Hazardous Medication Personal Protective Equipment …

1 Hazardous Medication Personal Protective Equipment (PPE) Guide REDUCING OCCUPATIONAL EXPOSURE TO Hazardous . Medication FOR ALL STAFF. OCTOBER 2021 ( ). 2018, 2020, 2021 Alberta Health Services (Pharmacy Services, Health Professions Strategy and Practice and Workplace Health and Safety) and Covenant Health (Pharmacy Services). This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike International License. To view a copy of this license, visit The license does not apply to AHS or Covenant Health logos and trademarks or third party works licensed by AHS or Covenant Health Disclaimer This material is intended for general information only and is provided on an as is, where is basis. Although reasonable efforts were made to confirm the accuracy of the information, neither Alberta Health Services nor Covenant Health make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information.

2 This material is not a substitute for the advice of a qualified health professional. Each of Alberta Health Services and Covenant Health expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use. i OCTOBER 2021 ( ). Preamble The Alberta Health Services (AHS) / Covenant Health (COV) Hazardous Medication Personal Protective Equipment (PPE) Guide Reducing Occupational Exposure Risks to Hazardous Medication for Staff has been developed to provide guidance for safe handling of Hazardous Medication in AHS and Covenant Health and to reduce occupational exposure of staff. This document is intended to provide guidance to all AHS and COV Health employees, members of the medical and midwifery staffs, students, volunteers, and other persons acting on behalf of AHS or COV Health (including contracted service providers as necessary).

3 The AHS / COV Health Hazardous Medication PPE Guide in conjunction with the Hazardous Medication List provide general guidance for some of the possible scenarios that staff may encounter in AHS / COV Health, but may not cover all possible situations. The Provincial Hazardous Medication Committee (PHMC) has separated the Hazardous Medication Personal Protective Equipment (PPE) Guide and AHS Hazardous Medication List to allow updates to the list in a timely manner. When in doubt, protect yourself from occupational exposure to Hazardous Medication . 1 OCTOBER 2021 ( ). Table of Contents Preamble .. 1. Hazardous Medication and Occupational Exposure .. 5. What is a Hazardous Medication ? .. 5. What is Occupational Exposure? .. 5. Reducing Occupational Exposure in the Workplace .. 5. Spill Management .. 6. Hierarchy of Hazard Control.

4 6. Hazard vs. Risk What's the Difference? .. 7. Who Does This Apply To? .. 8. Classification of Hazardous Medication .. 9. KNOWN Hazard Medication .. 10. POTENTIAL Hazard Medication .. 10. REPRODUCTIVE Hazard 10. Non-sterile Compounds and Hazardous Medications in AHS / COV Health Pharmacies (applicable to pharmacy only) .. 11. Labelling of Hazardous Medication .. 12. Personal Protective Equipment (PPE) .. 13. Disposal of Used PPE and Hazardous Medication Waste .. 14. Hazardous Medications Handling Risk Assessment (HMHRA).. 15. Chapter 1 KNOWN Hazard Medication ..17. Pharmacy Services Staff ..18. Receiving, Unpacking and Stocking of KNOWN Hazard Medication in 19. Delivery of KNOWN Hazard Medication within AHS / COV Facilities from Pharmacy .. 19. Handling, Packaging and Preparation of Non-Sterile Preparations: KNOWN Hazard Medication .

5 20. Preparation of Compounded Sterile Preparations (CSPs): KNOWN Hazard Medication .. 21. Spill Management of KNOWN Hazard Medication in Pharmacy .. 22. Cleaning of Areas Involving KNOWN Hazard Medication in Pharmacy .. 23. Handling KNOWN Hazard Medication Waste 23. Frontline Clinical Staff ..24. Receiving, Storing and Delivery of KNOWN Hazard Medication in Patient Care 25. Spill Management of KNOWN Hazard Medication .. 25. 2 OCTOBER 2021 ( ). Preparation and Administration of KNOWN Hazard Medication in Patient Care Areas .. 26. Handling Human Waste .. 27. Handling Patient Specimens .. 27. Handling KNOWN Hazard Medication Waste 27. Handling Human Waste After the Precautionary Period .. 28. Handling Patient Specimens After the Precautionary Period .. 28. Handling Medication Waste Containers .. 28. Frontline Non-Clinical Receiving, Storage and Delivery of KNOWN Hazard Medication .

6 30. Spill Management of KNOWN Hazard Medication .. 30. Handling Human Waste .. 30. Handling KNOWN Hazard Medication Waste 30. Nutrition & Food Services and Linen & Environmental Services Staff ..31. Spill Management of KNOWN Hazard Medication .. 32. Cleaning of Areas Involved in KNOWN Hazard Medication .. 32. Handling Soiled Linen within Linen Processing Area .. 32. Handling KNOWN Hazard Medication Waste 32. Cleaning of Patient Care Areas and / or Handling Human Waste DURING the Precautionary Period When Signage is Posted .. 33. Handling Soiled Linen in Patient Care Areas DURING the Precautionary Period When Signage is Posted .. 33. Cleaning of Patient Care Areas and / or Handling Human Waste AFTER the Precautionary Period When Signage is No Longer Posted .. 34. Handling Soiled Linen in Patient Care Areas AFTER the Precautionary Period When Signage is No Longer Posted.

7 34. Chapter 2 POTENTIAL & REPRODUCTIVE Hazard Pharmacy Services Staff ..36. Receiving, Unpacking and Stocking of POTENTIAL & REPRODUCTIVE Hazard Medication in Pharmacy37. Delivery of POTENTIAL & REPRODUCTIVE Hazard Medication within AHS / COV Facilities from Pharmacy .. 37. Handling and Packaging of Non-Sterile Preparations: POTENTIAL & REPRODUCTIVE Hazard Medication .. 38. Cleaning of Areas Involving POTENTIAL & REPRODUCTIVE Hazard Medication in Pharmacy .. 38. 3 OCTOBER 2021 ( ). Compounding of Non-Sterile Preparations (Levels B, B+)*: POTENTIAL & REPRODUCTIVE. Hazard Medications .. 39. Preparation of Compounded Sterile Preparations (CSPs): POTENTIAL & REPRODUCTIVE Hazard Medication .. 40. Spill Management of POTENTIAL & REPRODUCTIVE Hazard Medication in Pharmacy .. 41. Cleaning of Areas Involving POTENTIAL & REPRODUCTIVE Hazard Medication in 42.

8 Handling POTENTIAL & REPRODUCTIVE Hazard Medication Waste Containers .. 42. Frontline Clinical Staff ..43. Receiving, Storage and Delivery of POTENTIAL & REPRODUCTIVE Hazard Medication in Patient Care Areas .. 44. Spill Management of POTENTIAL & REPRODUCTIVE Hazard Medication in Patient Care Areas .. 44. Preparation and Administration of POTENTIAL & REPRODUCTIVE Hazard Medication in Patient Care Areas .. 45. Handling Human Waste .. 46. POTENTIAL and REPRODUCTIVE RISK Hazardous medications on the AHS Hazardous Medication List do not require a precautionary period.. 46. Handling Patient Specimens .. 46. Handling POTENTIAL & REPRODUCTIVE Hazard Medication Waste Containers .. 46. Frontline Non-Clinical Receiving, Storage and Delivery of POTENTIAL & REPRODUCTIVE Hazard Medication .. 48. Spill Management of POTENTIAL & REPRODUCTIVE Hazard 48.

9 Handling Human Waste .. 48. Handling POTENTIAL & REPRODUCTIVE Hazard Medication Waste Containers .. 48. Nutrition & Food Services Staff and Linen & Environmental Services Staff ..49. Spill Management of POTENTIAL & REPRODUCTIVE Hazard 50. Cleaning of Areas Involved in POTENTIAL & REPRODUCTIVE Hazard Medication .. 50. Handling Soiled 50. Cleaning of Patient Care Areas and Handling Human Waste .. 50. Handling POTENTIAL & REPRODUCTIVE Hazard Medication Waste Containers .. 50. Acronyms and Definitions ..51. Appendix A: Special Handling Considerations for Specified Hazardous Medication ..54. Appendix B: Hierarchy of Control ..55. Appendix C: Reproductive Population Subset ..56. Resources and References ..57. 4 OCTOBER 2021 ( ). Hazardous Medication and Occupational Exposure What is a Hazardous Medication ? Hazardous Medication are those medications that, although therapeutic to the patient, are known to or suspected to pose a health risk to health care workers exposed to them in the workplace due to the Medication 's inherent toxicity.

10 According to the National Institute for Occupational Safety and Health (NIOSH) they exhibit one or more of the following characteristics in humans or animals: Carcinogenicity capable of causing or promoting the development of cancer or a lesion which could be the starting point of a cancer Teratogenicity or other developmental toxicity capable of causing congenital malformations due to an action on the embryo Genotoxicity capable of damaging genetic material (DNA) to cause mutations Reproductive toxicity capable of affecting fertility ( miscarriages, late fetal death, infertility). Organ toxicity at low doses capable of causing serious organ or other toxic effects at a low dose ( liver damage, local necrosis of exposed tissue). Structure and toxicity profiles of Medication that mimic existing Medication determined Hazardous by the above criteria See Appendix A: Special Handling Considerations for Specified Hazardous Medication What is Occupational Exposure?