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Do you know where hazardous drug surface contamination can occur?


Where are hazardous drugs found? From the pharmacy to the nurse station, multiple surfaces are susceptible to contamination.1

The Invisible Threat game is an interactive way for you to explore spaces within a medical facility to see who can potentially be exposed to dangerous contaminates and where.

Although the game is entertaining, the dangers for healthcare workers are real.2


Test your knowledge with The Invisible Threat game

The Invisible Threat

Who is at risk?

According to several studies, hazardous drugs may be found on surfaces throughout the hospital (1,2,3,4,6) .
Healthcare providers, patients and visitors who are not even in direct contact with them can be contaminated (7,8) .

pharmacist
Pharmacists
drug administration nurses
Drug administration nurses
Pharmacy technicians/nurses
Pharmacy technicians / nurses
Waste managers/carriers
Waste managers / carriers
other care staff
Other care staff
cleaner
Cleaners
Operating room personnel
Operating room personnel
Maintenance personnel
Maintenance personnel
Patient relatives/visitors
Patient relatives / visitors

See where contamination can occur.

Let's play!

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Find out where hazardous drugs contamination has been shown to occur. Click different areas in each room to test your knowledge.




1. Nyman H.A., Jorgenson J.A., Slawson M.H. Workplace contamination with antineoplastic agents in a new cancer hospital using a closed-system drug transfer device. Hospital Pharmacy , 2007, 42.3: 219-225.

2. Wick, C., Slawson, M. H., Jorgenson, J. A., Tyler, L. S. Using a closed-system protective device to reduce personnel exposure to antineoplastic agents. American Journal of Health-System Pharmacy , 2003, 60.22: 2314-2320.

3. Castiglia L., et al. Evaluation of occupational exposure to antiblastic drugs in an Italian hospital oncological department. Journal of occupational health, 2008, 50.1: 48-56.

4. Ndaw S., Denis F., Marsan P., Rémy A., Robert A.   Professional exposure of hospital healthcare staff to cytotoxic medicines. 2018. Références En Santé Au Travail (Occupational Health References)— No. 154

5. Nabhani-Gebara, S. ISOPP Standards for the safe handling of cytotoxics. Journal of Oncology Pharmacy Practice , 2022, 28.3_suppl: S1-S126.

6. Connor T.H., Zock M.D., Snow A.H. Surface wipe sampling for antineoplastic (chemotherapy) and other hazardous drug residue in healthcare settings: methodology and recommendations. Journal of occupational and environmental hygiene , 2016, 13.9: 658-667.

7. ALERT, NIOSH. Preventing occupational exposures to antineoplastic and other hazardous drugs in health care settings. NIOSH, Pub. 2004, 165.

8. Yuki M., Sekine S., Takase K., Ishida T., Sessink P. J. Exposure of family members to antineoplastic drugs via excreta of treated cancer patients. Journal of Oncology Pharmacy Practice , 2013, 19.3: 208-217.

9. Boiano J.M., Steege A.L., Sweeney M.H. Adherence to safe handling guidelines by health care workers who administer antineoplastic drugs. Journal of occupational and environmental hygiene , 2014, 11.11: 728-740.

10. Turci R, Minoia C, Sottani C, et al. Occupational exposure to antineoplastic drugs in seven Italian hospitals: The effect of quality assurance and adherence to guidelines. Journal of Oncology Pharmacy Practice . 2011;17(4):320-332

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