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1Repair Windows errors before they cause bigger problems2Fix the driver behind crashes, sound loss and screen glitches3Clear out junk files and repair common Windows errorsTechnicians handle chemotherapy safely by controlling exposure at every stage—not by relying on gloves alone. A dependable program identifies hazardous drugs, uses suitable containment and ventilation, matches work practices and personal protective equipment (PPE) to the task, trains every potentially exposed worker, and provides a written response for spills and exposures. The details must come from your facility’s procedures and the requirements that apply in your jurisdiction; this guide explains the prevention principles used in U.S. healthcare settings.
What “chemotherapy safety” covers
In occupational-safety guidance, chemotherapy is part of a wider category called hazardous drugs. These medicines may have carcinogenic, reproductive, organ-system, genotoxic, or other properties that can harm workers. The risk is not confined to a pharmacy technician drawing a dose. A hazardous drug can be encountered while it is received, unpacked, stored, compounded, labeled, transported, administered, cleaned up, or discarded.
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USP <800> describes that complete lifecycle and sets goals for worker safety, patient safety, and environmental protection. OSHA guidance addresses occupational exposure-control programs. Neither source replaces your employer’s written procedures, the current official USP text, or applicable state and federal requirements.
How technicians can be exposed
Exposure can occur through skin or eye contact, breathing airborne droplets or particles, contact with contaminated surfaces, or injuries involving contaminated needles and other sharps. Routine actions that deserve a risk review include:
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- Opening shipping containers or moving packages that are leaking, damaged, or contaminated.
- Transferring a drug between containers, manipulating vials, or preparing a dose.
- Connecting equipment, priming an intravenous line, or handling a dose during administration support.
- Handling needles, syringes, tubing, gowns, pads, or other materials that may carry residue.
- Labeling, transporting, stocking, or returning containers after preparation.
- Cleaning biological-safety cabinets, containment devices, counters, carts, refrigerators, or floors.
- Collecting hazardous-drug waste and responding to a spill.
“Nothing splashed me” does not prove that a task was exposure-free. Trace contamination can be transferred from a package or work surface to gloves, clothing, skin, or another location. Treat each task according to its potential route of exposure and your facility’s assessment.
Build protection around five decisions
1. Know which drugs your facility classifies as hazardous
Start with the facility’s current hazardous-drug list and the location-specific procedures for each dosage form. The current NIOSH publication is the NIOSH List of Hazardous Drugs in Healthcare Settings, 2024, published in 2025. NIOSH added 25 drugs to the 2016 list; 12 of those additions include manufacturer special-handling information, and seven drugs were removed. Those numbers describe changes to the list, not a rate of worker illness or a ranking of danger.
Do not rely on an old binder, a memory-based list, or a product name alone. Check the current list, the manufacturer’s handling information when required by your procedure, and any facility-specific additions. A drug may require controls in one dosage form or operation even when another form presents a different risk.
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Before beginning work, identify what you will do, where it will occur, what equipment is required, and what to do if the process fails. Receiving a sealed tablet bottle, cleaning a compounding area, and manipulating a powdered vial are not interchangeable activities. The procedure should identify the engineering controls, PPE, labeling, transport container, waste stream, decontamination method, and reporting route.
3. Use containment and engineering controls first
Containment devices, biological-safety cabinets or other appropriate primary engineering controls, closed-system transfer technology where required, ventilation, and designated work areas reduce the amount of drug that can escape. Keep equipment certified, maintained, and used only as trained. A cabinet cannot protect a worker if the sash, airflow, cleaning method, or loading practice is wrong.
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Engineering controls also include physical separation of hazardous-drug activities, restricted access, leak-resistant transport containers, and surfaces that can be decontaminated. PPE is a second layer, not a substitute for a failed or missing control.
4. Put on task-appropriate PPE
OSHA handling guidance identifies powder-free chemotherapy gloves tested to ASTM D6978 for hazardous-drug handling contexts. That statement supports a glove category; it is not a universal prescription for every task, drug, or facility. Your procedure should specify glove material, number of pairs, gown, eye or face protection, respiratory protection when applicable, and the order for donning, changing, and removing each item.
| Protection decision | What determines it | Technician check |
|---|---|---|
| Gloves | Drug, dosage form, manipulation, contact duration, and facility policy | Use the specified powder-free chemotherapy glove; verify ASTM D6978 testing when your procedure requires it. Change gloves at the stated interval and immediately after contamination or damage. |
| Gown | Potential for splashes, contact with contaminated surfaces, and the task’s containment level | Use the gown type and closure specified for hazardous-drug work; do not substitute a general disposable gown without approval. |
| Eye and face protection | Likelihood of splash or spray | Use the protection named in the procedure, especially for transfer, cleaning, or spill work. |
| Respiratory protection | Airborne hazard, task, engineering control, and respiratory-protection program | Never improvise a respirator. Follow the facility program for selection, fit testing, medical evaluation, and use. |
Inspect PPE before use. Avoid touching clean surfaces with contaminated gloves, and remove PPE in the sequence that prevents transferring residue to skin, clothing, handles, phones, or documentation. Dispose of or launder items through the designated process.
5. Know the emergency route before starting
Find the spill kit, eyewash or emergency shower, notifications, exposure-reporting form, and after-hours contact before handling the drug. OSHA says training should cover hazards, protective measures, and emergency procedures, and personnel should be trained before they are assigned relevant work. The exact spill steps, equipment, evacuation decisions, medical evaluation, and reporting deadlines are facility-specific.
Safe handling through the hazardous-drug lifecycle
Receiving and unpacking
Receive hazardous drugs only in the area and with the controls designated by your facility. Look for wetness, broken seals, crushed cartons, powder, or other evidence of a leak before opening a package. Do not handle a questionable package as ordinary stock. Isolate it according to the receiving procedure, restrict access, use the required PPE and containment, and notify the designated person. Document the event through the normal reporting system.
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Storage and internal transport
Store hazardous drugs in the designated location, with segregation and temperature controls maintained. Keep containers closed and labels legible. Use a leak-resistant, labeled transport container rather than carrying an exposed syringe, vial, or bag by hand. Plan the route to reduce public contact and avoid elevators, pneumatic tubes, or other transport methods that your procedure excludes.
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Preparation and compounding
Only trained and authorized personnel should manipulate hazardous drugs. Complete the required checks before entering the containment area: confirm the drug and dose, inspect equipment, verify that the primary engineering control is operating, assemble supplies to minimize interruptions, and don the specified PPE. Keep absorbent materials and waste containers positioned as the procedure directs. Avoid forceful movements that can create aerosols, and never use a technique that defeats the containment device.
After preparation, wipe or decontaminate the outside of the final container as required, apply the correct label, and place it in the designated transport packaging. Remove waste and contaminated supplies through the correct stream rather than leaving them on a work surface.
Administration support and cleanup
Technicians who deliver supplies, prime lines, connect equipment, or clean treatment areas can encounter residue even when they did not prepare the dose. Follow the administration-area procedure for PPE, tubing, absorbent pads, and sharps. Keep contaminated items contained; do not recap needles unless a specific safety procedure requires it. Clean surfaces with the approved sequence and agent, using the required PPE and contact time. Ordinary housekeeping methods may spread residue instead of removing it.
Waste and disposal
Place contaminated gloves, gowns, tubing, syringes, absorbent pads, and drug containers in the labeled hazardous-drug waste or sharps containers specified by your facility. Close containers before moving them, keep them upright, and use the designated route to temporary storage or disposal. Do not place hazardous-drug waste in regular trash or pour drug residue into a sink unless your written procedure explicitly authorizes that action.
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What to do when a spill or exposure occurs
A spill response is a practiced procedure, not a judgment call made in the moment. If a spill occurs, stop the task, warn others, restrict the area, and follow the facility’s written sequence. Depending on the event, that may include obtaining the spill kit, putting on specified PPE, using absorbent materials, collecting broken glass with tools rather than hands, cleaning and decontaminating the area, and placing all cleanup material in hazardous-drug waste. Do not improvise a chemical neutralizer or use a household cleaner unless the procedure identifies it.
For a skin or eye contact, use the eyewash, emergency shower, or washing method immediately as directed. For a puncture or other sharps injury, perform the first aid and urgent reporting steps in the exposure procedure. Notify the supervisor or designated occupational-health contact, obtain the required medical evaluation, and complete documentation even when symptoms are absent. Preserve relevant labels and records so the event can be investigated.
Never re-enter a restricted area simply because the visible liquid is gone. The responsible person must determine when cleanup is complete and when the area and equipment can return to service.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.Training, competency, and records
Training should occur before assignment and whenever a drug, device, procedure, engineering control, or policy changes. Effective competency evaluation covers more than watching a video. It should address:
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- Routes of exposure and the hazards of the specific dosage form.
- Operation, limitations, and cleaning of containment and ventilation equipment.
- Correct PPE selection, donning, doffing, disposal, and glove changes.
- Labeling, transport, storage, waste segregation, and documentation.
- Spill, splash, sharps-injury, and accidental-exposure response.
Keep training and competency records according to facility policy. Report near misses, damaged packages, equipment failures, and recurring contamination findings; prevention improves when the program learns from events that did not injure anyone.
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How facilities decide which controls are needed
USP’s risk-assessment approach considers the drug type, dosage form, potential exposure, packaging, and the way the product will be manipulated. A sealed commercial container, a tablet that must be split, a liquid that will be withdrawn from a vial, and a powder requiring reconstitution can therefore require different controls. The assessment should also account for receiving, storage, transport, administration, cleaning, and disposal—not just compounding.
Use the assessment to compare the task, route of exposure, engineering control, PPE, and local procedure. Do not convert one example into a universal glove, cabinet, or spill recipe. OSHA requirements, professional standards such as USP <800>, and facility policy are related but not identical; your supervisor or safety officer should identify which rules govern your assignment.
Common failure modes and practical corrections
- “It is only one dose.” Repeated small tasks can contaminate surfaces. Apply the procedure every time.
- “The gloves make it safe.” Gloves can tear or become contaminated. Use containment, ventilation, work practices, and PPE together.
- Using an old hazardous-drug list. Check the current NIOSH list and the facility’s controlled copy.
- Carrying an uncontained syringe or bag. Use the specified closed, labeled transport container.
- Cleaning a spill with ordinary supplies. Stop, isolate, and use the trained spill procedure and kit.
- Removing PPE in the wrong order. Follow the trained doffing sequence and perform hand hygiene as directed.
- Skipping a report because there is no symptom. Report contact, spills, and near misses promptly so medical follow-up and corrective action are possible.
A pre-task checklist for technicians
- Confirm the drug, dosage form, and hazardous-drug classification.
- Read the procedure for the exact task and location.
- Verify that the required containment, ventilation, and equipment are available and functioning.
- Locate the spill kit, eyewash or shower, emergency contacts, and reporting route.
- Gather supplies to avoid unnecessary movement and interruptions.
- Don the specified PPE and check its condition.
- Perform the task without bypassing containment or labeling controls.
- Contain, clean, transport, and discard materials exactly as the procedure states.
- Remove PPE safely, wash as directed, and report any deviation, spill, or exposure.
Questions technicians commonly ask
Are all chemotherapy drugs handled the same way?
No. Controls depend on the drug, dosage form, packaging, manipulation, exposure route, and task. Use the facility’s risk assessment and procedure rather than applying one PPE or containment recipe to every product.
Does ASTM D6978 testing make a glove suitable for every task?
No. OSHA guidance identifies powder-free chemotherapy gloves tested to ASTM D6978 for hazardous-drug handling contexts, but the task and facility procedure still determine the required glove, number of pairs, change interval, and other PPE.
Who needs hazardous-drug training?
Anyone whose assignment may expose them—including receiving, pharmacy, nursing, environmental-services, transport, waste, and other support personnel—should receive role-appropriate training before performing the work.
Where can I find the exact spill steps?
Use your facility’s current hazardous-drug spill procedure and training materials. They should identify the kit, PPE, isolation steps, cleanup method, notifications, medical evaluation, and documentation route. If you cannot find them, stop the task and contact your supervisor or safety officer before handling the spill.
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