handling guidelines for antineoplastic drugs. Despite these improvements in guidance and recommendations, more recent studies have shown that workers continue to be exposed to these toxic agents. In 1995, OSHA updated its recommendations and included some non-antineoplastic medications in its list of hazardous drugs. The National Institute for Occupational Safety and Health (NIOSH) issued an alert in 2004 reviewing literature on hazardous drug exposure and recommending a program of safe drug handling. This alert incorporated a comprehensive list of hazardous drugs that require special handling by healthcare workers. Although most of the drugs are antineoplastic agents, approximately one third are used to treat other diseases. This list was updated and expanded in 2010 to include newly-approved drugs and existing drugs with new health warnings.
Links with this icon indicate that you are leaving the CDC website.
The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
You will be subject to the destination website's privacy policy when you follow the link.
CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.
For more information on CDC's web notification policies, see Website Disclaimers.
CDC.gov Privacy Settings
We take your privacy seriously. You can review and change the way we collect information below.
These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. They help us to know which pages are the most and least popular and see how visitors move around the site. All information these cookies collect is aggregated and therefore anonymous. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance.
Cookies used to make website functionality more relevant to you. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests.
Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data.
Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. These cookies may also be used for advertising purposes by these third parties.
Thank you for taking the time to confirm your preferences. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page.