NIOSH Hazardous Handling - Mpje

1. Identify the correct gown type for HD compounding and spill response per NIOSH concepts.

   Disposable, lint-free, low-permeability chemotherapy gown. These gowns provide a barrier against drug permeation while minimizing particle generation in clean environments.

2. Which respirator type is generally appropriate for HD spill cleanup when powders/aerosols may occur?

   NIOSH-certified N95 or higher; use per risk assessment. N95 respirators filter airborne particulates, selected based on exposure assessment to protect against inhalable hazards.

3. Which NIOSH criterion covers drugs that mimic hazardous drugs in structure or toxicity?

   Structure and toxicity profiles of new drugs that mimic HDs. This criterion includes novel drugs resembling known hazardous ones in molecular structure or toxicological effects.

4. Which NIOSH concept prioritizes engineering controls over PPE when reducing exposure?

   Hierarchy of controls (engineering > administrative > PPE). This prioritizes source elimination via engineering, then safe practices, and lastly barriers like PPE for exposure reduction.

5. What NIOSH criterion refers to organ toxicity at low doses (acute or chronic)?

   Organ toxicity at low doses. This criterion applies to drugs causing serious damage to organs like liver or kidneys even at minimal exposure levels.

6. What NIOSH criterion refers to causing genetic mutations or DNA damage?

   Genotoxicity. This criterion targets drugs that damage DNA or chromosomes, leading to potential heritable changes.

7. What NIOSH criterion refers to harming fertility or reproductive capability?

   Reproductive toxicity. This criterion includes drugs that impair fertility, cause germ cell mutations, or disrupt reproductive functions.

8. Which exposure routes must be controlled when handling hazardous drugs per NIOSH concepts?

   Dermal, inhalation, ingestion, injection (needlesticks), ocular. Controlling these routes prevents hazardous drug absorption through skin, lungs, mouth, punctures, or eyes during handling.

9. A worker is pregnant and assigned to handle Group 3 drugs; what is the NIOSH-consistent staffing action?

   Offer alternative duty or reassignment to minimize reproductive exposure. Reassignment protects pregnant workers from reproductive toxins, aligning with NIOSH's emphasis on vulnerable populations.

10. Which NIOSH group includes antineoplastic drugs and is treated as hazardous by default?

    Group 1: Antineoplastic drugs. These cancer-treating drugs are inherently hazardous due to their cytotoxic mechanisms affecting cell division.

11. A tablet is on the NIOSH list but is intact and film-coated; which handling approach is most appropriate?

    Use risk-assessed precautions; avoid crushing/splitting if possible. Intact coatings reduce exposure risk, so site-specific assessments guide precautions while minimizing manipulation.

12. Which action is appropriate if an HD oral capsule must be opened for administration?

    Treat as higher risk; use containment and PPE to prevent aerosolization. Manipulation increases aerosol or dust risks, necessitating engineering controls and PPE to contain potential releases.

13. Which disposal approach best follows NIOSH concepts for trace-contaminated HD items (e.g., gloves)?

    Dispose as hazardous drug waste per facility policy and regulations. Proper hazardous waste management ensures regulatory compliance and prevents environmental or secondary exposures.

14. Which PPE item is considered essential for most HD handling tasks due to dermal exposure risk?

    Chemotherapy gloves (tested for HD permeability). These gloves are specifically evaluated to resist penetration by chemotherapy agents, reducing dermal absorption risks.

15. Which federal body publishes the authoritative hazardous drug list used in pharmacy practice guidance?

    NIOSH (National Institute for Occupational Safety and Health). NIOSH researches and recommends practices to prevent occupational hazards, including maintaining the list for safe drug handling in healthcare.

16. What is the primary engineering control used for HD sterile compounding to protect the worker?

    Containment primary engineering control (C-PEC), such as a CACI. C-PECs like CACIs provide isolated, ventilated environments to contain hazards and maintain sterility during compounding.

17. What is the core purpose of the NIOSH hazardous drug list in pharmacy handling decisions?

    To identify drugs needing exposure controls to protect workers. The list categorizes drugs based on toxicity to guide implementation of protective measures against occupational exposure in pharmacies.

18. Which practice best aligns with NIOSH guidance for receiving HD shipments with visible damage?

    Do not open; isolate area and manage as an HD spill. Avoiding opening prevents release of contaminants, allowing safe containment and cleanup as per hazardous protocols.

19. What NIOSH criterion refers to causing cancer in humans or animals?

    Carcinogenicity. This criterion identifies drugs shown to induce tumors or cancer through experimental or human studies.

20. What is the main reason NIOSH recommends a closed-system drug-transfer device for HDs?

    To mechanically prevent escape of HD and entry of contaminants. CSTDs ensure sealed transfers, minimizing leaks of hazardous substances and ingress of external contaminants.

21. Which NIOSH criterion alone is sufficient for a drug to be considered hazardous?

    Any one criterion (e.g., carcinogenicity, teratogenicity, etc.). NIOSH classifies drugs as hazardous if they meet at least one toxicity criterion, ensuring comprehensive risk identification.

22. Which NIOSH group includes non-antineoplastic drugs that still meet HD criteria?

    Group 2: Non-antineoplastic hazardous drugs. These drugs meet hazardous criteria for toxicity but are used for non-cancer indications like autoimmune disorders.

23. Which NIOSH group includes drugs that primarily pose reproductive risk to workers?

    Group 3: Reproductive risk drugs. These drugs mainly pose risks to fertility or pregnancy, requiring precautions for workers of reproductive age.

24. Which glove material is generally preferred for HD handling due to chemical resistance?

    Nitrile chemotherapy gloves. Nitrile offers broad chemical resistance and low permeability to hazardous drugs, making it suitable for safe handling.

25. What NIOSH criterion refers to causing birth defects or fetal harm?

    Teratogenicity or developmental toxicity. This criterion covers drugs that cause congenital malformations or adverse developmental effects in offspring.

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