HI
NIOSH has recommendations for antineoplastic surveillance.  It recommends pre hire, post exposure, every 2 years, and upon transfer or resignation.   We do not mandate the evalutions. 
NIOSH has a booklet and on line fir resource.  

Thank you
 Betty Kuschel-Rapaski RN
HFHS Detroit, MI


Sent from Samsung tablet.


-------- Original message --------
From: mcoh-eh-request@mylist.net
Date: 05/31/2016 3:00 PM (GMT-05:00)
To: mcoh-eh@mylist.net
Subject: MCOH-EH Digest, Vol 251, Issue 109

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Today's Topics:

   1.  hazardous drugs and medical surveillance
      (Hodgson, Michael - OSHA)
   2. Re:  OSHA update re: Hazardous Drugs (Hodgson, Michael - OSHA)


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Message: 1
Date: Tue, 31 May 2016 12:33:07 +0000
From: "Hodgson, Michael - OSHA" <Hodgson.Michael@dol.gov>
To: MCOH/EH <mcoh-eh@mylist.net>
Subject: [MCOH-EH] hazardous drugs and medical surveillance
Message-ID:
<BLUPR09MB07860DF9EFCCCE2A1F909F40F2460@BLUPR09MB0786.namprd09.prod.outlook.com>

Content-Type: text/plain; charset="utf-8"

In follow-up to last week's discussion of appropriate content for medical surveillance after exposure to hazardous drugs, please know that OSHA has updated its AtoZ Topics Page on Hazardous Drugs.  That points to the new ACOS/ONS consensus guidelines, the new USP<800> chapter, and a major update document that provides a rigorous review of the literature and detailed guidance (http://www.osha.gov/SLTC/hazardousdrugs/controlling_occex_hazardousdrugs.html#surveillance ).  It is worth reading through with care. 

As some may remember, about a year ago we here tried to do a relatively informal survey of management practices but got little response (I do understand that OSHA asking such questions might not generate the most enthusiastic response.  Discussions with several large heath care systems identified that most do not have a written program but many have very structured informal policies.  All of the big systems with whom we spoke had a voluntary job transfer with pay retention program.  There are some interesting additional issues, like what kind of surveillance should we be doing for birth defects or can we even expect employers to do that effectively? Are there effective ways we could in fact create such surveillance programs?   Is there a place for an inception cohort study of pharmacy techs and oncology nurses, like the National Children's Study, to sort out competing risks and drivers.

Maybe the MCOH leadership could put this on next years's MCOH course agenda ...

Michael Hodgson, MD, MPH
OSHA

------------------------------

Message: 2
Date: Tue, 31 May 2016 16:17:24 +0000
From: "Hodgson, Michael - OSHA" <Hodgson.Michael@dol.gov>
To: "Kumar, Bindu, MD" <KumarB@MLHS.ORG>
Cc: MCOH/EH <mcoh-eh@mylist.net>, Marian Condon
<mcondon@medicine.umaryland.edu>
Subject: Re: [MCOH-EH] OSHA update re: Hazardous Drugs
Message-ID:
<BLUPR09MB0786DE6395690BBF13B20CB1F2460@BLUPR09MB0786.namprd09.prod.outlook.com>

Content-Type: text/plain; charset="us-ascii"

Hi, some elements covered in the topic are clearly addressed under specific OSHA standards, like PPE, respirators, Hazcom, etc.   Others, like the broader  management issues, represent guidance.   USP represents a national consensus standard, currently primarily enforced by State agencies as Federal agencies have not claimed authority or initiated their own rule making.  Some of that guidance reflects long-standing professional recommendations from a variety of sources.  The OSHAct grants OSHA the right to cite not only under specific standards (5(b)) but also under the general duty clause, 5(a)(1).  OSHA has issued several general duty clause citations for hazardous drugs within the last year.

From: Kumar, Bindu, MD [mailto:KumarB@MLHS.ORG]
Sent: Tuesday, May 31, 2016 12:07 PM
To: Hodgson, Michael - OSHA
Subject: OSHA update re: Hazardous Drugs

Dr. Hodgson,
Can I clarify whether this OSHA update is now a regulated requirement, much like the other standards (i.e. respirator fit testing on an annual basis)?  Under what authority does the USP <800>  fall?   Thank you for clarifying.

Bindu Kumar MD, CCBOM, MRO
Associate Medical Director
Occupational and Travel Health
Main Line Health
484-476-2881
Fax: 610-886-0164

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