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BD^® HD Check System

Get results in less than 10 minutes with the first and only rapid hazardous drug* detection system

BD® HD Check System

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Overview
Results and Evidence
Products & Accessories
EIFU & Resources

Anyone who handles hazardous drugs (HDs) during transportation, preparation, administration or waste disposal may be at risk. A Canadian study of six hospitals found that frequently contacted surfaces at every stage of the hospital medication system had measurable levels of antineoplastic drug contamination.⁹

The revolutionary BD^® HD Check System has a convenient handheld design that enables testing for select HDs at any location. It provides reliable, easy-to-read results in less than 10 minutes, so you can take immediate corrective action and prevent HD residue from spreading.

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Close to 8 million healthcare workers are potentially exposed to hazardous drugs in the U.S.¹ And the risks to their health are real and significant.

Detrimental effect on DNA

Pharmacists and nurses who handle antineoplastic drugs show a 2.5-fold increase in total chromosomal aberrations (CAs), with up to a 5-fold increase in certain CA types^2,3
Increased rates of cancer

This includes relative risk of leukemia increases for oncology nurses,⁴ a 2.8-times increase in non-melanoma skin cancer and a 3.7-times increase in non-Hodgkin’s lymphoma in pharmacy techs⁵
Damage to internal organs

Three consecutive head nurses handling cytostatic agents over time had liver damage⁶
Reproductive issues

Double the risk of miscarriage among staff handling antineoplastic drugs, along with an increase in risk of malformations in offspring^7,8

Exposure can occur at any point in the journey of a hazardous drug at your facility

Dock/pharmacy receiving and storage
Pharmacy compounding
Pharmacy verification
Transport and storage in patient area
Nurse Administration
Housekeeping

Your facility may have already invested in safety measures such as engineering controls and personal protective equipment (PPE) to help protect your healthcare workers. But a NIOSH survey¹⁰ of 1,954 professionals revealed that up to 61% of them touched other work surfaces while wearing chemotherapy gloves:

61%

through IV pump/bed controls¹⁰
26%

through pens/pencils¹⁰

Contact Us
20%

through doorknobs/cabinets¹⁰

Explore other high-touch work surfaces that could be contaminated:

Countertops

Door Handles

Storage Trays

Drug vials and other equipment

Chairs

Computer Keyboard/Mouse

Surface in front of BSC

Pharmacy Floor

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IV Bag Storage Area

IV Controls

Countertops

Chairs

Patient Care Area Floor

Nurses’ Station

IV Bag Storage Areas

Door Handles

Restroom Floor

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Hazardous drug exposures in healthcare. Centers for Disease Control and Prevention website. www.cdc.gov/niosh/topics/hazdrug/. Published September 27, 2018. Accessed December 2, 2019.
Cavallo D, Ursini CL, Perniconi B, et al. Evaluation of genotoxic effects induced by exposure to antineoplastic drugs in lymphocytes and exfoliated buccal cells of oncology nurses and pharmacy employees. Mutat Res. 2005;587(1-2):45–51.
McDiarmid MA, Oliver MS, Roth TS, Rogers B, Escalante C. Chromosome 5 and 7 abnormalities in oncology personnel handling anticancer drugs. J Occup Environ Med. 2010;52(10):1028– 34.
Skov T, Maarup B, Olsen J, et al. Leukaemia and reproductive outcome among nurses handling antineoplastic drugs. Br J Ind Med. 1992;49(12):855–861.
Hansen J, Olsen JH. Cancer morbidity among Danish female pharmacy technicians. Scand J Work Environ Health. 1994;20(1):22–26.
Sotaniemi EA, Sutinen S, Arranto AJ, et al. Liver damage in nurses handling cytostatic agents. Acta Med Scand. 1983;214(3):181–189.
Nurses’ Health and Workplace Exposures to Hazardous Substances. Study conducted by Environmental Working Group, Health Care Without Harm, American Nurses Association, Environmental Health Education Center at University of Maryland School of Nursing. Environmental Working Group website. http://www.ewg.org/research/nurseshealth/nurses-exposure Published December 11, 2007. Accessed January 24, 2017.
Hemminki K, Kyronen P, Lindbohm ML. Spontaneous abortions and malformations in the offspring of nurses exposed to anesthetic gases, cytostatic drugs, and other potential hazards in hospitals, based on registered information of outcome. J Epidemiol Community Health. 1985; 39(2): 141–147.
Hon CY, Teschke K, Chu W, Demers P, Venners S. Antineoplastic drug contamination of surfaces throughout the hospital medication system in Canadian hospitals. J Occup Environ Hyg. 2013;10(7):374-83. doi: 10.1080/15459624.2013.789743.
Connor TH, Zock MD, Snow AH. Surface wipe sampling for antineoplastic (chemotherapy) and other hazardous drug residue in healthcare settings: Methodology and recommendations. J Occup Environ Hyg. 2016;13(9):658-687. doi: 1080/15459624.2016.1165912.
Gabay M, Johnson P, Fanikos J, et al. Report on 2020 Safe to Touch Consensus Conference on Hazardous Drug Surface Contamination. Am J Health Syst Pharm. 2021;78(17):1568-1575. doi:10.1093/ajhp/zxab134
Valero-García S, González-Haba E, Gorgas-Torner MQ, et al. Monitoring contamination of hazardous drug compounding surfaces at hospital pharmacy departments. A consensus Statement. Practice guidelines of the Spanish Society of Hospital Pharmacists (SEFH). Farm Hosp. 2021;45(2):96-107. doi:10.7399/fh.11655
Domingo T, Fontán G, Enríquez M, et al. Guide for monitoring surfaces for hazardous drug contamination. 1st ed. Instituto Español de Investigación Enfermera; Consejo General de Enfermería; 2021.
Valero García S, Centelles-Oria M, Palanques-Pastor T, Vila Clérigues N, López-Briz E, Poveda Andrés JL. Analysis of chemical contamination by hazardous drugs with BD HD Check® system in a tertiary hospital. J Oncol Pharm Pract. 2021;10781552211038518. doi: 10.1177/ 10781552211038518
Kiffmeyer TK, Tuerk J, Hahn M, et al. Application and assessment of a regular environmental monitoring of the antineoplastic drug contamination level in pharmacies–the MEWIP project. Ann Occup Hyg. 2013;57(4):444–455. doi:10.1093/annhyg/mes081.
Salch SA, Zamboni WC, Zamboni BA, Eckel SF. Patterns and characteristics associated with surface contamination of hazardous drugs in hospital pharmacies. Am J Health Syst Pharm. 2019;76(9):591-598. doi:10.1093/ajhp/zxz033
United States Pharmacopeial Convention (USP). USP general chapter <800>. Hazardous drugs – handling in healthcare settings. Rockville, MD: United States Pharmacopeial Convention. DocID: GUID-5D76173F-5CB6-47B8-815E-7C275A916085_7_en-US
Wipe Analysis. Pharmacy Purchasing & Products. https://www.pppmag.com/article/2525. Published March 2020. Accessed May 21, 2021.
Massoomi F. HD Check-In An interview with HD safety expert Fred Massoomi, RPh, PharmD, FASHP. BD-7875. 2018.

BD-5894 (09/22)

Routinely testing high-touch work surfaces for HD contamination is the proactive solution to help detect HDs, manage their associated risk and evaluate the effectiveness of your investments. The body of supporting evidence is growing worldwide—through consensus conferences, peer-reviewed journal articles and best practice guidelines.

Explore most recent peer-reviewed studies contributing to the movement in more detail below:

The 2020 Safe to Touch Consensus Conference on Hazardous Drug Surface Contamination published in AJHP recommends the BD^® HD Check System to qualitatively test and obtain rapid results to detect HDs¹¹
The Spanish Society of Hospital Pharmacists (SEFH)¹² and the Spanish Nursing Council (SNC)¹³recommend conducting an assessment of the contamination risk to detect HDs better and to evaluate effectiveness of current protocols
Silvia Valero García et al publish the first known in-use study on qualitative testing to detect HDs on surfaces in JOPP, finding multiple advantages such as speed, immediacy and efficacy with the BD^® HD Check System at their tertiary hospital¹⁴

A surface wipe sample study N=1,269 demonstrated a 56% decrease in contamination levels when monitoring occurred at regular intervals.¹⁵

During the study, approximately 75% of the monitoring group introduced cleaning protocol changes as a result of monitoring.¹⁵

67% of participating pharmacies stated that they had changed or would change their work procedures as a consequence of these findings.¹⁵

— The MEWIP Project¹⁵

A higher rate of contamination was identified at first wipe event compared to subsequent wipe events, suggesting that monitoring is beneficial in recognizing and correcting practices that lead to hazardous drug surface exposures, preventing future contamination from occurring.¹⁶

— Salch et al¹⁶

The BD^® HD Check System can detect surface contamination for select HDs in less than 10 minutes and can be integrated easily into your daily routine:

Easy-to-read results
Convenient handheld design
Track contamination levels over time

The BD^® HD Check System currently tests for three commonly used HDs: cyclophosphamide, methotrexate and doxorubicin

Qualitative testing is recommended when rapid results are needed in order to determine the presence or absence of an HD.

Currently, there is only 1 commercially available qualitative system (BD^® HD Check, BD, Franklin Lakes, NJ), which offers 3 HDs that can be tested.

—

2020 Safe to Touch Consensus Conference on Hazardous Drug Surface Contamination¹¹

The 2020 National Consensus Conference peer-reviewed report was published in the American Journal of Health-System Pharmacy (AJHP) and became one of their top 25 articles in 2021.¹¹

Explore 5 of the consensus statements, so you can act on these expert recommendations¹¹:

Create an effective surface contamination monitoring plan in order to serve as a process validation tool and support a nonpunitive, fair and just institutional culture
Establish a surface contamination monitoring policy for every healthcare setting where HDs are handled
Develop a comprehensive, setting-specific wipe sampling plan for ongoing HD surface contamination monitoring
Determine which surfaces are high risk areas, which HDs are to be detected, what tests need to be performed and at what frequency
Employ both qualitative and quantitative tests for ongoing surface contamination monitoring

Read the 2020 Safe to Touch Consensus Conference report

To be efficient, any surface contamination monitoring plan should include an assessment of the contamination risk present in the different sections of the HPD’s compounding area.

This is essential to determine where to sample and establish a suitable monitoring frequency.

—

2021 practice guidelines of the Spanish Society of Hospital Pharmacists (SEFH)¹²

The 2021 guidelines from the Spanish Society of Hospital Pharmacists (SEFH)¹² and the Spanish Nursing Council (SNC)¹³ offer structured solutions, with safe practices to monitor surfaces for HDs throughout your facility.

Here are some their practice recommendations:

Frequency of testing: Both recommend conducting a custom assessment to determine which areas carry high, medium or low contamination risk.¹² The SEFH recommends typical sampling frequencies as monthly, quarterly or half-yearly.¹² The SNC recommends establishing a sampling frequency based on the risk level assigned to areas during the assessment: weekly for high risk, monthly for medium risk and quarterly for low risk areas.¹³

Drugs to test for: Both the SEFH and SNC recommend testing for marker drugs, specifically naming cyclophosphamide, methotrexate and doxorubicin as the most commonly monitored HDs.^12,13They recommend monitoring at least cyclophosphamide as a marker for control of surface contamination in the pharmacy and administration areas.^12,13

Read their safe practices and key recommendations here and here >

But approximately one in four U.S. hospitals practice environmental wipe sampling.¹⁸ Safety experts are sharing the benefits of routine monitoring with the BD^® HD Check System.

Negative results today do not mean that tomorrow will be safe. [...] I find the BD^® HD Check System fast, easy and reliable to use.

It takes about 10 minutes to set up the device initially. After that, it takes less than 10 minutes to process a sample. This is a significant improvement over traditional wipe sampling kits that may take up to two weeks or longer to give a result, during which time HD residue may be spread to other locations.

—

Fred Massoomi, RPh, PharmD, FASHP¹⁹

Performing surface monitoring at select locations in their tertiary hospital, Silvia Valero García and colleagues found that the BD® HD Check System offered multiple advantages, the primary being speed and immediacy in obtaining results.

This allowed them to take immediate corrective measures when contamination was detected, and to quickly assess the effectiveness of containment and control measures.

—

The first known published study to use a qualitative technique to detect HDs on surfaces¹⁴

Silvia Valero García and colleagues evaluated the suitability of using the BD^® HD Check System to routinely monitor surfaces at select locations in their tertiary hospital. Their in-use study was published in the Journal of Oncology Pharmacy Practice (JOPP).

Read more here about how the benefits of routine qualitative testing of surfaces for HDs can help your facility recognize and correct practices that lead to HD surface contamination.¹⁴

You can set up, customize and sustain HD surface monitoring in your facility, step by step

1. Assess
2. Develop
3. Test
4. Track

Assess what, where and how often to test for HDs in your facility

Develop a plan for routine monitoring with procedures as per your needs

Test for HD residue on multiple surfaces using the BD^®HD Check System

Track results over time, now and as needed in the future

Hazardous drug exposures in healthcare. Centers for Disease Control and Prevention website. www.cdc.gov/niosh/topics/hazdrug/. Published September 27, 2018. Accessed December 2, 2019.
Cavallo D, Ursini CL, Perniconi B, et al. Evaluation of genotoxic effects induced by exposure to antineoplastic drugs in lymphocytes and exfoliated buccal cells of oncology nurses and pharmacy employees. Mutat Res. 2005;587(1-2):45–51.
McDiarmid MA, Oliver MS, Roth TS, Rogers B, Escalante C. Chromosome 5 and 7 abnormalities in oncology personnel handling anticancer drugs. J Occup Environ Med. 2010;52(10):1028– 34.
Skov T, Maarup B, Olsen J, et al. Leukaemia and reproductive outcome among nurses handling antineoplastic drugs. Br J Ind Med. 1992;49(12):855–861.
Hansen J, Olsen JH. Cancer morbidity among Danish female pharmacy technicians. Scand J Work Environ Health. 1994;20(1):22–26.
Sotaniemi EA, Sutinen S, Arranto AJ, et al. Liver damage in nurses handling cytostatic agents. Acta Med Scand. 1983;214(3):181–189.
Nurses’ Health and Workplace Exposures to Hazardous Substances. Study conducted by Environmental Working Group, Health Care Without Harm, American Nurses Association, Environmental Health Education Center at University of Maryland School of Nursing. Environmental Working Group website. http://www.ewg.org/research/nurseshealth/nurses-exposure Published December 11, 2007. Accessed January 24, 2017.
Hemminki K, Kyronen P, Lindbohm ML. Spontaneous abortions and malformations in the offspring of nurses exposed to anesthetic gases, cytostatic drugs, and other potential hazards in hospitals, based on registered information of outcome. J Epidemiol Community Health. 1985; 39(2): 141–147.
Hon CY, Teschke K, Chu W, Demers P, Venners S. Antineoplastic drug contamination of surfaces throughout the hospital medication system in Canadian hospitals. J Occup Environ Hyg. 2013;10(7):374-83. doi: 10.1080/15459624.2013.789743.
Connor TH, Zock MD, Snow AH. Surface wipe sampling for antineoplastic (chemotherapy) and other hazardous drug residue in healthcare settings: Methodology and recommendations. J Occup Environ Hyg. 2016;13(9):658-687. doi: 1080/15459624.2016.1165912.
Gabay M, Johnson P, Fanikos J, et al. Report on 2020 Safe to Touch Consensus Conference on Hazardous Drug Surface Contamination. Am J Health Syst Pharm. 2021;78(17):1568-1575. doi:10.1093/ajhp/zxab134
Valero-García S, González-Haba E, Gorgas-Torner MQ, et al. Monitoring contamination of hazardous drug compounding surfaces at hospital pharmacy departments. A consensus Statement. Practice guidelines of the Spanish Society of Hospital Pharmacists (SEFH). Farm Hosp. 2021;45(2):96-107. doi:10.7399/fh.11655
Domingo T, Fontán G, Enríquez M, et al. Guide for monitoring surfaces for hazardous drug contamination. 1st ed. Instituto Español de Investigación Enfermera; Consejo General de Enfermería; 2021.
Valero García S, Centelles-Oria M, Palanques-Pastor T, Vila Clérigues N, López-Briz E, Poveda Andrés JL. Analysis of chemical contamination by hazardous drugs with BD HD Check® system in a tertiary hospital. J Oncol Pharm Pract. 2021;10781552211038518. doi: 10.1177/ 10781552211038518
Kiffmeyer TK, Tuerk J, Hahn M, et al. Application and assessment of a regular environmental monitoring of the antineoplastic drug contamination level in pharmacies–the MEWIP project. Ann Occup Hyg. 2013;57(4):444–455. doi:10.1093/annhyg/mes081.
Salch SA, Zamboni WC, Zamboni BA, Eckel SF. Patterns and characteristics associated with surface contamination of hazardous drugs in hospital pharmacies. Am J Health Syst Pharm. 2019;76(9):591-598. doi:10.1093/ajhp/zxz033
United States Pharmacopeial Convention (USP). USP general chapter <800>. Hazardous drugs – handling in healthcare settings. Rockville, MD: United States Pharmacopeial Convention. DocID: GUID-5D76173F-5CB6-47B8-815E-7C275A916085_7_en-US
Wipe Analysis. Pharmacy Purchasing & Products. https://www.pppmag.com/article/2525. Published March 2020. Accessed May 21, 2021.
Massoomi F. HD Check-In An interview with HD safety expert Fred Massoomi, RPh, PharmD, FASHP. BD-7875. 2018.

BD-5894 (09/22)

Specimen Collection Kit BD® HD Check Vial NonSterile

SKU/REF 515033
CYC KIT 20 TEST

SKU/REF 515031
MTX II KIT 20 TEST

SKU/REF 515029
HD Check System Doxorubicin assay cartridges

SKU/REF 515026
HD Check System Doxorubicin assay cartridges

SKU/REF 515025
HD Check System Surface area templates

SKU/REF 515024
HD Check System Analyzer

SKU/REF 515020

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true

BD® HD Check System

Dock/pharmacy receiving and storage

Pharmacy compounding

Pharmacy verification

Transport and storage in patient area

Nurse Administration

Housekeeping

Countertops

Door Handles

Storage Trays

Drug vials and other equipment

Chairs

Computer Keyboard/Mouse

Surface in front of BSC

Pharmacy Floor

IV Bag Storage Area

IV Controls

Countertops

Chairs

Patient Care Area Floor

Nurses’ Station

IV Bag Storage Areas

Door Handles

Restroom Floor

Currently, there is only 1 commercially available qualitative system (BD® HD Check, BD, Franklin Lakes, NJ), which offers 3 HDs that can be tested.

To be efficient, any surface contamination monitoring plan should include an assessment of the contamination risk present in the different sections of the HPD’s compounding area.

Negative results today do not mean that tomorrow will be safe. [...] I find the BD® HD Check System fast, easy and reliable to use.

This allowed them to take immediate corrective measures when contamination was detected, and to quickly assess the effectiveness of containment and control measures.

1. Assess

2. Develop

3. Test

4. Track

BD^® HD Check System

Currently, there is only 1 commercially available qualitative system (BD^® HD Check, BD, Franklin Lakes, NJ), which offers 3 HDs that can be tested.

Negative results today do not mean that tomorrow will be safe. [...] I find the BD^® HD Check System fast, easy and reliable to use.