Objective  To provide medical institutions with occupational exposure risk prevention and control strategies for cytotoxic drugs, enhance the protective awareness of medical personnel and reduce potential occupational exposure risks.

Methods  The World Health Organization guideline was used to develop a manual for the study and design of protective guidelines for occupational exposure risk classification and control of cytotoxic drugs. Through systematic retrieval, guide working group extensively collected the exposure risk issues in the allocate, use and other aspects of cytotoxic drugs after entering the hospital. The Delphi method was used to construct clinical issues. After forming the relevant evidence using evidence-based approach, quality evaluation was conducted in accordance with the evaluation, formulation and assessment methods of recommended grading, and consensus was again reached on the recommendation opinions and evidence levels through expert consensus method. Ultimately, the Guidelines for Prevention and Control of Occupational Exposure Risks to Cytotoxic Drugs in Medical Institution was formulated.

Results  Through the online questionnaire survey of 143 experts, consensus on the guidelines was achieved using the Delphi method. By combining engineering controls, administrative controls and personal protective equipment at three different levels, a graded control approach was established. A total of 37 clinical issues were identified through a hierachical control approach, re-sulting in 36 recommendations.

Conclusion  This guideline covers seven steps after cytotoxic drugs enter the hospitial, including transportation, receipt, storage, unpacking, dispensing, finished product use and waste treatment,which provide reference for medical institutions to develop cytotoxic drugs related prevention and control measures. Therefore, the possibility of occupational exposure to cyto-toxic drugs can be reduced and the safety of medical personnel can be protected.

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