[MCOH-EH] [External] Medical surveillance for employees who work with hazardous drugs

[Winters, Tom (BIDMC - Occupational Health)]

At several Harvard teaching hospitals we have post exposure programs, no annual surveillance
Tom Winters


On Jul 28, 2025, at 11:35 AM, Esty, Elizabeth via MCOH-EH <mcoh-eh at mylist.net> wrote:


Hi All,

I've tried to look through the archive, but I don't see anything addressing this topic since 2017. (It's very possible I missed something.)

I've recently begun working in a medical center occupational health clinic. We have a medical surveillance program for employees who work with hazardous drugs that adheres to OSHA standards<https://urldefense.com/v3/__https://www.osha.gov/hazardous-drugs/standards__;!!AIv8Mrc!-LpJ_2E5zKb_xbDRcMmEyB1czgsW7ik4hFMKNj6102xLpXDnPpJCnI8ip7NrHF2x5h9VHSelnTniq0eThXYIon7m$>, USP 800 and ONS/ASCO guidance. We also use NIOSH materials, including the 2024 update<https://urldefense.com/v3/__https://www.cdc.gov/niosh/newsroom/updates/upd-12-20-25.html*:*:text=Updates*20in*20the*202024*20list,Drug*20Exposure*20in*20Healthcare*20webpage.__;I34lJSUlJSUlJQ!!AIv8Mrc!-LpJ_2E5zKb_xbDRcMmEyB1czgsW7ik4hFMKNj6102xLpXDnPpJCnI8ip7NrHF2x5h9VHSelnTniq0eThcLMEs8J$> on list of hazardous drugs.

We've been debating whether or not to expand surveillance to housekeepers and OR staff with frequent exposures and to nurses who handle only oral drugs on the NIOSH list.

I reached out to several larger hospital systems and found that at least two do not have surveillance programs of any kind. They've decided that their employees don't have significant exposures and that the challenge of linking exposure to outcome is too great to make surveillance effective. The Joint Commission appears not to require a program.

I would love to know how other medical center occupational health centers across the US (and abroad) are approaching medical surveillance. If your medical center is opting not to surveille at all, please let me know.

Thank you,
Elizabeth Esty


Elizabeth Esty, M.D., M.P.H.
Board Certified in Occupational and Environmental Medicine
Assistant Program Director, University of Colorado Residency in Occupational and Environmental Medicine
Department of Environmental and Occupational Health
University of Colorado Anschutz Medical Campus
Level II Certified, Colorado Division of Workers' Compensation
elizabeth.esty at cuanschutz.edu
303-229-2325<tel:303-229-2325>

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