SafetyVet

Solutions for the veterinary professions!

Looking for answers to OSHA Questions?  Check out our OSHA Center!

The Facility Precautions for Chemo Procedures in the Veterinary Practice

The health risks to the staff from cytotoxic drugs (CDs) in the veterinary practice are a combination of the drugs' inherent toxicity and the extent to which the staff member is exposed to the drug during procedures. Exposure can occur at many points in the process, and in the veterinary practice, the most probable scenarios for exposure are:

• through inhalation of dusts or droplets during the preparation,
• dermal absorption during the administration of the drug, patient care or because of an accidental spill, and
• ingestion through contact with contaminated food or cigarettes.

When deciding on a method to control or eliminate any safety hazard, OSHA expects the business to first rely on “engineering controls” as the solution before the use of procedural policies or personal protective equipment. Certainly good procedures and PPE are necessary, but they do not negate the need for proper workspace design and facility preparation.

Perhaps the most basic purpose of using physical safeguards is to prevent or control environmental exposure during procedures. Typically, this exposure comes in the form of splattering, spraying, and aerosol generation of the material during handling, preparation or accidental spills. In that vein, environmental controls are not only designed to protect those staff members immediately involved in the procedure, but also other staff members in the area or those who may utilize the area at a later time.

All CDs must be stored and prepared in one centralized area to minimize the risk of “extraneous” contamination throughout the facility. This is generally interpreted to mean a single-purpose room, used exclusively for chemotherapy procedures. In specialty practices with oncology services, this room should be large enough to prepare and administer the drugs as well as segregate patients from the “common areas” during hospitalization. The busy treatment room is the least suitable place for these procedures.

OSHA requires that a Biological Safety Cabinet (BSC) will be used for the dilution, “drawing up” or mixing of all dangerous drugs. Click here to view our Suggested Sources Sheet for chemo cabinets.

Warning signs identifying the area as a CD preparation area should be clearly posted on the door to the chemotherapy area and entry restricted to authorized persons.

Spill clean-up procedures should be clearly posted in the area and a prepared spill response kit should be nearby for use in a spill emergency.

There must be a yellow sharps container present inside the BSC and another in the administration area. A suitable waste collection container and segregated laundry container must be available in the room.

An appropriate eye wash device must be readily available; in this case, it’s considered essential that the eyewash device be in the room where all procedures are performed. (See the SEP/OCT 02 issue of The Digest for information on eyewash devices.)

Since normal disinfection procedures with a germicidal agent are inappropriate for CD areas, special care must be observed in the cleaning of the chemotherapy room. At the end of each procedure or when cleaning patient cages, the precautions outlined for spill clean-up should be followed. Additionally, at the end of each day, the entire area should be “sprayed” thoroughly with 70% alcohol.

Naturally, smoking, drinking, applying cosmetics, and eating should never take place in the preparation area, as these activities greatly increase the chance of exposure.

Obviously, there are many other considerations for using these hazardous drugs in the veterinary practice, such as:

• caring for treated patients;
• preparation of the drug;
• clean-up and spill response procedures; and
• staff training issues.

Answers to all of these questions are available in The Complete Veterinary Practice Regulatory Compliance Manual and The Veterinary Safety & Health Digest.

Back to OSHA Questions page

The information on these pages is excerpted from
The Veterinary Safety & Health Digest
Copyright 2003 Philip J. Seibert, Jr., CVT  All Rights Reserved
No part of this publication may be reproduced for distribution without prior permission from the publisher.