According to OSHA, there are potential risks involved with the administration of hazardous drugs to patients. Their guidance in the HCS provides the following scenarios:
- Administration of drugs to patients is generally performed by nurses or physicians. Drug injection into the IV line, clearing of air from the syringe or infusion line, and leakage at the tubing, syringe, or stopcock connection present opportunities for skin contact and aerosol generation. Clipping used needles and crushing used syringes can produce considerable aerosolization as well.
- Excreta from patients who have received certain antineoplastic drugs may contain high concentrations of the drug or its hazardous metabolites. For example, patients receiving cyclophosphamide excrete large amounts of the drug and its mutagenic metabolites. Patients treated with cisplatin have been shown to excrete potentially hazardous amounts of the drug. Unprotected handling of urine or urine-soaked sheets by nursing or housekeeping personnel poses a source of exposure.