Full compliance as reported in annual relicensing of all private hospitals, pharmacies, etc.ItalyCompliance is necessary. Approximately half reported that their recommendations were required under federal, state, or provincial legislation. Only 11 countries reported that monoclonal antibodies were covered in their recommendations. Closed-system drug-transfer products are widely used, but Morphothiadin were not specifically recommended in four countries, while one country required their use. Medical surveillance programs are in place in 20 countries, but only in The Netherlands is surveillance required. Nine countries reported that they have completed recent updates or revisions of recommendations, and the actions for his or her adoption have been initiated. Conclusions: Morphothiadin Although the overall goals in the Morphothiadin participating countries were related, the methods taken to assure safe handling of dangerous medicines assorted substantially in some cases. Agency for Sanitary (Anvisa) in 2004Agency for Sanitary (Anvisa) in 2007, NR n 32 published by Ministry of Labor and Employment in 2005. br / Recommendations are mandatoryAntineoplastic and cytotoxicNoPersonal protecting equipmentCanadaNationalCSHP Recommendations for Sterile Preparation (under revision), CAPhO br / Provincial: br / AlbertaBased on ISOPP,15 CAPhO-Guidelines are required, National Association of Pharmacy Regulatory Government bodies (NAPRA) guidance for compounding dangerous sterile drugs educated by USP800 1 February 2016 revised upgrade enforceable. br / English ColumbiaProvincial occupational health and security regulationsEnforceable; Rabbit Polyclonal to OR2Z1 Provincial safe handling standards, College of Pharmacists of English Columbia-Non-enforceable br / ManitobaCSHP, NIOSH, English Columbia-Mandatory br / Newfoundland and LabradorProvincial occupational health and security regulationsEnforceable NIOSH list br / OntarioSafe Handling of Cytotoxics: Guideline Recommendations16 br / QuebecOrder of PharmacistsMandatory ASSTSASNationalCSHP and CAPhO br / Provincial: br / AlbertaNIOSH list br / English ColumbiaNIOSH + BCCA addendum br / ManitobaNIOSH list br / New Brunswick, Newfoundland and LabradorNIOSH divided into cytotoxic and non-cytotoxic, Large, low risk HD lists br / Nova Scotiacytotoxic medicines br / QuebecNIOSH listAlbertaYes br / English ColumbiaNIOSH list/BCCA addendum br / ManitobaYes br / New Brunswick, Newfoundland and LabradorNIOSH list. br / Nova ScotiaNo br / QuebecNIOSH HD listEngineering controlsChileInternational recommendations, Quapos5 and GEDEFO. br / Chilean recommendations general technic norm n25 of our health ministry. Compliance is definitely mandatoryAntivirals, antineoplasics, cytotoxics, and monoclonal antibodies.YesPersonal protecting equipmentDenmarkDanish Operating Environment Expert guidelines for cytotoxics (December 2004)Compliance is required. br / Recommendations developed in collaboration from the Danish Hospital Pharmacies (February 2010) br / Hospital pharmacy guidelines-VoluntaryCytotoxics (ATC L01 and medicines having a similar risk for the operator)Not directlyNot usedFinlandFinnish Institute of Occupational Health (2007) Recommendations are voluntaryCytotoxicsNoNot usedFrance(Bonnes Pratiques de Prparation-AFSSAPS JO du 21/11/2007)17 br / Recommendations are mandatoryAll harmful/hazardous medicines (chemical and biological)NoNot specifically recommendedGermanyGerman National regulation, TRGS 905 br / Platform directive: 89/391/EEC for occupational security and health German hazardous substances ordinance br / German Guideline: TRGS 525 Guideline for handling dangerous drugs in healthcare facilities br / Recommendations are required br / Revised by German committee on dangerous substances effective 7/2015Medicinal products with Carcinogenic, Mutagenic or Harmful to Reproduction (CMR) activity br / Medicinal products without CMR activityNoEngineering settings Morphothiadin ~50% of facilitiesIranAPHON, ASHP, ISOPP br / Recommendations are mandatoryAlkylating providers, antimetabolites, hormones, and antagonistsYesEngineering controlsIsraelIsraeli comprehensive recommendations on safe handling and administration of cytotoxics which is definitely mandatoryConventional antineoplastic agentsFuture recommendations are forthcomingPersonal protecting equipmentItaly em PROVVEDIMENTO 5 agosto 1999 /em Documento di linee-guida per la sicurezza e la salute dei lavoratori esposti a chemioterapici antiblastici in ambiente sanitario (Repertorio atti. n. 376) ( em Pubblicato sulla Gazzetta Ufficiale n. 236 del 7 ottobre 1999 /em ) br / Recommendations for the Security and Health of Health Care Workers Exposed to Antineoplastic Medicines br / Recommendations are mandatoryAntineoplastic medicines, with particular attention to those classified from the IARCNoEngineering controlsJapanAseptic compounding guideline for injectable medicines and antineoplastic medicines2007 by JSHP br / Compounding manual for antineoplastic medicines2008. Recommendations are voluntary and no recommendation by any governmental organizationAntineoplastic drugsNoPersonal protecting equipmentMalaysiaNIOSH, ISOPP br / Recommendations are voluntaryNIOSH listYesYes. Generally used when there are no clean roomsMexicoRegulation for compounding centers-NORMA Oficial Mexicana NOM-249-SSAI-2010, Mezclas estriles: nutricionales y medicamentosas, e instalaciones em virtude de su preparacin br / Recommendations are mandatoryCytotoxics. penicillins, cephalosporins, cytotoxics, hormonals, immuno-suppressing medicines of biological source and others considered as high riskNoYes. Not specifically designated.