Handling cytotoxic drugs in isolators in NHS pharmacies

This guidance is aimed at NHS pharmacies and licensed contractors. Isolators perform two functions. They are a key control measure in preventing employee exposure to cytotoxic drugs, many of which are classified as hazardous to health and may also be carcinogens. They also protect the product from microbiological contamination during drug reconstitution.

Operators can be exposed to cytotoxic drugs through factors such as:

• breathing air contaminated with cytotoxic drug as a powder, or aerosol or vapour;
• skin contact with the drug itself or contaminated surfaces, some of  these drugs can pass through intact skin;
• accidental ingestion.

The current edition of this guidance note was published in 2003, and reflected the input of key stakeholders.  Following advice from the same key stakeholders the document has been reviewed and slightly updated to reflect current practice. NHS and the Medicines and Healthcare products Regulatory Authority have provided input into the revision of the document.