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4121143 
Journal Article 
Manufacturers' Recommendations for Handling Spilled Antineoplastic Agents 
Johnson, EG; Janosik, JE 
1989 
Yes 
American Journal of Hospital Pharmacy
ISSN: 0002-9289 
NIOSH/00187545 
46 
2 
318-319 
Spill response procedures for 22 injectable antineoplastic agents (ANAs) were surveyed using information provided in the drug manufacturers' Material Safety Data Sheets (MSDSs). Containment and/or inactivation of spilled ANA before cleanup was considered to be a safer response than directly mopping up spilled material. MSDSs provided no recommended inactivation agent (IA) for nine drugs although absorption by kitty litter or vermiculite was recommended in two of these cases. For nine ANAs, 5 percent sodium-hypochlorite (plus sodium-hydroxide for one drug) was the recommended IA. One percent potassium-permanganate was an alternative for sodium-hypochlorite in three cases but was considered less desirable because of a tendency to stain. Trisodium-phosphate (5 or 10 percent) was recommended in two cases. Five percent sodium-thiosulfate plus sodium-bicarbonate and 10 percent sulfuric-acid were also recommended for one drug each. In most cases there were no clear guidelines for the quantity of IA required but the authors suggested using a 1:1 volume ratio (IA to ANA) as a starting point for neutralization. All of the recommended IAs were considered inexpensive, and pharmacies could stock all of the recommended IAs.