Critical Risks of Occupational Exposure in Pharmaceutical Industries: Protecting Healthcare Heroes

Occupational exposure of workers at healthcare institutes are exposed to unintentional entry of hazardous drugs into the body via different routes; namely: dermal or mucosal absorption, inhalation, eye contact, mouth contact with contaminated hands &/or injections.

Such exposure poses serious health risks, as hazardous drugs may cause carcinogenicity, reproductive toxicity, organ toxicity, teratogenicity, or genotoxicity, as defined by the National Institute for Occupational Safety and Health (NIOSH).

Routes of Occupational Exposure 

Potential routes of occupational exposure are mainly based on the activity conducted. The following table describes how the route of exposure differs with different conducted activities

 Table 1 Potential routes for exposure, the healthcare workers involved, and hazardous drug activities

Definitions of Key Processes

• A hazardous drug is any drug that is identified by NIOSH as causing carcinogenicity, reproductive toxicity, organ toxicity, teratogenicity or genotoxicity

• Decontamination is the process of inactivating, neutralizing, or removing hazardous drug contaminants on the work surface.

• Deactivation is the process of handling of contaminated areas with a chemical, heat, ultraviolet, or any other substance that will alter the area into a less hazardous area.

• Disinfection is the process of inhibiting &/or destroying any microorganism.

What is Occupational Exposure Banding (OEB)?

What is Occupational Exposure Banding (OEB)?

Occupational Exposure Banding (OEB) is a process that is used to evaluate and categorize chemical substances based on their potential health hazards. This system helps determine appropriate exposure controls for workers encountering hazardous chemicals. The goal is to minimize the risk of adverse health effects from workplace exposures, especially for chemicals with limited toxicological data.

Risk Assessment and Dosage forms 

Some dosage forms of hazardous drugs may not have a significant risk impact of occupational exposure. These dosage formulations are solid intact medications that are directly administered by the patient without any modification. That is why during the risk assessment of potential occupational exposure, the following must be questioned at least:

• Type of the hazardous drug in terms of the risk imposed (antineoplastic, non-antineoplastic, organ toxicity, or reproductive risk).
• Dosage form: Certain formulations (e.g., powders, and aerosols) are more likely to generate exposure risks.
• Presence of risk exposure: Includes factors such as aerosol generation, drug residue, or liquid spills.
• Packaging form: Bulk packaging or poorly sealed containers may increase the risk of contamination.
• Manipulating or way of handling: Crushing, reconstituting, or transferring drugs can significantly heighten exposure risks.

Responsibilities of Healthcare Workers 

Healthcare workers handling hazardous drugs are obliged to understand and follow the necessary work practices and potential precautions. Continuous evaluation of such procedures is a must to prevent harm to themselves &/or to the patients. Along with minimizing exposure to personnel and to lessen contamination, that may arise, in the workplace and the patient-care environment.

Surface Contamination: A Persistent Risk 

Surface contamination is a potential risk to healthcare workers. Adhering to proper controls, and following appropriate procedures that comply with the applicable regulations and standards are preventive measures towards minimizing occupational exposure.

Regulations and Standards 

Adhering to applicable regulations and standards is vital for minimizing occupational exposure to hazardous drugs. These guidelines are often provided by organizations such as:

• NIOSH: Offers recommendations on safe handling practices for hazardous drugs.
• USP Chapter <800>: Outlines standards for handling hazardous drugs to protect healthcare workers and patients.
• Occupational Safety and Health Administration (OSHA): Provides guidelines for workplace safety, including hazardous drug handling.