Introduction: Chemical contamination in hospital environments poses a persistent occupational hazard for healthcare workers, particularly nurses. Intensive Care Units (ICUs) represent high-risk areas due to the frequent use of hazardous drugs, disinfectants, and reprocessed personal protective equipment (PPE). Despite advancements in exposure control technologies, measurable contamination remains a widespread concern. This systematic review aimed to evaluate the extent of chemical contamination in hospital and ICU environments, summarize surface and biological monitoring data, and identify implications for nurses’ occupational safety.
Methods: databases for studies published between 2015 and 2024. Forty studies were included, focusing on environmental and biological monitoring of antineoplastic and disinfectant exposures in healthcare settings. Methodological quality was appraised using the Newcastle–Ottawa Scale (NOS), and studies scoring below 6 were excluded from synthesis.
Results: Surface contamination with antineoplastic drugs was consistently detected across multiple hospital departments, including ICUs not directly involved in chemotherapy preparation. Reported contamination levels varied widely due to methodological heterogeneity, yet wipe sampling and biomonitoring data indicated ongoing exposure risks for nurses. Studies identified inadequate cleaning practices, PPE reuse, and insufficient decontamination as major contributing factors. Implementation of closed-system transfer devices (CSTDs) and standardized cleaning protocols significantly reduced contamination levels but did not eliminate them entirely .
Conclusion: Despite improved awareness and technology, chemical contamination remains a critical occupational issue in hospital settings, particularly for ICU nurses. Continuous environmental monitoring, strict adherence to PPE protocols, and regular staff training are essential to mitigate exposure risks. Future research should focus on ICU-specific contamination pathways, chemical byproducts from PPE reprocessing, and the long-term health effects of chronic low-dose exposure.