Background: Antineoplastic drugs are chemotherapy agents that control or kill cancer cells. Drugs used in the treatment of cancer are cytotoxic (destructive to cells within the body) but are generally more damaging to dividing cells than to resting cells.

Workers may be exposed to a hazardous drug at many points during its manufacture, transport, distribution, receipt, storage, preparation, and administration, as well as during waste handling and equipment maintenance and repair. All workers involved in these activities have the potential for contact with an uncontained hazardous drug.

Exposure to these drugs in the workplace has been associated with acute and short-term reactions, as well as long-term effects. Reports range from skin-related and ocular effects to flu-like symptoms, sore throat, chronic cough, infections, dizziness, eye irritation, and headaches among nurses, pharmacists, and pharmacy technicians routinely exposed to hazardous drugs in the workplace. Reproductive studies on health care workers have shown an increase in fetal abnormalities, fetal loss, and fertility impairment resulting from occupational exposure to these drugs.

Hazardous drugs enter the body through inhalation, accidental injection, ingestion of contaminated foodstuffs or mouth contact with contaminated hands, and dermal absorption.

Compounding of these drugs often requires sterile preparation and as such is regulated as pharmaceutical compounding by the United States Pharmacopeia (USP), chapter 797. USP 797 has provided minimal guidance for the handling of hazardous drugs.

A series of articles, published in July 2010 in the Seattle Times, highlighted health care personnel who had worked with hazardous drugs and been subsequently diagnosed with some form of cancer.

Summary: The Department of Labor and Industries (L&I) will adopt rules for the handling of hazardous drugs in health care facilities. Rule development will consider input from hospitals, organizations which represent health care personnel, and other stakeholders. It will take into account reasonable time for facilities to implement new requirements. Rules developed will be consistent with National Institute for Occupational Safety and Health (NIOSH) provisions adopted in the 2004 alert, as updated in 2010, but will not exceed them. Rules adopted can incorporate updates and changes by the Centers for Disease Control and Prevention.

Votes on Final Passage:

Senate	49	0
House	92	0