Risk assessment of hazardous drug handling

Hazard identification should establish who may be at risk, the cytotoxic drugs being used, the routes of exposure and the specific activities where there is a risk of exposure. Risk control measure currently in use and their effectiveness with future planned treatments should be identified and recorded in action plans. The purpose for the assessment is to enable decision to be made about the appropriate risk control measures, induction and training, monitoring and health surveillance as may be required by legislation. The assessment process enables a distinction to be made between ‘hazard’ and ‘risk’. If a cytotoxic drug is classified as hazardous, it has the potential to be harmful to health.

The risk is the likelihood that harm will be caused in the actual circumstances of use of the substance. Decisions about appropriate action to protect workers will depend on the degree of health risk that arises from the use of cytotoxic drugs and related wastes in particular environments. The risk assessment may be done for a work process, could be job safety analysis or safe work method statement and may cover more than one cytotoxic drug. The following step-by-step procedure may be used to assist with the risk assessment process. Risk assessment can be separated into two parts; assessing the hazard and evaluating the risk.

The Work Health and Safety regulations set out a hierarchy of controls or ranking of controls that incorporate a best practice approach to managing risks. These controls are in order of greatest effectiveness to

least effective as follows: The most effective, elimination. Elimination is to remove the hazard or hazardous work practice from the workplace. Substitution, the second effective,

replacing the hazardous chemical with a chemical that is less hazardous.