Cytotoxic Drugs and CoSHH Law

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Published: 13th December 2010
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This article examines the use of cytotoxic drugs and the hazards associated when using them. It focuses on the precautions needing to be followed under CoSHH and will be of interest to those currently working in hospitals, oncology units and hospices etc.

Cytotoxic drugs are used extensively in the treatment of cancer patients. They are able to deter tumour growth by interfering with cell division. They don't however, only affect tumour cells, but can also damage normal cells. Therefore, this can result in significant side effects in patients or others exposed. Health care workers preparing and administering cytotoxic drugs are of particular concern.

For the most part, cytotoxic drugs are hazardous substances, according to the Control of Substances Hazardous to Health (CoSHH) legislation. A few are deemed to be carcinogenic and hence are subject to Appendix 1 of the CoSHH Approved Code of Practice (ACoP) which gives further guidance on the control of carcinogenic substances. Under CoSHH, employers have a legal responsibility to assess the risks arising from employees handling cytotoxic drugs plus anybody else who could be impacted by this kind of work, and to take sufficient measures to protect their health.

The first precaution to take is to assess the risk. Identify which cytotoxic drugs are handled and what the possible harmful effects on health are. Examine who could be harmed from exposure to the drug and how they could be harmed, such as drug leakage during preparation. Next, determine how cytotoxic drugs may cause ill health and decide if existing control measures are sufficient or if more needs to be done. Keep a record of the findings from the CoSHH risk assessment and review annually as well as when any significant changes occur throughout the year.

It is imperative that exposure to the drugs is controlled. Drugs should always be stored in a lockable safety cabinet and when is use, exposure should be controlled at source. Use personal protective equipment (PPE) such as gloves when necessary.

Other more specific control measures contained within the assessment will include organising work to reduce the quantities of drugs used, the number of employees exposed and keeping the duration of exposure to a minimum. Use good hygiene practices and ensure all staff are trained in the handling of cytotoxic drugs. Staff should be trained in the risks associated with contamination and the procedures to follow if spillages occurr. Health records should also be kept for staff.


Dale Allen delivers CoSHH compliance as one of the UK's leading compliance authorities. Find out more about how you can use his online COSHH365 CoSHH assessment tool to produce compliant CoSHH assessments with the benefits of a managed Safety Data Sheet library.

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