Assessing Etoposide and Cyclophosphamide Contamination and Current Cleaning Practices in Patient Bathrooms

BACKGROUND: Antineoplastic drug (AD) exposure presents severe risks to healthcare workers. Previous studies have demonstrated that patient bathrooms are highly contaminated and have led to concern for excreta as a source of environmental contamination with ADs. OBJECTIVES: This study assessed AD contamination and current cleaning practices to remove AD surface contamination in patient bathrooms. METHODS: Three surfaces in the bathrooms of patients who had received etoposide and/or cyclophosphamide were sampled and analyzed for contamination at three time points. Liquid chromatography-tandem mass spectrometry was used for analysis. Interviews and observations of daily and discharge cleaning were conducted to understand cleaning practices. FINDINGS: A significant reduction in etoposide contamination on toilets and floors was observed following discharge cleaning; however, no significant reduction was observed on walls for either AD or on floors for cyclophosphamide.