The National Institute for Occupational Safety and Health (NIOSH) have set criteria for what “Makes a HD.” The six criteria include: carcinogenicity, teratogenicity, reproductive toxicity, organ toxicity at low doses, genotoxicity, structure, and toxicity profiles that mimic drugs deemed HD by previously stated criteria. These criteria were originally set in the late 1970s—years before genetically modified drugs and some of the other treatment modalities available today. As many older regulations, these also need to be adjusted based with progressive modern medicine. Many groups/governing bodies exist to evaluate and develop safety protocols based upon specific criteria. One of these agencies is USP. The most current hazardous drug handling recommendations are outlined in USP 800.

Implementing these new guidelines will require hospitals to adapt new technology, gain additional training and potentially change the facility physical structure. Four main points of USP 800 require the use of PPE, CSTD, class IIb hood and a negative pressure room. All four of these points will be required for any facility to pass compliance. Enforcement will mainly lie within state regulations and it is unclear at this time the true impact financially. Routes of potential exposure are also included in 800, including receipt, unpacking and storage of HD.

Chemotherapy safety is a constant topic for veterinary oncology personnel. Over the past few years, with the publishing of USP 800 many veterinary facilities have been trying to understand the recommendations and become compliant. Safety guidelines and topics are typically not a subjective conversation. This lecture will cover updates and frequently asked questions regarding USP 800 compliance.