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placement on the List, their tabular location on the List. • Determining whether to place an evaluated drug on the List, and if so, in which Table 1 or 2. Drugs placed on the NIOSH List of Hazardous Drugs must indicate whether the drug has Manufacturer’s Special Handling Information (MSHI) and whether the drug meets the NIOSH definition of a hazardous drug. If a reviewed drug is not placed on the Hazardous Drug list it will be due to one of the following three reasons: • Insufficient toxic information is available to meet the NIOSH definition of a hazardous drug. • Available data indicates a toxic effect that does not meet the NIOSH definition. • Hazard assessment does not indicate the NIOSH determination the drug meets NIOSH definition. The National Institute for Occupational Safety and Health (NIOSH) published its first list of Hazardous drugs in 2004, updated the list in 2010, 2012, 2014, and 2016 and most recently in 2024 with its publication of NIOSH List of Hazardous Drugs in Healthcare Settings in 2024. The list is updated peri- odically but not on a fixed schedule. The NIOSH List of Hazardous Drugs is intended to assist employers in identifying drugs that are hazardous to the health and safety of workers who handle these drugs.
CHANGES IN THE 2024 NIOSH LIST OF HAZARDOUS DRUGS
NIOSH performed a hazard identification and characterization of each drug on the List, in accor- dance with the NIOSH Procedures for Developing the NIOSH List of Hazardous Drugs in Healthcare Settings. The 2024 List added 25 drugs, 12 of which have special handling information from the man- ufacturers (MSHI) and removed 7 drugs from the list. Drugs reviewed for this update were new drug approvals or received new safety-related warnings from FDA during the period from January 2014 through December 2015.The tables categorizing hazardous drugs have been reorganized. Table 1 of the NIOSH List of Hazardous Drugs now includes drugs that have MSHI in the package insert and/or adhere to the NIOSH definition of a hazard- ous drug and one or more of these criteria: • Classified by the National Toxicology Program (NTP) as “known to be a human carcinogen.” • Classified by the International Agency for Research on Cancer (IARC) as Group 1 “car- cinogenic to humans” or Group 2A “probably carcinogenic to humans.” • The 2016 List identified antineoplastic, however the 2024 update all the medications in Table 1 were not antineoplastics. • In Table 2 of the NIOSH List of Hazardous Drugs. 2024 List, the medications meet one or more of the criteria of the NIOSH definition of a hazardous drug and • Do not have MSHI. • Are not classified by the NTP as “known to be a human carcinogen.” • Are not classified by the IARC as Group 1 “carcinogenic to humans” or Group 2A “probably carcinogenic to humans.” Some of the medications listed in Table 2 possess adverse developmental and/or reproductive effects. Table 2 now includes drugs that only meet the NIOSH criteria as a developmental (including teratogenicity)
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