USP General Chapter <800> Hazardous Drugs—Handling in Healthcare Settings

USP General Chapter <800> provides standards for safe handling of hazardous drugs to minimize the risk of exposure to healthcare personnel, patients and the environment. 

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The National Institute for Occupational Safety and Health (NIOSH) considers a drug to be hazardous if it exhibits one or more of the following characteristics in humans or animals: carcinogenicity, teratogenicity or developmental toxicity, reproductive toxicity, organ toxicity at low doses, genotoxicity, or structure and toxicity profiles of new drugs that mimic existing hazardous drugs.

USP General Chapter <800> describes requirements including responsibilities of personnel handling hazardous drugs; facility and engineering controls; procedures for deactivating, decontaminating and cleaning; spill control; and documentation. These standards apply to all healthcare personnel who receive, prepare, administer, transport or otherwise come in contact with hazardous drugs and all the environments in which they are handled.

Important Updates
USP published the official date of General Chapter <800> of December 1, 2019. The new official date aligns General Chapter <800> with the official date of the new revision of General Chapter <797> Pharmaceutical Compounding Sterile Preparations, to provide a unified approach to quality compounding.

Important Dates
-  May 31, 2019: Revision Bulletin published to confirm the official date of USP General Chapter <800>
- December 1, 2019: Official date for <800>

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To protect patients and healthcare workers from potential harm, USP General Chapters <800> Hazardous Drugs – Handling in Healthcare Settings <797> Pharmaceutical Compounding – Sterile Preparations and <795> Pharmaceutical Compounding – Nonsterile Preparations were developed to provide a complete set of standards for all healthcare workers to help ensure the safe handling of hazardous drugs throughout the healthcare system, including in the practice of compounding. The intent of the Expert Committee has always been to align these standards, providing a unified approach to quality compounding.

As we all move towards safer handling of hazardous drugs in the work place, USP strongly encourages early adoption and implementation of USP General Chapter <800> to protect the public health in all healthcare settings. We will continue to support our stakeholders through ongoing education and outreach. To find out more information about how <800> applies and its compendial status, see the Compendial Applicability Video, the <800> FAQs (FAQ #8 and #9) and FAQs on Identifying Official Text (FAQ #8).

Developing USP General Chapter <800>

Public Health Need

The need to help ensure a quality environment and to protect healthcare personnel from hazardous drugs has been a topic of concern for decades. Growing evidence highlights that acute and chronic health effects can occur due to occupational exposure to over 200 hazardous drugs used commonly in healthcare settings. While NIOSH defines criteria and identifies hazardous drugs, USP developed standards for handling these hazardous drugs to minimize the risk to public health. The goals of these standards are to help increase awareness, provide uniform guidance to reduce the risk of managing hazardous drugs, and help reduce the risk posed to patients and the healthcare workforce.

USP Process

USP is a not-for-profit, science-driven organization that has an established process for convening independent experts in the development and maintenance of healthcare quality standards. The process is public health focused, leveraging current science and technology, and draws on the expertise of scientists and healthcare practitioners while providing opportunities for public input from stakeholders throughout the standard-setting progress.

The USP Compounding Expert Committee is responsible for the development of General Chapter <800>. Review their work plan and past meeting summaries. General Chapter <800> was published on February 1, 2016.