TOILET PLUME AEROSOL STUDIES

To protect caregivers, the Oncology Nursing Society (ONS) recommends flushing the toilet with the lid down, especially 48-to-72 hours after a patient receives chemotherapy. Since most hospitals do not have protective lids, ONS recommends wearing personal protective equipment such as gloves, chemotherapy gowns, respiratory masks, and face shields. ONS further recommends that nurses apply a plastic-backed chuck pad over the toilet before flushing. However, this action presents concerns about handling safety, disposal and landfill costs, chucks not readily available, and routine noncompliance.

When interviewed in a published survey, nurse managers cited several reasons for caregivers' noncompliance with personal protective equipment use when disposing human waste including, but not limited to, urgent patient situations, nurses too busy or rushed, and precautions being "too extreme". In fact, according to EPINet occupational mucocutaenous exposure incident data, when an employee has an exposure, 62% of all exposures were to the eyes, nose, and mouth, and less than 16% were wearing any kind of face protection (e.g., protective eye wear, faceshield, surgical mask).