Bathroom contamination control
The post-administration restroom is the single most common source of contamination findings on routine surveys. Urine is the dominant excretion pathway for Ac-225 and its progeny in the first 24-48 hours, and a designated, well-controlled restroom is the difference between a routine survey and a reportable finding. Design and operate the restroom as a restricted area, not a courtesy.
Design and finishes
Non-porous, sealed surfaces
Sealed sheet vinyl or epoxy flooring coved 4-6 inches up the wall. Solid-surface or sealed-laminate walls behind the toilet and at splash zones. Avoid grout lines, unsealed tile, fabric privacy curtains, or porous millwork. Every joint is a place contamination lodges and a place decon fails.
Single-cohort access
Restroom is access-controlled to the alpha-therapy cohort — not shared with general clinic, staff, or visitor traffic during the post-administration window. Posted per 10 CFR §20.1902 and locked when not in active patient use.
Fixtures sized for survey
Wall-hung toilet (no floor-mounted base to trap drips), elongated bowl, lever or sensor flush, hands-free faucet. Single-roll dispenser with disposable seat covers. No upholstered seating or rugs.
Ventilation and waste
Continuous mechanical exhaust to the outside, ideally negatively pressured relative to the corridor. Lined sharps and soft-waste containers inside the restroom for any patient-generated consumables (e.g., incontinence products). Do not co-mingle with general clinical waste.
Operational protocol
Patient-facing
Sit-to-void signage in plain language and the patient's preferred language. Flush twice. Wash hands thoroughly. Do not leave personal items on the floor or counter. If a spill occurs, do not clean — exit and notify the technologist. Provide a written copy in the discharge packet, not just signage on the door.
Staff-facing
Routine alpha + gamma survey after each patient use and at end-of-day. Survey log kept at the door, signed by the surveyor. Spill response cart and PPE staged immediately outside. Cleaning performed by trained EVS using the alpha-specific decon procedure — never by ad-hoc nursing or housekeeping coverage.
Survey and cleaning cadence
Per-patient survey
ZnS direct frisk of toilet seat/rim, flush handle, sink handles, floor in front of the toilet, and the doorknob/exit-side push plate. Wipe test on the toilet seat and floor in front of the toilet. Results recorded against the patient's administration log entry.
End-of-day clearance
Wipe survey of full floor, walls to 4 ft, fixtures, and the waste container exterior, counted on a low-background alpha counter. Threshold defined in the written procedure; failure routes to alpha-specific decon and re-survey before next use.
Decon procedure
Work perimeter-inward with absorbents. Use a dedicated alpha-decon kit — not a general clinical cleaner. Every wipe used is primary waste, surveyed and bagged. Final clearance survey is the same standard as initial release: alpha + gamma, both at or below background.
It's worth specifying floor and wall finishes for cleanability before the first patient — retrofitting porous flooring after a contamination finding costs more than getting it right up front. Building the per-patient survey into the technologist's discharge checklist helps ensure it isn't skipped under pressure.
- 10 CFR §20.1902 — Posting requirements.
- 10 CFR §35.75 — Release of individuals containing unsealed byproduct material.
- NCRP Report No. 155 — Management of Radionuclide Therapy Patients.