New Standards for Safe Handling of Hazardous Drugs Focus on Developing Evidence-Based Measures

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ASCO recently published standards on the safe handling of hazardous drugs in the Journal of Clinical Oncology.1 ASCO’s standards largely endorse best practices issued by other stakeholder groups for safely handling hazardous drugs but offer alternatives in several key areas where more research is needed to identify evidence-based safety measures.

The standards recommend a set of practices and procedures that entities handling hazardous drugs should incorporate into their occupational safety plan, including, at a minimum:

  • A list of hazardous drugs;
  • Facility and engineering controls;
  • Competent personnel;
  • Safe work practices;
  • Proper use of appropriate personal protective equipment; and
  • Policies for hazardous drug waste segregation and disposal.

ASCO’s safe handling standards differ from existing standards in four areas: (1) the use of medical surveillance, (2) closed system transfer devices, (3) external ventilation of containment secondary engineering controls or containment segregated compounding areas, and (4) alternative duties. In a systematic review of the available scientific literature, ASCO found that recommended practices in these areas are currently not supported by high-quality, unbiased studies on health outcomes.

Monica M. Bertagnolli, MD, FACS, FASCO

Monica M. Bertagnolli, MD, FACS, FASCO

“ASCO takes very seriously its role in promoting evidence-based standards, educating members, and helping oncology practices implement processes that have demonstrated efficacy in protecting patients and staff,” said ASCO President Monica M. Bertagnolli, MD, FACS, FASCO. “We share with other professional societies the same primary concern for the welfare of cancer care providers and their patients.”

The standards were developed following requests from ASCO members and committees, including the ASCO State Affiliate Council, for evidence-based support on handling hazardous drugs. ASCO will continue to work with stakeholder groups to raise awareness about available safety standards and legislation addressing the safe handling of hazardous drugs.

Survey on Practice Operations

In addition, ASCO’s Survey of Oncology Practice Operations is now open. Physicians and oncology administrators from all practice settings are encouraged to participate—responses help ASCO stay informed on the current state of business and operational issues in oncology. The survey is open until March 8, 2019. Visit for more information, and visit for updates on these and other cancer policy priorities. 

© 2019. American Society of Clinical Oncology. All rights reserved.


1. Celano P, Fausel CA, Kennedy EB, et al: Safe handling of hazardous drugs: ASCO standards. J Clin Oncol. January 8, 2019 (early release online).