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12.7 million healthcare workers in the EU face daily exposure to hazardous drugs.

Are you one of them?

You Protect Patients. We Protect You.

Hazardous drugs may be invisible, but they are everywhere, and they have
real consequences.

You Protect Patients. We Protect You.

12.7 million healthcare workers in the EU face daily exposure to hazardous drugs. Are you one of them?

Hazards | Who

Everyone along the drug handling lifecycle is at risk for health consequences

Hazards | Where

Hazardous drug contamination is everywhere

Hazards | How Much

Small but frequent amounts of exposure are serious risks

Solutions | Best Technology

Safeguard yourself and comply with EU regulations with EQUASHIELD CSTDs

Solutions | Best Practice

A closed system is the only way to prevent exposure

Solutions | EU Regulation

EU legislation mandates better protections for workers

Are you Exposed?

12.7 million workers in the EU are exposed to hazardous cytotoxic medications, of which 7.3 million are nurses.¹ Workers both with and without direct contact to the oncology ward are at risk of contamination.

Where is the Contamination?

Can you guess where the hotspots are for hazardous drug contamination?²

Pharmacy

Nursing

How is Contamination Absorbed?

^{The main routes of exposure are inhalation of aerosolized drug, ingestion, injection, and dermal absorption.¹}

Oral

through ingestion

Inhalation

breathing in vapors

Dermal

contact

How is Contamination Absorbed?

^{The main routes of exposure are inhalation of aerosolized drug, ingestion, injection, and dermal absorption.¹}

What are the Risks?

Cancer is a leading cause of work-related deaths in the EU, accounting for 100,000+ annual deaths.³

CMRs are classified into categories of Carcinogens, Mutagens and Reprotoxic hazards, each with various risks.⁴

What are the Risks?

Cancer is a leading cause of work-related deaths in the EU, accounting for 100,000+ annual deaths.³

CMRs are classified into categories of Carcinogens, Mutagens and Reprotoxic hazards, each with various risks.⁴

Acute

Hair loss

Taste disturbances

Headaches

Reproductive issues

Infection

Respiratory disease

Long term

Cancer

Genetic and developmental issues

Damage to internal organs

Reprotoxic issues

Infection

Respiratory disease

Acute

Hair loss

Taste disturbances

Headaches

Reproductive issues

Infection

Respiratory disease

Long term

Cancer

Genetic and developmental issues

Damage to internal organs

Reprotoxic issues

Hierarchy of Controls From Most to Least Effective

In chemotherapy, closed systems are the most effective controls

In healthcare units handling HMDs like chemotherapy, elimination and substitution isn’t feasible. The next best approach is to implement engineering controls to isolate workers from exposure. This means ensuring a closed system throughout the lifecycle. ⁵

Compounding in Often Results in Drug Residues Lingering on Gloves, Vials, and Surfaces

Drug residues spread throughout every stage of the HD lifecycle, posing exposure risks to everyone involved

63%

of vials were contaminated ⁶

Contact with surfaces contaminated by cytotoxic drugs is likely the main cause of transdermal exposure, as indicated by external and cross-contamination on tested vial surfaces.

65%

of administration samples were contaminated⁷

75%

of pharmacy samples were contaminated

Antineoplastic agent contamination was measured on surfaces such as biological safety cabinets, countertops, floors, and areas adjacent to preparation sites.

Compounding in Often Results in Drug Residues Lingering on Gloves, Vials, and Surfaces

Drug residues spread throughout every stage of the HD lifecycle, posing exposure risks to everyone involved

63%

of vials were contaminated ⁶

Contact with surfaces contaminated by cytotoxic drugs is likely the main cause of transdermal exposure, as indicated by external and cross-contamination on tested vial surfaces.

65%

of administration samples were contaminated ⁸

75%

of pharmacy samples were contaminated

Antineoplastic agent contamination was measured on surfaces such as biological safety cabinets, countertops, floors, and areas adjacent to preparation sites.

Eliminate Exposure Risk with CSTDs

Closed System Transfer Devices (CSTDs) are essential to create a truly closed system and eliminate exposure throughout the drug handling lifecycle ⁸

EQUASHIELD is Clinically Backed to be
the Most Closed CSTD on the Market

Eliminates Surface Contamination | Eliminates Vapor | Eliminates Plunger Contamination⁹

EQUASHIELD is Clinically Backed to be the Most Closed CSTD on the Market ⁹

Our Mission

To provide advanced, automated, and innovative solutions to protect healthcare workers and facilities from the risks associated with hazardous drug exposure and contamination.

Awareness is Growing in the EU of the Need to Protect Workers from the Dangers Posed by Cytotoxic Medication ¹⁰

Awareness of the Need to Protect Workers from the Dangers Posed by Cytotoxic Medication is Growing in the EU ¹⁰

Comply with EU Best Practices

European Directive 431 | CMR Guidelines | ETUI List | EU-OSHA

Comply with EU Best Practices

/01

European Directive 431

/02

CMR Guidelines

/03

ETUI List

/03

EU-OSHA

EQUASHIELD Leads the CSTD Market

Safe, Simple, and Closed

EQUASHIELD is engineered to be the safest and most closed option on the market. Its proprietary design makes it faster and more user-friendly compared to other CSTDs.¹¹

Our Mission is to Ensure Your Success

We are proud to maintain a 99% customer retention rate, a reflection of our dedication to excellence. By understanding your unique needs and providing tailored solutions, we deliver a seamless experience.

Our Mission is to Ensure Your Success

The EQUASHIELD Clinical Team consists of certified pharmacy technicians and registered nurses. With decades of clinical experience and advanced certifications in sterile compounding and oncology nursing, our mission is to protect healthcare teams from hazardous drugs. We understand your needs and speak your language in order to ensure seamless integration.

References

ETUI. (2020). Inclusion of Hazardous Medicinal Products within the scope of the Carcinogens and Mutagens Directive September 2020. Retrieved from https://www.stopcanceratwork.eu/wp-content/uploads/2020/10/ETUI-Briefing-Note-HMP-CMD4.pdf
Clark, B. A., & Sessink, P. J. M. (2013). Use of a closed system drug-transfer device eliminates surface contamination with antineoplastic agents. Cleveland Clinic Cancer Center, Fairview Hospital. Retrieved from https://www.equashield.com/clinical-studies/eliminating-antineoplastic-contamination-equashield-device/
Musu & Vogel, 2018. ETUI. (2020). Inclusion of Hazardous Medicinal Products within the scope of the Carcinogens and Mutagens Directive September 2020. Retrieved from https://www.stopcanceratwork.eu/wp-content/uploads/2020/10/ETUI-Briefing-Note-HMP-CMD4.pdf
National Institute for Occupational Safety and Health (NIOSH). (2004). Preventing occupational exposures to antineoplastic and other hazardous drugs in healthcare settings (DHHS (NIOSH) Publication Number 2004−165). Retrieved from https://www.cdc.gov/niosh/docs/2004-165/pdfs/2004-165.pdf
EU CLP Classification System of Carcinogenic, Mutagenic, and Reprotoxic (CMR) Substances Guidance for the safe management of hazardous medicinal products at work. Published by the European Commission Directorate-General for Employment, Social Affairs and Inclusion, Directorate EMPL.C — Working Conditions and Social Dialogue Unit C.2— Health and Safety at Work. Retrieved from https://osha.europa.eu/sites/default/files/KE0322175ENN_0.pdf.
Forshay, M., Streeter, S. O., Salch, S. A., & Eckel, S. F. (2018). Application of the 2015 proposed NIOSH vapor containment performance protocol for closed system transfer devices used during pharmacy compounding and administration of hazardous drugs. University of North Carolina, Charlotte. Retrieved from https://www.equashield.com/clinical-studies/application-of-the-2015-proposed-niosh-vapor-containment-performance-protocol-for-closed-system-transfer-devices-used-during-pharmacy-compounding-and-administration-of-hazardous-drugs/
Clark, B. A., & Sessink, P. J. M. (2013). Use of a closed system drug-transfer device eliminates surface contamination with antineoplastic agents. Cleveland Clinic Cancer Center, Fairview Hospital. Retrieved from https://www.equashield.com/clinical-studies/eliminating-antineoplastic-contamination-equashield-device/
Migal Analytical Chemistry Laboratory, Dr. Igal Bar-Ilan. (2009). Fluorescent Evaluation of Dry Connections in the EQUASHIELD™, Phaseal® and Tevadaptor®/Onguard™ Closed System Drug Transfer Devices. Kiryat Shmona, Israel. Retrieved from https://www.equashield.com/clinical-studies/fluorescent-evaluation-of-dry-connections-in-the-equashield-phaseal-and-tevadaptor-onguard-closed-system-drug-transfer-devices/.
https://www.equashield.com/eq-academy/resources/infographic/
Lindsley, I., & Musu, T. (2022). The ETUI’s list of hazardous medicinal products (HMPs). European Trade Union Institute, Brussels. Retrieved from https://www.europeanbiosafetynetwork.eu/wp-content/uploads/2022/10/The-ETUIs-list-of-hazardous-medicinal-products-HMPs_2022.pdfhttps://www.stopcanceratwork.eu/wp-content/uploads/2020/10/ETUI-Briefing-Note-HMP-CMD4.pdf
https://www.equashield.com/eq-academy/resources/infographic/

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12.7 million healthcare workers in the EU face daily exposure to hazardous drugs. Are you one of them?

You Protect Patients. We Protect You.

Hazardous drugs may be invisible, but they are everywhere, and they have real consequences.

You Protect Patients. We Protect You.

12.7 million healthcare workers in the EU face daily exposure to hazardous drugs. Are you one of them?

Hazards | Who

Everyone along the drug handling lifecycle is at risk for health consequences

Hazards | Where

Hazardous drug contamination is everywhere

Hazards | How Much

Small but frequent amounts of exposure are serious risks

Solutions | Best Technology

Safeguard yourself and comply with EU regulations with EQUASHIELD CSTDs

Solutions | Best Practice

A closed system is the only way to prevent exposure

Solutions | EU Regulation

EU legislation mandates better protections for workers

Are you Exposed?

Where is the Contamination?

Pharmacy

Nursing

Oral

Inhalation

Dermal

What are the Risks?

What are the Risks?

Acute

Hair loss

Taste disturbances

Headaches

Reproductive issues

Infection

Respiratory disease

Long term

Cancer

Genetic and developmental issues

Damage to internal organs

Reprotoxic issues

Infection

Respiratory disease

Acute

Hair loss

Taste disturbances

Headaches

Reproductive issues

Infection

Respiratory disease

Long term

Cancer

Genetic and developmental issues

Damage to internal organs

Reprotoxic issues

Hierarchy of Controls From Most to Least Effective

63%

65%

of administration samples were contaminated 7

75%

of pharmacy samples were contaminated

63%

65%

of administration samples were contaminated 8

75%

of pharmacy samples were contaminated

Eliminate Exposure Risk with CSTDs

EQUASHIELD is Clinically Backed to be the Most Closed CSTD on the Market

EQUASHIELD is Clinically Backed to be the Most Closed CSTD on the Market 9

Our Mission

Awareness is Growing in the EU of the Need to Protect Workers from the Dangers Posed by Cytotoxic Medication 10

Awareness of the Need to Protect Workers from the Dangers Posed by Cytotoxic Medication is Growing in the EU 10

Comply with EU Best Practices

Comply with EU Best Practices

/01

European Directive 431

/02

CMR Guidelines

/03

ETUI List

/03

12.7 million healthcare workers in the EU face daily exposure to hazardous drugs.

Are you one of them?

Hazardous drugs may be invisible, but they are everywhere, and they have
real consequences.

of administration samples were contaminated⁷

of administration samples were contaminated ⁸

EQUASHIELD is Clinically Backed to be
the Most Closed CSTD on the Market

EQUASHIELD is Clinically Backed to be the Most Closed CSTD on the Market ⁹

Awareness is Growing in the EU of the Need to Protect Workers from the Dangers Posed by Cytotoxic Medication ¹⁰

Awareness of the Need to Protect Workers from the Dangers Posed by Cytotoxic Medication is Growing in the EU ¹⁰