The American Society of Health-System Pharmacists (ASHP)

ASHP Guidelines state the following with regard to safely handling hazardous drugs:

Contamination is Still Prominent While Using Current Ventilation Controls

• …environmental and worker contamination occurs in workplace settings despite the use of Class II BSCs;
• …vaporization of hazardous drug solutions may reduce the effectiveness of the HEPA filter in providing containment;
• workers must understand and accept that the Class II BSC does not prevent the generation of contamination within the cabinet…;
• isolators, like Class II BSCs, do not prevent the generation of contamination within the cabinet workspace…

• none of these devices has been tested for reduction of hazardous drug contamination;
• the appropriateness of these devices in the safe handling of hazardous drugs is unproven;
• filtered, vented spikes are not closed-system transfer devices (CSTD);
• many devices labeled as “chemo adjuncts” utilize a filtered, vented spike to facilitate reconstituting…;
• it must be noted that none of these devices may be considered a closed-system drug transfer device and none has yet been formally studied with the results published in peer-reviewed journals;
• as other products become available, they should meet the definition of a closed-system drug transfer device established by NIOSH and should be required to demonstrate their effectiveness in independent studies.