NIOSH Hazardous Drugs: What You Need to Know About Safe Handling and Risks
When you hear NIOSH hazardous drugs, drugs identified by the National Institute for Occupational Safety and Health as posing serious health risks to healthcare workers through exposure. Also known as hazardous pharmaceuticals, these are medications that can cause cancer, reproductive harm, organ toxicity, or other serious effects—even from small, repeated exposures. This isn’t about patients taking these drugs. It’s about the nurses, pharmacists, cleaners, and technicians who handle them every day—opening vials, preparing infusions, cleaning up spills, or disposing of waste.
Chemotherapy drugs, a major category of NIOSH hazardous drugs used to treat cancer, are the most common. But it’s not just chemo. Some antivirals, hormone therapies, and even certain painkillers like fentanyl patches fall under this list because they’re potent enough to harm healthy people. The NIOSH List of Hazardous Drugs, a regularly updated guide used by hospitals and pharmacies across the U.S. breaks them into categories based on risk level. You won’t find this list on a patient’s prescription—but you’ll find it in every hospital’s safety manual.
Why does this matter? Because exposure doesn’t need to be dramatic. A tiny splash on the skin, an aerosol during mixing, or even dust from crushed pills can lead to long-term problems. Studies show nurses handling these drugs without proper protection have higher rates of miscarriage, infertility, and even leukemia. That’s why hazardous drug handling, the set of safety practices required in healthcare settings to prevent worker exposure isn’t optional—it’s life-saving. Gloves alone aren’t enough. You need closed-system transfer devices, ventilated cabinets, spill kits, and strict waste protocols.
What you’ll find in the articles below are real, practical guides on how these drugs are handled, stored, and disposed of safely. You’ll learn how refrigerated medications like some biologics require special care to stay effective—and how improper storage can turn a safe drug into a dangerous one. You’ll see how stability testing ensures drugs don’t break down into toxins. You’ll find out why pharmacists are pushing back on generic substitution for narrow therapeutic index drugs, because even small changes can increase exposure risks. And you’ll get clear advice on spotting counterfeit meds, avoiding alcohol interactions, and understanding why labeling rules matter when lives are on the line.
This isn’t theory. It’s what happens in hospitals, clinics, and pharmacies every day. If you work with meds—or care about someone who does—this collection gives you the facts you need to stay safe.