Why some medicinal products can be hazardous

The European Commission Guidance for the safe management of hazardous medicinal products at work provides comprehensive instructions on how to handle hazardous medicinal products from identification to administration and even including laundry and wastewater management. The 200-plus pages are packed with valuable information about how to protect staff and patients from hazardous medicinal products. IMI spoke to Paul Sessink – a member of the core team of authors – and Birgit Sessink – an experienced hospital pharmacist responsible for hazardous drug compounding at the University Hospitals of Leuven – to find out more.

Hazardous medicinal products (HMPs) are defined as those which are carcinogenic, mutagenic or reprotoxic. Many countries have guidelines for handling such products but there is considerable variation between member states. Some three-four million people are working with these drugs on a daily basis and there is growing concern that this could have adverse long-term health effects for them. Moreover, many people working in the field said that there was a need for Europe-wide guidance. The final document is long and covers all aspects of HMP-handling, but it is organised in such a way that it is only necessary to refer to the sections of the guidance that are relevant for your job. “For instance, [if] you are a pharmacist, you have to read maybe four or five sections of the whole guidance which are relevant for you”, explains Dr Sessink.

Clearly, the first step is identification of HMPs.  There are a number of standard lists of hazardous drugs, for example the NIOSH (National Institute for Occupational Safety and Health) list of hazardous drugs in healthcare settings and the  European Trade Union Institute’s (2022) list of hazardous medicinal products.  However, there are also drugs that do not appear in the lists, for example, investigational drugs that are used in clinical trials. In such cases the producer of the drug should provide the necessary information, he says.

About Birgit Tans and Paul Sessink

Birgit Tans is a hospital pharmacist at the University Hospitals of Leuven in Belgium. For the past 30 years she has specialised in compounding of cytotoxic drugs and is an expert on safe handling of hazardous drugs.

Paul Sessink first studied chemistry and later completed a PhD on hazardous drug exposure. In 1995 he founded the company, Exposure Control to provide services related to monitoring of hazardous drugs in the working environment. The company has provided services to about 350 hospitals in the world.

 

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