Common Questions About the Chemfort® CSTD

Global focus on occupational safety during hazardous drug handling is rising. The risks associated with hazardous drug exposure are increasingly recognized, and enforcement of USP <800>, NIOSH guidance and EU safe-handling frameworks continues to grow. At the same time, hospitals are moving beyond just a basic “compliance mindset” and focusing on real workflow optimization, measurable safety outcomes and long-term operational consistency.

Closed System Drug-Transfer Devices (CSTDs) are now viewed not only as protective tools, but as system-level safety enablers within oncology and sterile compounding environments. The Chemfort® CSTD sits at the center of this increased awareness and move to occupational safety in healthcare environments. The following addresses the most common practical questions pharmacists, oncology nurses and pharmacy leaders ask when evaluating Chemfort®.

A Closed System Drug-Transfer Device, as defined by the National Institute for Occupational Safety and Health (NIOSH), is a device that mechanically prevents the escape of hazardous drug or vapor concentrations outside the system while also preventing environmental contaminants from entering the sterile pathway.

The Chemfort® CSTD is built around three core safety principles: drug-binding mechanical barrier containment, controlled pressure equalization and a fully sealed drug pathway. Together, these elements keep the system closed during drug preparation and administration, including during transfer and disconnection.

Traditional needle-and-syringe systems or vial spikes can allow aerosolization during reconstitution and create pressure buildup inside vials. These open systems can lead to micro-spray events, residual contamination on surfaces and measurable hazardous drug residue on gloves and work areas. Such risks are routinely documented in wipe sampling studies across oncology pharmacies¹.

Chemfort® addresses these risks through elastomer-to-elastomer connection that creates a closed pathway. Chemfort®’s passive pressure equalization mechanism manages internal vial pressure changes without releasing hazardous drug vapors or aerosols into the environment. The closed disconnection design further reduces the likelihood of spray events when separating components. In addition, Chemfort® contains the needle fully in the septum to eliminate accidental needle-stick injuries.

In practice, Chemfort®’s innovative design prevents exposure to antineoplastic and other hazardous drug substances, reduces drug residues on surfaces and enables standardized workflows that do not rely heavily on operator technique. In busy oncology environments, this intuitive operation and consistency is critical to maintaining predictable protection across shifts and staff members.

CSTDs are designed to reduce multiple types of occupational exposure, including surface contamination, airborne drug particles and direct staff contact during transfer and disconnection. Exposure reduction is typically evaluated through surface wipe sampling, air sampling within compounding areas and, in some studies, biological monitoring of staff.

Closed systems, including Chemfort®, have demonstrated significant reductions in detectable hazardous drug residue compared to open needle-and-syringe techniques. In controlled testing aligned with the 2016 NIOSH draft protocol, closed systems have shown substantial reductions in vapor release, in some cases reducing detectable surrogate vapor levels to below quantifiable thresholds², while traditional open systems produced measurable vapor concentrations. In real-world oncology settings, institutions report lower compounding area contamination levels and improved predictability of contamination control across different work shifts.

For healthcare facilities, this translates into improved staff safety, reduced environmental cleaning burden and greater confidence in exposure mitigation programs. Measurable exposure reduction is becoming a key performance indicator rather than a theoretical benefit.

The Chemfort® CSTD functions as an engineering control within the hierarchy of hazard controls. Engineering controls are positioned above personal protective equipment in effectiveness because they aim to eliminate or isolate the hazard at its source rather than relying solely on individual compliance. Chemfort® does not replace PPE during hazardous drug handling, but it reduces dependence on PPE as the primary protective mechanism for healthcare professionals.

Under USP <800>, CSTDs are required during administration of hazardous drugs when the dosage form allows and are recommended during compounding. NIOSH guidance emphasizes closed handling practices to minimize occupational exposure. Internationally, including across Europe, procurement mandates and institutional policies increasingly integrate CSTDs into oncology medication workflows.

Chemfort® supports compliance by standardizing technique, reducing operator variability and simplifying training and onboarding. As part of a full vial-to-vein drug delivery approach, it contributes to audit-ready environments and consistent closed handling practices. The emphasis is not simply on complying with regulatory language, but on ensuring consistent, measurable protection across departments and over time.

A common concern among pharmacy directors and oncology managers is whether implementation of a CSTD will slow operations or require extensive retraining. Chemfort® is designed to integrate into existing preparation and administration processes with minimal disruption. Its elastomer-to-elastomer “click” connection creates a predictable, intuitive closed connection without requiring excessive force, complex timing or specialized technique.

The design supports both pharmacy compounding and bedside administration and helps reduce preparation variability between technicians. Because the connection is standardized and repeatable, onboarding of new staff is streamlined and cognitive load during busy shifts is reduced. Over time, this ease of use contributes to smoother workflow standardization and fewer technique-related exposure events.

Not all CSTDs rely on the same containment mechanisms. Chemfort® differentiates itself through its needle-free dry connection technology and its drug-binding matrix mechanical barrier. The innovative dual-action barrier locks in hazardous drug vapors, aerosols and droplets while simultaneously maintaining the sterility of drug preparation.

Chemfort® delivers consistent performance that is less dependent on individual user technique. The overall system is designed for both safety and ease of use in real-world clinical environments. In addition, Chemfort®’s system architecture is streamlined with just 4 SKUs enabling over 90% of workflows, supporting cost-effectiveness and procurement simplicity.

Healthcare institutions are evaluating CSTDs not only on laboratory performance, but on reliability and usability during everyday oncology practice. Chemfort® is designed to address both.

Today, relying on traditional open drug systems is a risk no facility can afford. The evidence is clear: CSTDs are a scientifically validated, cost-effective solution to protect healthcare staff from hazardous drug exposure.

In addition, safe handling of hazardous drugs has evolved from simple policy compliance toward measurable exposure reduction and operational consistency. CSTDs are now recognized as central and essential engineering controls within oncology medication workflows. Adoption decisions are increasingly based on performance in everyday clinical practice, not only on regulatory necessity.

The Chemfort® Closed System Drug Transfer Device addresses both safety performance and workflow reliability, helping institutions move to consistent, standardized protection.

For product information or to schedule a demo of Chemfort® contact us.