New Standards for Safe Handling of Hazardous Drugs Focus on Developing Evidence-Based Measures

ASCO Offers Alternatives to Existing Standards in Key Areas Where More Research is Needed
For immediate release
January 8, 2019


Melissa Lee

Alexandria, Va. – The American Society of Clinical Oncology (ASCO) today published standards on the safe handling of hazardous drugs in the Journal of Clinical Oncology (JCO). ASCO’s standards largely endorse best practices issued by other stakeholder groups for safely handling hazardous drugs but offer alternatives in several key areas where more research is needed to identify evidence-based safety measures.

In the new standards, ASCO recommends a comprehensive set of practices and procedures that entities that handle hazardous drugs should incorporate into their occupational safety plan. According to the standards, an entity's health and safety management system, at a minimum, must include:

  • a list of hazardous drugs
  • facility and engineering controls
  • competent personnel
  • safe work practices
  • proper use of appropriate personal protective equipment
  • policies for hazardous drug waste segregation and disposal

ASCO’s safe handling standards differ from existing standards in four areas: (1) the use of medical surveillance, (2) closed system transfer devices (CSTDs), (3) external ventilation of containment secondary engineering controls (C-SEC) or containment segregated compounding areas (C-SCA), and (4) alternative duties. In a systematic review of the available scientific literature, ASCO found that recommended practices in these areas are currently not supported by high-quality, unbiased studies on health outcomes.

“ASCO takes very seriously its role in promoting evidence-based standards, educating members, and helping oncology practices implement processes that have demonstrated efficacy in protecting patients and staff,” said ASCO President Monica M. Bertagnolli, MD, FACS, FASCO. “We share with other professional societies the same primary concern for the welfare of cancer care providers and their patients.”

The society’s safe handling standards were developed primarily in response to requests from ASCO members and committees, including the ASCO State Affiliate Council, for evidence-based guidance, tools, and support on how to handle hazardous drugs. ASCO will continue to work with state affiliates to raise awareness about available safety standards and legislation to address the safe handling of hazardous drugs.

Additionally, ASCO will continue to work with other professional societies on tools, resources, and other strategies for education, dissemination, and implementation of its standards to promote the safe handling of hazardous drugs. ASCO also will continue to monitor the medical and scientific literature for new evidence on these topics and will revise its standards as new information becomes available.

Read ASCO’s standards.

A draft of ASCO’s standards were posted online for public comment from April 6 to April 20, 2018. Ten external responses from stakeholder groups or individuals were received and are summarized in the final standards.


About ASCO: 

Founded in 1964, the American Society of Clinical Oncology, Inc. (ASCO®) is committed to making a world of difference in cancer care. As the world’s leading organization of its kind, ASCO represents nearly 45,000 oncology professionals who care for people living with cancer. Through research, education, and promotion of the highest-quality patient care, ASCO works to conquer cancer and create a world where cancer is prevented or cured, and every survivor is healthy. ASCO is supported by its affiliate organization, the Conquer Cancer Foundation. Learn more at, explore patient education resources at www.Cancer.Net, find breaking policy and practice news on ASCO in Action, and follow us on Facebook, Twitter, LinkedIn, and YouTube.