At a glance
| Chemical family | Antineoplastic (chemotherapy) drug — a nitrogen-mustard alkylating agent |
| CAS number | 50-18-0 |
| Classification | IARC Group 1 (carcinogenic to humans); listed by NIOSH among hazardous drugs requiring occupational handling controls (USP <797>/<800>) |
| Who it concerns | Patients receiving the drug, their household members and family caregivers, and healthcare workers who prepare or administer it — not the general public |
| Documented transfer evidence | Detected on the cotton undershirts of all patients in a sweat-exposure study at 7.38–160.77 ng/cm²; detected in the urine of family members and caregivers in secondary-exposure studies |
| Reducing secondary exposure | Household-hygiene precautions during and after treatment: gloves for soiled linens, separate laundering, and the handling guidance provided by the care team |
Regulatory & certification status
Where Cyclophosphamide stands across the major regulatory systems and the certifications a bedroom product might carry. Each row links to the governing instrument; where a jurisdiction has no specific measure, that is stated plainly rather than left blank.
| European Union | Cyclophosphamide (EC 200-015-4, CAS 50-18-0) is regulated in the EU primarily as a medicinal product and sits largely outside REACH/CLP industrial controls. It is included in the EU's indicative list of hazardous medicinal products drawn up under the Carcinogens, Mutagens and Reprotoxic substances at Work Directive 2004/37/EC (Commission Communication C/2025/1150, Feb 2025), which flags it for carcinogenic, mutagenic and reproductive-toxicity hazard in an occupational-protection context. No entry on the REACH SVHC Candidate List or the Authorisation List (Annex XIV) was identified, and no harmonised CLP Annex VI classification was independently confirmed. Note: the precise hazard-category coding within C/2025/1150 (e.g. 1A/1B and any self-classification flag) could not be independently verified from the primary text and is not asserted here. Regulatory — EUR-Lex · ECHA |
| United States | Under federal TSCA, cyclophosphamide falls outside the TSCA Inventory because substances whose use is governed by the Federal Food, Drug, and Cosmetic Act (drugs) are among the uses not regulated under TSCA; accordingly it is not on the TSCA Inventory and has no EPA risk evaluation. It is listed on California's Proposition 65 for cancer (listed 02/27/1987) and for developmental, male reproductive and female reproductive toxicity (all listed 01/01/1989). Both the anhydrous form (CAS 50-18-0) and the hydrated/monohydrate form (CAS 6055-19-2) appear as separate OEHHA entries, each carrying the same four listings and dates. Regulatory — OEHHA |
| Canada | Cyclophosphamide appears on Canada's Domestic Substances List (an inventory of existing substances). It is not on the CEPA Schedule 1 list of toxic substances, and no Chemicals Management Plan risk-management action or other Canadian government control measure for it was identified. It is regulated as a pharmaceutical under the Food and Drugs Act, not as a pesticide under the Pest Control Products Act. Regulatory — CAREX Canada · Government of Canada |
| Australia | In Australia, cyclophosphamide is regulated as a therapeutic good by the TGA, which places it outside the AICIS industrial-chemicals scheme: AICIS's remit covers industrial chemicals and expressly excludes use as a therapeutic good under the Therapeutic Goods Act 1989. No AICIS industrial evaluation or Industrial Chemical Environmental Management Standard (IChEMS) Register listing for it was identified. Regulatory — AICIS · TGA |
| United Kingdom | Great Britain assimilated the pre-2021 EU regime, so as a medicinal product cyclophosphamide sits largely outside UK REACH / GB CLP industrial controls. No GB Mandatory Classification and Labelling (harmonised) entry was identified for it, and no UK REACH restriction or SVHC listing was identified; it is regulated as a medicine by the MHRA. Regulatory — HSE |
| International | The International Agency for Research on Cancer (IARC) classifies cyclophosphamide in Group 1 (carcinogenic to humans), with sufficient evidence in humans including excess bladder cancer and leukaemia; in the IARC master list it is recorded as Group 1 across Volumes 26, Supplement 7 and Volume 100A. It is not covered by the Stockholm Convention on Persistent Organic Pollutants or the Minamata Convention on Mercury. Regulatory — IARC · IARC Monographs |
| Certifications | None of the consumer sleep-product certifications target this drug. CertiPUR-US, OEKO-TEX Standard 100, and GREENGUARD/GREENGUARD Gold screen flexible polyurethane foam / textile content or low-VOC emissions; none lists a cytotoxic chemotherapy agent like cyclophosphamide in its published criteria. It is not an expected mattress, foam or textile constituent, so it falls outside these programs' scopes rather than being specifically named or prohibited. Industry — CertiPUR-US · OEKO-TEX |
| The 72-hour test window | Not applicable to a normal sleep environment and not a target of short-term VOC chamber testing. Cyclophosphamide is a non-volatile solid pharmaceutical (an alkylating chemotherapy agent), not a material off-gassing constituent, so a ~72-hour emissions test would neither expect nor detect it; it is relevant to occupational/clinical handling, not consumer bedding. Inferred — from the compound's volatility/emission profile versus the VOC focus of short chamber tests |
What it is
Cyclophosphamide is one of the most widely used chemotherapy drugs — a nitrogen-mustard alkylating agent given for several cancers and some immune conditions. It is itself classified by IARC as a Group 1 carcinogen (it can cause secondary cancers), which is why it is handled as a hazardous drug in healthcare settings, with closed-system transfer devices and protective equipment recommended by NIOSH and the U.S. Pharmacopeia. Regulatory — IARC, Group 1 Regulatory — NIOSH, USP <800>
For an atlas about the chemistry of the bedroom, cyclophosphamide matters because of what happens after a dose. The body does not fully retain it: roughly a quarter of a dose is excreted unchanged in urine within 24 hours, and it is also excreted in sweat. That means the drug reaches the skin surface and the textiles in contact with it — exactly the body-to-textile pathway that this Atlas exists to document.
The body-to-textile transfer evidence
Measured on patients' clothing via sweat
The clearest single piece of evidence comes from Miyazawa et al. (2023), who measured cyclophosphamide on the cotton undershirts of patients receiving CHOP chemotherapy, worn from the start of therapy through 24 hours after the dose. Cyclophosphamide was detected on the undershirts of all patients, at concentrations from 7.38 to 160.77 ng/cm² — establishing that sweat, not only urine, deposits the drug onto textiles in direct skin contact. Peer-reviewed — Miyazawa et al. 2023, PMID 36514300 This is the strongest, most direct demonstration in the entire Atlas that a compound moves from the body onto the fabric a person wears and sleeps against.
Secondary exposure of family members and caregivers
Because the drug reaches textiles, surfaces, and bodily fluids, it can reach the people who share a home with a patient. A pilot study of outpatients' families detected cyclophosphamide in the urine of family members, and a study of caregivers of pediatric patients detected it in the urine of a meaningful fraction of caregivers, peaking 24–48 hours after a dose. Peer-reviewed — Secondary family exposure, PMID 26488834; caregiver exposure, PMID 38870739 The measured amounts are low, but the detection is the point: it confirms the patient-to-household transfer the textile measurements predict.
What this establishes for the Atlas
Cyclophosphamide is the proof-of-principle for the whole body-to-textile premise: a compound carried in sweat and excreta deposits onto clothing and bedding at measurable levels, and can reach household contacts. Peer-reviewed It is an extreme case — a potent, measurable, regulated drug — but the mechanism it demonstrates (skin and bodily fluids loading textiles) is the same mechanism that underlies the rest of this Atlas's interest in what ends up on the sleep surface.
What the research says
It is a regulated occupational hazard
NIOSH lists cyclophosphamide among antineoplastic and other hazardous drugs, and surface-contamination studies in hospital pharmacies repeatedly detect it — sometimes persisting after cleaning — which is why closed-system transfer devices and strict handling protocols exist. Regulatory — NIOSH, USP The occupational framework is well-developed; the household side is less formalized but is what the secondary-exposure studies address.
Laundering reduces it
A pilot study evaluated washing methods for cyclophosphamide-contaminated linens against a 1 ng/cm² benchmark, informing guidance on how to launder soiled items. Peer-reviewed — Washing study, PMID 37267487 Standard cancer-care guidance already includes handling and laundering precautions for the days after a dose; the research supports that those precautions meaningfully reduce contamination.
Reducing secondary exposure
These are documented household- and occupational-hygiene measures — the kind already found in cancer-care guidance — not medical advice; patients and caregivers should follow their own care team's instructions.
Follow the care team's household-precaution guidance during and after treatment. Most chemotherapy programs provide specific instructions for the days after a dose, when excretion is highest; those instructions are the authoritative source.
Handle soiled linens and clothing with gloves and launder them separately. The washing research supports separate laundering of visibly soiled items during the high-excretion window.
Use waterproof mattress and pillow protectors that can be wiped or laundered. A washable barrier limits how much reaches the mattress itself and makes cleanup easier.
Ventilate and clean surfaces. General hygiene reduces the surface and dust reservoirs that secondary-exposure studies measure.
Open research questions
- How much cyclophosphamide accumulates specifically in a patient's mattress and bedding over a treatment course, and how long it persists. Speculation
- The real-world reduction in household secondary exposure achieved by specific bedding-hygiene practices. Speculation
The Embr Exposure Ledger: Cyclophosphamide
One chemical, several public questions, answered from independent datasets and joined here — the environment it shows up in, the body burden it carries, how it is regulated, and what actually reduces it.
Detection and body-burden figures are occurrence data, not a personal measurement or a health diagnosis. Part of the Embr Exposure Ledger — an open, cross-dataset chemical join (download the data), reusable with attribution.
Citations
- IARC. Cyclophosphamide — Group 1 (carcinogenic to humans). Regulatory
- Miyazawa M, Yamashita R, Ichinohe Y, Kohzai Y, Kishimoto K (2023). Cyclophosphamide exposure via sweat of patients receiving CHOP therapy. Journal of Oncology Pharmacy Practice. PMID 36514300 Peer-reviewed
- Secondary Exposure of Family Members to Cyclophosphamide After Chemotherapy of Outpatients With Cancer: A Pilot Study. PMID 26488834 Peer-reviewed
- Cyclophosphamide exposure factors in family caregivers for pediatric cancer patients (2024). PMID 38870739 Peer-reviewed
- The Effectiveness of Washing Clothing Contaminated With Cyclophosphamide: A Pilot Study. PMID 37267487 Peer-reviewed
- NIOSH. List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings; USP <797>/<800> handling guidance. Regulatory
Frequently asked questions
Why is a chemotherapy drug in the Bedroom Chemistry Atlas?
Because cyclophosphamide is the clearest documented example of a compound moving from a person's body onto the textiles they sleep and live in. Patients excrete the drug in urine and sweat, and researchers have measured it directly on patients' clothing. This page describes that documented secondary (environmental) exposure — an occupational- and household-hygiene topic. It is not medical advice about cancer treatment, and nothing here implies any product treats, prevents, or affects cancer or its therapy.
How does cyclophosphamide get onto clothing and bedding?
Patients receiving cyclophosphamide excrete it and its metabolites in urine and sweat — roughly a quarter of a dose leaves unchanged in urine within 24 hours. A 2022 study measuring patients' cotton undershirts during CHOP therapy detected cyclophosphamide in the undershirts of all patients, at 7.38 to 160.77 ng/cm², showing that sweat as well as urine deposits the drug onto textiles in direct skin contact.
Can family members be exposed?
Studies of secondary exposure have detected cyclophosphamide in the urine of family members and caregivers of treated patients, including a meaningful fraction of caregivers of pediatric patients. The amounts are low, but the detection establishes that the drug can move from patient to household contact via contaminated textiles, surfaces, and bodily fluids. This is why cancer-care guidance includes household-hygiene precautions during and after treatment.
Does washing remove it?
A pilot study tested washing methods for cyclophosphamide-contaminated linens against a 1 ng/cm² benchmark. Laundering reduces contamination, and standard guidance is to handle and wash visibly soiled linens separately, with gloves, during the days after a dose. Following the laundering and handling precautions in cancer-care guidance is the documented way to reduce this secondary exposure.
Is this a risk for the general public?
No. This is specific to households of patients receiving the drug and to healthcare workers who handle it — not the general public. NIOSH lists cyclophosphamide among hazardous drugs requiring occupational controls, and the secondary-exposure literature is centered on patients' families and caregivers. The Atlas includes it because it is the strongest evidence that body chemistry transfers onto textiles, not because it is a broad consumer exposure.
Related compounds
This Atlas entry describes documented environmental and secondary exposure science. It is not medical advice; patients and caregivers should follow their care team's guidance. Last reviewed 2026-06-27. If you find a factual error, contact us.