Key to establishing an HD list is ensuring its usability. While the lists are widely established, accessible, and reviewed annually, some of the more challenging list maintenance tasks, such as including a severity classification by route of administration, are not as widespread. Of particular note is the fact that the vast majority of facilities are following the letter of the law, yet very few have expanded their efforts to encompass products that are not listed as HDs in the NIOSH list.
The commitment to creating a hazardous drug and substance list is nearly universal; just 4% of facilities have yet to complete this.
The required list maintenance steps, reviewing and editing the list as needed and at least annually and storing the list in an accessible location to ensure all workers with potential exposure to HDs can access it, are almost universally applied. It is notable that very few facilities have made the additional commitment to review drugs that are not on the NIOSH HD list (eg, drugs approved since the 2018 list update).
There was limited growth this year in the number of facilities that include a severity classification for each HD and for each route of administration.
Facilities typically follow the direction of the study sponsor in determining whether investigational drugs (IDs) should be handled as HDs. Notably, 23% of facilities are handling all IDs as HDs in order to ensure the safest possible conditions for their staff.
HDs, which are also biological hazards, are not utilized on a widespread basis, yet they do require significant special handling precautions.