At a glance
| Chemical family | An antineoplastic (chemotherapy) drug — an anthracycline (brand name Adriamycin) |
| CAS number | 23214-92-8 |
| Carcinogen status | IARC Group 2A — probably carcinogenic to humans (sufficient animal evidence, strong genotoxicity); also linked to secondary leukaemias in treated patients |
| Where you encounter it | Only in a home where someone is being treated: excreted in urine and other fluids (often reddish-tinted), depositing on toilet/bathroom surfaces, bedding and laundry |
| Sleep micro-environment relevance | A household caregiver- and laundry-hygiene concern — contaminated bedding and surfaces, not the mattress — for a limited period after each dose |
| Activated carbon capture | Not relevant — a surface/laundry-residue issue managed by gloves, separate laundering and cleaning, not air filtration |
Regulatory & certification status
Where Doxorubicin 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 | No specific REACH restriction identified: doxorubicin is not on the SVHC Candidate List, the Authorisation List (Annex XIV) or the Restriction list (Annex XVII). Under REACH Article 2, substances to the extent they are used in medicinal products for human/veterinary use are exempted from Titles II, V, VI and VII (registration, downstream-user, evaluation and authorisation obligations); doxorubicin is such an active pharmaceutical substance. No harmonised CLP classification exists in Annex VI of Regulation (EC) No 1272/2008 (the carcinogen 1B / mutagen 1B labels seen on supplier safety data sheets are self-classifications, not a harmonised Annex VI entry). It is not an EU POP. Regulatory — EUR-Lex |
| United States | California Proposition 65: listed as 'Doxorubicin Hydrochloride (Adriamycin)' — known to cause cancer (listed 1 July 1987) and known to cause developmental toxicity and male reproductive toxicity (both listed 29 January 1999). OEHHA originally entered the listing under CAS No. 23214-92-8 and subsequently issued a formal correction changing the CAS number for both endpoints to 25316-40-9 (the hydrochloride salt). Federally, doxorubicin is a prescription drug regulated by the FDA under the Federal Food, Drug, and Cosmetic Act; no EPA TSCA risk-evaluation or FIFRA pesticide determination for it was identified. Regulatory — OEHHA |
| Canada | A final CEPA screening assessment of doxorubicin (chemical-grade CAS 23214-92-8; pharmaceutical-grade doxorubicin hydrochloride CAS 25316-40-9) concluded the substance does not meet the criteria set out in section 64 of CEPA 1999, so it was not added to Schedule 1 (List of Toxic Substances). It was assessed because it had been identified as a potential high hazard to human health based on carcinogenicity classifications by other national/international agencies; the assessment addressed environmental exposures (e.g., residues from manufacture, formulation and disposal) not covered when drugs containing doxorubicin are regulated for safety, efficacy and quality under the Food and Drugs Act. Regulatory — Government of Canada |
| Australia | No specific AICIS/IChEMS restriction identified: doxorubicin is a therapeutic good regulated by the TGA, and therapeutic goods are expressly out of scope of the Industrial Chemicals Act 2019 / AICIS (which covers industrial chemicals only). No AICIS evaluation or IChEMS listing was located. No determination found. Regulatory — AICIS |
| United Kingdom | No specific GB CLP mandatory (harmonised) classification or UK REACH restriction identified. Great Britain inherited the EU baseline at the end of the transition period (no harmonised/mandatory classification for doxorubicin), and as a medicine it is regulated by the MHRA rather than as an industrial chemical under UK REACH. No determination found. Regulatory — HSE |
| International | IARC classifies doxorubicin (Adriamycin) in Group 2A, probably carcinogenic to humans (evaluated in Supplement 7, 1987), on the basis of sufficient evidence in experimental animals and inadequate evidence in humans; it remains in Group 2A on the current IARC list of classifications. No Stockholm or Minamata Convention relevance. Regulatory — IARC Monographs Supplement · IARC |
| Certifications | CertiPUR-US: not addressed — it is a content/emissions program for flexible polyurethane foam, and doxorubicin (a cytotoxic anthracycline drug) is not a foam input. OEKO-TEX Standard 100: not addressed — its Restricted Substances List targets textile/processing chemicals, and doxorubicin is not named in the published limit-value criteria. GREENGUARD / GREENGUARD Gold: a low-VOC chemical-emissions certification that would not screen for a non-volatile pharmaceutical compound like this. Industry — CertiPUR-US · OEKO-TEX |
| The 72-hour test window | Largely missed. Doxorubicin is a high-molecular-weight, non-volatile anthracycline drug with no meaningful vapor pressure, so a short ~72-hour VOC chamber test would not detect it; it is also not a plausible bedroom/mattress constituent in the first place. Inferred — from the compound's volatility/emission profile versus the VOC focus of short chamber tests |
What it is
Doxorubicin is an anthracycline — a class of chemotherapy drugs derived originally from Streptomyces bacteria — and one of oncology's workhorses, used against breast cancer, lymphomas, leukaemias, sarcomas and many solid tumours. It kills cancer cells by intercalating into DNA and poisoning topoisomerase II, the enzyme that untangles DNA during cell division. Patients and nurses know it as the "red devil," both for its vivid red colour and for the harshness of its side effects, including cardiotoxicity. As with everything in this family, it is first and foremost an important medicine.
Its place in this Atlas rests on a clear classification. The International Agency for Research on Cancer evaluated doxorubicin (under the name adriamycin) and placed it in Group 2A — probably carcinogenic to humans: there was sufficient evidence in experimental animals, where it produced mammary tumours in rats and was active across other tumour systems, and it is strongly genotoxic, even though the direct human evidence was inadequate at the time. Regulatory — IARC Monographs Suppl. 7, Adriamycin The same property that makes it lethal to tumour cells — DNA damage — is what underlies that classification.
How it relates to the bedroom
The household route: excretion onto surfaces and bedding
Doxorubicin reaches the sleep environment through the patient's excreta, and it is unusually easy to picture because it is so visibly coloured — it can tint urine and other fluids reddish for a day or two after a dose. Hospital monitoring repeatedly finds antineoplastic drugs across patient areas and getting into staff: most nurses studied carried measurable internal antineoplastic-drug contamination, doxorubicin among the drugs detected, some of it from skin contact with contaminated surfaces rather than direct handling. Peer-reviewed — Villa et al. 2021
And the bedroom-specific finding holds for doxorubicin as for the platinum drugs: among the tasks that most strongly predicted picking up these agents, changing the sheets or making the bed of a treated patient stood out. Peer-reviewed — Villa et al. 2023 In a home, that task belongs to the family caregiver — and the reddish staining doxorubicin can leave is a built-in cue for what to handle with care.
Keeping it in proportion
The calibration is the same as for the rest of the family. Doxorubicin is a genotoxic, IARC Group 2A drug, so precautions are warranted — but documented third-party exposures are low-level traces, and the right response is sensible hygiene, not alarm. Inferred — household third-party exposure is low-level; precaution follows the ALARA principle The drug is doing essential work for the patient; the caregiver's job is to keep their own incidental contact low during the short window after each dose.
What the research says
- IARC Group 2A. Probably carcinogenic to humans — sufficient animal evidence (mammary tumours in rats), strongly genotoxic. Regulatory — IARC Suppl. 7, Adriamycin
- Excreted and surface-deposited. Detected among antineoplastic drugs on patient-area surfaces and in nurses. Peer-reviewed — Villa et al. 2021
- Bedding is a real route. Sheet-changing/bed-making strongly associated with internal contamination. Peer-reviewed — Villa et al. 2023
- Visibly traceable. Reddish tinting of fluids is a practical cue for what to handle carefully. Inferred — well-known clinical property of doxorubicin
What helps reduce it
Follow your care team's home-chemo precautions. Generally for about a week after each dose. Inferred — standard home-chemotherapy caregiver guidance
Glove up and launder separately. Disposable gloves for soiled linens and fluids; wash contaminated bedding apart from other laundry with an extra rinse. Peer-reviewed — Villa et al. 2023
Manage the bathroom. Close the lid before flushing and clean surfaces — the documented hot spots. Peer-reviewed — Villa et al. 2021
What does NOT help
- Replacing the mattress. The drug is a transient excreted residue, not a bedding ingredient; hygiene and laundering address it. Inferred
- Panic over the red staining. The colour is a useful cue, not a sign of danger in itself; the response is gloves and separate laundering, not fear. Inferred
Open research questions
- The real magnitude of any health risk to home caregivers from low-level contact with excreted anthracyclines. Speculation
- How long doxorubicin and its coloured metabolites remain detectable on home bedding and surfaces after a dose. Speculation
Citations
- IARC Monographs, Supplement 7 (1987). Adriamycin (Doxorubicin). International Agency for Research on Cancer. Group 2A, probably carcinogenic to humans; sufficient animal evidence (mammary tumours in rats), strongly genotoxic. inchem.org Regulatory
- Villa A, et al. (2021). Nurses' internal contamination by antineoplastic drugs in hospital centers. Int. Arch. Occup. Environ. Health. 60.8% of nurses internally contaminated, doxorubicin among drugs detected; some from skin contact with contaminated surfaces. Via Consensus. DOI 10.1007/s00420-021-01706-x Peer-reviewed
- Villa A, et al. (2023). Factors associated with internal contamination of nurses by antineoplastic drugs. Int. J. Hyg. Environ. Health. Changing sheets / making the bed of a treated patient strongly associated with internal contamination (OR ~10). Via Consensus. DOI 10.1016/j.ijheh.2023.114264 Peer-reviewed
Frequently asked questions
What is doxorubicin?
Doxorubicin (brand name Adriamycin, often called the "red devil" for its bright red colour and harsh side effects) is an anthracycline chemotherapy drug used against breast cancer, lymphomas, leukaemias and many solid tumours. It works by wedging into DNA and poisoning the enzyme topoisomerase II, which makes it a powerful cancer killer. Like every drug in this family, it is a valuable medicine; it appears in a bedroom atlas only because of what happens after a dose.
Is doxorubicin a carcinogen?
Yes. The International Agency for Research on Cancer classifies doxorubicin (adriamycin) as Group 2A, probably carcinogenic to humans, based on sufficient evidence in animals — it caused mammary tumours in rats and was active in other tumour systems — together with strong genotoxicity. It is also linked to secondary leukaemias in treated patients. This is the basis for handling it, and a caregiver's exposure to excreta, with care.
Why does it matter in the bedroom?
Because patients excrete it for days, and it is vividly traceable — doxorubicin can tint urine and other fluids reddish after a dose. Hospital monitoring finds antineoplastic drugs, doxorubicin among them, on patient-area surfaces and getting into staff through skin contact. The single strongest bedroom-specific finding is that changing the sheets or making the bed of a treated patient is one of the best predictors of picking these drugs up — in a home, that is the family caregiver.
What should a caregiver do?
Follow the home-chemotherapy precautions from the care team, generally for about a week after each dose. Wear disposable gloves when handling soiled bedding, clothing or body fluids; launder contaminated linens separately with an extra rinse; close the toilet lid before flushing and clean bathroom surfaces; and wash hands afterward. The reddish staining doxorubicin can cause is a useful visual cue for what to handle carefully. The goal is to keep a caregiver's incidental exposure as low as reasonably achievable.
Related compounds
Embr is a sleep environment company researching and addressing the chemistry of the bedroom. Research and product development in progress. This page is informational and is not medical advice; follow your care team's guidance.
Last reviewed 2026-06-27. If you find a factual error, contact us.