[MCOH-EH] hazardous drugs and medical surveillance

[Hodgson, Michael - OSHA]

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