Toilet Cover May Significantly Reduce Aerosol Exposure in Hospital Bathrooms

A real-world study across 15 hospitals demonstrated that the Splashblocker, a reusable toilet barrier, significantly reduced aerosolized particles from urine, minimizing potential exposure to harmful drugs for oncology nurses and advanced practice providers, among other healthcare professionals.¹

In the study published in the Journal of Occupational and Environmental Hygiene, researchers took into account HEPA filtering, floor elevation, and building age among other factors when investigating the efficacy of the Splashblocker toilet cover in the clinical setting, according to lead investigator Seth Eisenberg, ASN, RN, OCN, BMTCN.

Oncology Nursing News spoke with Eisenberg about the real-world study’s key considerations and results. The study examined toilets at 15 hospitals across the country and tested particle number concentrations before and after flushing, with and without the toilet cover.¹

Eisenberg noted that factors including the age of the building and HEPA filtering made a difference at baseline, but after using the Splashblocker, reductions in particle count was similar across bathrooms.

Transcript

Well, there’s been an ongoing concern over, I’d say, the decades about potential exposure in oncology, particularly to drugs that are excreted in urine. And so an oncology nurse actually came up with the concept of designing a solid, removable and reusable barrier that could actually prevent or minimize the amount of exposure of the aerosols that come out of a toilet.

We had this incredibly good laboratory data that was also presented at ONS Congress. What happens in the laboratory is great, but we need to get this out and see what's happening clinically as well.

So we designed a large scale, multi-center study, and we ended up enrolling 15 different hospitals across the country, and there was no statistical difference in the elevation of the buildings.

What we did find, however, [was] that there was a definitely a difference in the design of the ventilation in the bathrooms. Older facilities tended to be less efficient at removing aerosols from bathrooms. We found several bathrooms that had ventilation was totally nonfunctioning.

[In] one bathroom, we measured it: it was an outpatient facility, a shared bathroom. We were there, we measured it uncovered first, and then we go back in, usually about 15 minutes later, and measure the ambient to make sure it went back down to baseline, because you need to know where you're starting from.

It didn't go down. It never went down. We actually opened up the door and propped it open; even after 45 minutes, that bathroom still had a high concentration of particles because the vent in the ceiling was not doing anything at all.

HEPA-filtered bathrooms tend to have fewer ambient particles. So it means, when you made a baseline, it was statistically significantly lower.

Once we put the cover on, all bets were off. With a Splashblocker in place, it was [a] 99% reduction, which is almost as if the toilet was never flushed at all. It's like it never happened.

This transcript has been edited for clarity and conciseness.

Reference

Eisenberg S, Cai C. Reducing the particles generated by flushing institutional toilets. Part II: Assessing a portable and reusable toilet cover in U.S. hospitals. J Occup Environ Hyg. 2024;21(12):847-856. doi:10.1080/15459624.2024.2398752