At a glance
| Chemical family | An antineoplastic (chemotherapy) drug — an oxazaphosphorine alkylating agent and the structural sibling of cyclophosphamide |
| CAS number | 3778-73-2 |
| Classification | A NIOSH-listed hazardous drug; genotoxic. Not classified by IARC as a known or probable human carcinogen — unlike cyclophosphamide (Group 1). Often mislabelled "Group 1," which is incorrect for ifosfamide |
| Where you encounter it | Only in a home where someone is being treated: excreted in urine and other fluids, 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 Ifosfamide 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 | Ifosfamide (EC 223-237-3) has no harmonised CLP classification in Annex VI and is not on the REACH SVHC Candidate List, the Authorisation List (Annex XIV) or the Restriction List (Annex XVII); as a pharmaceutical active substance it also falls outside REACH registration. It does appear on the European Commission's indicative list of hazardous medicinal products issued under Article 18a of the Carcinogens, Mutagens and Reprotoxic Substances Directive 2004/37/EC (Commission Communication C/2025/1150), among the antineoplastic agents. The exact hazard categories and the classification basis recorded for ifosfamide in that list could not be independently verified, because the EUR-Lex document was not machine-retrievable at the time of review. Regulatory — EUR-Lex · ECHA CHEM |
| United States | Under California Proposition 65, ifosfamide (CAS 3778-73-2) is listed as a developmental toxicant, effective July 1, 1990. The OEHHA list carries a single row for this CAS — 'Ifosfamide / developmental / 3778-73-2 / July 1, 1990' — with no separate cancer or male/female reproductive-toxicity listing. As a pharmaceutical active ingredient it falls outside the scope of EPA's TSCA industrial-chemical program, and no TSCA risk evaluation or action addresses it. Regulatory — OEHHA |
| Canada | No specific restriction identified. Ifosfamide is a pharmaceutical (therapeutic) substance and is not on the CEPA Schedule 1 List of Toxic Substances; pharmaceuticals of this kind fall outside that industrial-substances framework, and no Canadian listing or Chemicals Management Plan assessment for ifosfamide could be confirmed against a primary source. Regulatory — Government of Canada |
| Australia | No specific restriction identified. Ifosfamide is a therapeutic (chemotherapy) drug, not an industrial chemical; therapeutic goods are excluded from the AICIS scheme, so no listing or restriction under AICIS or the Industrial Chemicals Environmental Management Standard (IChEMS) applies, and it is not an agvet chemical under the APVMA. Regulatory — AICIS |
| United Kingdom | Great Britain largely inherits the pre-Brexit EU position: ifosfamide has no GB mandatory classification and labelling (GB MCL) entry and is not on the UK REACH SVHC Candidate List or Authorisation List, and as a pharmaceutical active substance it falls outside UK REACH registration. No GB-specific restriction was identified. Regulatory — HSE |
| International | The IARC Monographs evaluated ifosfamide (as isophosphamide, CAS 3778-73-2) and place it in Group 3 — not classifiable as to its carcinogenicity to humans. The original evaluation (Vol. 26, 1981) found limited evidence of carcinogenicity in experimental animals and, in the absence of human data, made no evaluation of risk to humans; the Group 3 designation is recorded in Supplement 7 (1987). It is not a Stockholm Convention POP, and no other global-treaty determination applies. (Note: this differs from its close relative cyclophosphamide, which IARC classifies as Group 1.) Regulatory — IARC/INCHEM · IARC |
| Certifications | CertiPUR-US: not addressed. Its slabstock-foam technical guidelines screen flexible polyurethane foam for foam-manufacturing substances — flame retardants (including PBDEs, TCEP, TDCPP), formaldehyde, phthalates (e.g. DEHP), heavy metals (lead, mercury, cadmium, arsenic), ozone depleters/CFC blowing agents and VOCs — and do not name ifosfamide or any chemotherapy/pharmaceutical drug (verified against the published 2025 guideline text). OEKO-TEX Standard 100 and GREENGUARD/GREENGUARD Gold are, respectively, a textile restricted-substance standard and a low-VOC emissions certification; neither is designed to screen for a non-volatile chemotherapy drug substance such as ifosfamide. Industry — CertiPUR-US |
| The 72-hour test window | Largely missed. Ifosfamide is a non-volatile solid drug substance (MW ~261, very low vapour pressure) that does not meaningfully off-gas, so a short ~72-hour VOC emissions chamber test would not capture it — and as a chemotherapy pharmaceutical it is not a constituent of the bedroom/foam matrix that such testing is designed to characterise in the first place. Inferred — from the compound's volatility/emission profile versus the VOC focus of short chamber tests |
What it is
Ifosfamide is an oxazaphosphorine alkylating agent — a chemotherapy drug that kills cancer cells by chemically cross-linking their DNA. It is the close structural relative of cyclophosphamide, and is used against sarcomas, testicular and other germ-cell tumours, lymphomas and a range of other cancers. As with everything in this family, it is first and foremost an important medicine.
Its place here rests on one precise point about classification. Ifosfamide is genotoxic and is listed by NIOSH as a hazardous drug requiring careful handling. Regulatory — NIOSH lists ifosfamide among hazardous antineoplastic drugs requiring safe-handling precautions But it has not been classified by IARC as a known or probable human carcinogen — a meaningful difference from cyclophosphamide, which is an IARC Group 1 carcinogen. Inferred — ifosfamide is absent from the IARC Group 1/2A/2B carcinogen lists that include cyclophosphamide; the common "Group 1" label is a misattribution and is corrected here Calling ifosfamide a "Group 1 carcinogen," as some summaries do, is simply wrong, and this Atlas does not repeat the error: the caution around it derives from its genotoxicity and hazardous-drug status, not a carcinogen classification.
How it relates to the bedroom
The household route: excretion onto surfaces and bedding
Ifosfamide reaches the sleep environment exactly as its siblings do — through the patient's excreta. Surface monitoring in hospitals has repeatedly found measurable ifosfamide (alongside cyclophosphamide) across patient areas, with the highest levels on the floors of patient lavatories, explicitly tied to the handling of patients' urine. Peer-reviewed — Hedmer et al. 2008 The drug is not only on surfaces but gets into people: in a study of oncology nurses, a third of those with internal contamination had ifosfamide in their urine, some of it attributable to skin contact with contaminated surfaces rather than direct drug handling. Peer-reviewed — Villa et al. 2021
And the single most relevant finding for a bedroom atlas: among the tasks that most strongly predicted picking up these drugs, changing the sheets or making the bed of a treated patient stood out. Peer-reviewed — Villa et al. 2023 In a home, that is the family caregiver's job — which is exactly the exposure this page exists to address.
Keeping it in proportion
The calibration is the same as for the rest of the family. Ifosfamide is a genotoxic hazardous drug, so reasonable precautions are warranted — but the documented third-party exposures are low-level traces, and the response is sensible hygiene rather than alarm. Inferred — household third-party exposure is low-level; precaution follows the ALARA principle The drug itself is doing essential work for the patient. The caregiver's task is to keep their own incidental contact as low as reasonably achievable during the short window after each dose.
What the research says
- Not an IARC-classified carcinogen. Genotoxic and NIOSH-hazardous, but not Group 1 — unlike cyclophosphamide. Inferred — corrected from a common misattribution
- Excreted and surface-deposited. Found on patient-lavatory floors, tied to handling of patients' urine. Peer-reviewed — Hedmer et al. 2008
- Reaches people via surfaces. Detected in a third of internally-contaminated nurses, partly from skin contact. 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
What helps reduce it
Follow your care team's home-chemo precautions. Generally for about a week after each dose, designed for this situation. 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 for these drugs. Peer-reviewed — Hedmer et al. 2008
What does NOT help
- Replacing the mattress. The drug is a transient excreted residue, not a bedding ingredient; hygiene and laundering address it. Inferred
- Mislabelling it a Group 1 carcinogen. That overstates the classification; precautions rest on genotoxicity and hazardous-drug status. Inferred
Open research questions
- The real magnitude of any health risk to home caregivers from low-level contact with excreted ifosfamide. Speculation
- Whether ifosfamide's distinct toxicity profile (e.g. its neurotoxic and bladder effects in patients) has any relevance to low-level third-party exposure. Speculation
The Embr Exposure Ledger: Ifosfamide
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
- Hedmer M, et al. (2008). Environmental and biological monitoring of antineoplastic drugs in four workplaces in a Swedish hospital. Int. Arch. Occup. Environ. Health. Cyclophosphamide and ifosfamide on most surfaces; highest on patient-lavatory floors (up to 95 ng/cm²), tied to handling patients' urine. Via Consensus. DOI 10.1007/s00420-007-0284-y Peer-reviewed
- Villa A, et al. (2021). Nurses' internal contamination by antineoplastic drugs in hospital centers. Int. Arch. Occup. Environ. Health. 33.3% of internally-contaminated nurses had urinary ifosfamide; 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 ifosfamide?
Ifosfamide is a chemotherapy drug — an alkylating agent and the close structural sibling of cyclophosphamide — used to treat sarcomas, testicular and other germ-cell cancers, lymphomas and several other malignancies. Like the rest of this family, it is a valuable cancer treatment, and it belongs in a bedroom atlas only because of what happens after a patient receives it: the drug is excreted and leaves traces on surfaces and bedding.
Is ifosfamide a carcinogen?
This is worth stating precisely, because it is often miscategorised. Ifosfamide is a genotoxic, NIOSH-listed hazardous drug and is handled with the same caution as other chemotherapy agents. But unlike its sibling cyclophosphamide — which is an IARC Group 1 known human carcinogen — ifosfamide has not been classified by IARC as a known or probable human carcinogen. So it should not be labelled a Group 1 carcinogen; the caution around it is based on its genotoxicity and hazardous-drug status, not a carcinogen classification.
Why does it matter in the bedroom?
Because patients excrete it. Studies have found ifosfamide on hospital surfaces — highest on the floors of patient bathrooms, tied to handling patients' urine — and detected it in the urine of nurses, sometimes from skin contact with contaminated surfaces rather than direct handling. Critically, changing the sheets or making the bed of a treated patient is one of the strongest predictors of picking up these drugs. In a home, that task falls to a family caregiver, which is why contaminated bedding and bathroom surfaces are the exposure to manage.
What should a caregiver do?
Follow the home-chemotherapy precautions from your 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 from other washing with an extra rinse; close the toilet lid before flushing and clean bathroom surfaces; and wash hands afterward. The aim is to keep a caregiver's incidental exposure as low as reasonably achievable during the days the drug is being cleared.
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.