Refrigerated storage for antineoplastic HD must be in which configuration?

• A. Separate refrigerator within a negative pressure area with 12 ACPH or in a CSCA
• B. Standard household refrigerator in any area
• C. Refrigerator inside a positive pressure room with 6 ACPH
• D. No refrigerator requirement

Answer: (A)

The key idea is containment and ventilation for hazardous drugs. Refrigerated storage must be in a dedicated setup that prevents any drug vapors or aerosols from escaping to non‑hazardous areas. A separate refrigerator dedicated to antineoplastic hazards, placed in a negative‑pressure area with at least 12 air changes per hour, achieves this by pulling air into the room and exhausting it safely, reducing exposure risk. If the facility uses a containment secondary area (CSCA), storing in that containment space also meets the requirement because it provides the necessary engineering controls to contain the drugs.

A standard household refrigerator in any area does not provide the needed containment or controlled airflow, so it’s not acceptable for HD storage. A refrigerator inside a positive‑pressure room would push any contaminants outward, increasing exposure risk, and in this context there is a need for negative pressure, not positive. There is a refrigerator requirement for storage when refrigeration is needed, so saying there is no refrigerator requirement would be incorrect.