What is required to manage the risk?

Hi everyone I am Shao-Chin Chiang. Currently working in Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan. As the deputy director of pharmacy. Today we are going to discuss the risk management in hazardous drug handling. Cytotoxic drugs are known to be highly toxic to health and classified as hazardous chemicals. The aim of the risk management is to eliminate or minimize the risk of illness or injury associated with work. There were persons that is responsible for risk management. The first type is the Persons Conducting a Business or Undertaking. The second type, their responsible agencies. The third type, all workers who handle cytotoxic drugs occupationally.

Persons Conducting a Business or Undertaking, their responsible agencies and all workers who handle cytotoxic drugs occupationally have an obligation to following functions. Number one, work to risk management plan. Keep up-to-date with current local safework procedures, practices and standards.

Three, consult with workers at key stages of risk strategy development — at the planning stage, during implementation, monitoring and review. Number four, assess safe work and procedures on a regular basis.

A Persons Conducting a Business or Undertaking and its responsible agency must manage risks associated with using, handling, generating or storing of hazardous chemicals at a workplace. To manage the risk, a duty holder must do following two things. Number one, identify reasonably foreseeable hazards that could give rise to the risk. Number two, eliminate the risk so far as is reasonably practicable. Number three, if it is not reasonably practicable to eliminate the risk, minimize the risk so far as is reasonably practicable by implementing control measures in accordance with the hierarchy of risk control. Maintain the implemented control measure so that it remains effective.

Review, and if necessary revise all risk control measures so as to maintain, so far as is reasonably practicable, a work environment that is without risks to health and safety. When managing the risks associated with cytotoxic drugs, the following must be considered. The hazardous properties of the cytotoxic drug. Any potentially hazardous reaction, could be chemical or physical, between the cytotoxic drug and another substance or mixture, including a substance that may be generated by the reaction. The nature of the work to be carried out with the cytotoxic drug. Any structure, plant or system of work that is used in the use, handling, generation or storage of the hazardous chemical or it could interact with the hazardous chemical at the workplace.

Generally, risk management is a process of follow. Number one, consultation and communication with workers. Number two, consultation, cooperation and coordination of activities with other duty holders, for example, waste management contractors, laundry, linen service providers. Number three, hazard identification. Number four, risk assessment. Number five, implementing risk control measures. Number six, evaluation of risk control measures. Number seven, continuous improvement.

Duty holders may have dual responsibility for health and safety matters. In these situations, communication and consultation with external and internal interested parties should take place during all stages of the risk management process. Therefore, plans for communication and consultation need to be developed from an early stage and should address issues related to the risk and the measures to control, treat and monitor the risk. This will ensure the exchange of information to determine roles and responsibilities and cooperation and coordination so that all risks are eliminated and minimized as far as reasonably practicable. Consultation must occur when identifying cytotoxic drug and associated hazards. And could also occur during the risk assessment process.

Or when determining which control strategies should be applied to eliminate or minimize risk associated with the handling of cytotoxic drugs. Or could occur when reviewing the effectiveness of risk control measures. It could also occur prior to changing premises, work environment, plant, systems of work or substance used for work, including safety data sheets.