Both a plastic-backed absorbent pad (PBP) and the SplashblockerÒ (SB) were effective at reducing postflush particle aerosol spread after flushing a hospital toilet, according to results of a study published in the Clinical Journal of Oncology Nursing.

Tiny aerosol particles are generated by flushing an uncovered toilet. These particles can be a vehicle for hazardous drugs (HDs), and HD contamination has been found on surfaces of bathrooms used by patients receiving chemotherapy.

This controlled-environment bathroom chamber experiment was conducted to compare the effect of a plastic-backed absorbent pad (Medline 23-by-36 quilted blue pad) and the SB at reducing particle spread. The number of particles was quantified using an optical particle counter after flushing a hospital-grade toilet uncovered or equipped with the PBP or the SB at 16 (H1) and 40 (H2) inches above the floor. Three tests for each scenario were performed.

Continue Reading

In uncovered conditions, the mean particle concentration at H1 was 61,344 (SD, 16,959) particles per liter, of which 94.5% were 0.3 to 0.5 mcm or 0.5 to 1 mcm in diameter. Smaller particles (0.3 to 3 mcm) peaked at 34 seconds and larger particles (3 to 20 mcm) peaked at 16 seconds. Trends were similar at H2.

Compared with the uncovered scenario, the PBP reduced the particle concentration by more than 99% at H1 (P =.034) and 99% or more at H2 (P =.033). The SB reduced particle concentrations by similar amounts at H1 (P =.034) and H2 (P =.008).

The limitations of this study included the small number of replications and the fact that air flow was not accounted for.

“These findings provide evidence that a PBP and the SB provide protection for [health care workers] compared to an uncovered toilet and underscore the rationale for their use,” the study authors concluded.

Disclosures: This research was supported by Splashblocker, LLC. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.


Eisenberg S, Cai C. Comparing two methods of reducing hospital toilet aerosols. Clin J Oncol Nurs. 2023;27(2):191-197. doi:10.1188/23.CJON.191-197