Handling toxic medicines can be the root cause of adverse health conditions. This article speaks about the importance of Safe handling of hazardous drugs.Exposure to hazardous medication can cause adverse effects like allergies and skin infections, infertility, reproductive disorders, and various types of cancers. Handling, preparation and administration of such medicines need to be done with care. Any lapse of precautionary measures can expose nurses, pharmacists and other healthcare personnel to adverse health effects.

Antineoplastics, cytotoxic substances, antiviral agents, biologic agents and immunosuppressive agents are the various categories of dangerous medications. Direct contact of such substances with skin and inhalation of aerosols and vapors, drug leakage during transfer and contamination of surfaces are the different ways in which health care personnel are often exposed to the hazardous medicines. Exposure to risk from such medicines can be minimized by the use of personal protective equipment like masks, gloves, gowns and caps. Safe handling of such hazardous drugs can be implemented by the use of machines, equipment and biological safety cabinets. Research has proved that the implementation of safety measures has reduced the risk of occupational exposure to such harmful chemicals.

In many cases of Chemotherapy, while transferring cytotoxin from a vial to the syringe, vapors and aerosols are expelled in the process exposing the nurses and other health care personnel to toxic chemicals. Safe handling of hazardous drugs includes implementing Engineering controls in the form of machines and equipment designed to curb the adverse effects of these substances. One such engineering control is the closed system drug transfer device which prevents drug leakage during transfer from one container to another. Administrative controls include policies, methods and procedures adopted to implement these safety measures; these controls are equally important to reduce exposure to toxic medications.

Though all these measures have been known for years, there are frequent cases of occupational exposure to hazardous medications due to the lack of serious approach of nurses and health care personnel towards the risk of exposure to such drugs. Other reason is the personal protective equipment is cumbrous and its usage is time consuming. Safe handling of hazardous drugs can be effectively implemented through educating and training the nurses, pharmacists and others involved in handling, preparing and administering toxic medications.

Recent surveys have shown that traditional vial-to-syringe technique is one of the riskiest modes of occupational exposure to hazardous drugs. Vial over-pressurization can lead to spraying and leakage. These sprays and spills are frequently unnoticed, which may result in exposure of contaminated finished products to staff and patients in healthcare centers.

Closed System Drug Transfer Devices are special protective devices, designed to reduce the risk of occupational exposure. They provide a safer system for administrators to reconstitute and transfer hazardous drugs from manufacturers drug container to the patient specific equipment while operating patients. These have closed cabinets which prevent spills, leakages during the preparation, administration and disposal of these drugs.

Various types of drug transfer devices have already entered into the market and have made success in delivering effective results. They include a complete line of closed, vial and bag access products for safe preparation, transfer and administration of hazardous substances. They also assure protection through the entire spectrum of hazardous drug delivery.

Genie, designed by ICU Medical System is a closed, needle-free, vial-access device that automatically equalizes vial pressure. When the desired amount of drug is taken out from vial, the genie balloon automatically inflate to equalize the pressure thereby reducing aerosols, vapors and leaks caused by pressurization of vials. Similar systems having dual-venting feature to enhance the equalization of vial pressure and automatically self-seals when disconnected, have been already designed.

There are various guidelines on the effective way of usage of these devices, which must be followed by nurses and practioners in healthcare centers. These devices should always be used with in a ventilated cabinet while following appropriate personal protective equipment and work practices. Staff members should be properly instructed and observed regularly while using these devices. In addition, system failure reports should be immediately reported by all users including pharmacy and nursing, to the manufacturer.

Presently, use of Closed System Drug Transfer Devices has been the strategy employed by healthcare centers, to minimize the risk of exposure to hazardous drugs. However, the consistent and proper usage of these systems is paramount in ensuring containment.