The role of the public toilet: pathogen transmitter or health facilitator?

Abstract

This paper discusses the role of public toilets, as transmitters of disease, but also of their importance in contributing to the health and well-being of society. Research has shown that public toilets are vital components in creating sustainable, accessible, inclusive cities. But there is no mandatory legislation requiring local authorities to provide them. Over 40% have been closed in the UK in the last 10 years. The promotion of the 24 hour city, characterized by a male youth drinking culture, along with toilet closure, has resulted in increased street urination, creating the conditions for the spread of previously-eradicated, water borne diseases in city streets. Less visible, but as virulent, has been the effect of toilet closure for women. Women, in response to lack of toilet provision, are likely to ‘hold on’ resulting in urine (and pathogen) retention, and bladder distension increasing the propensity for continence problems. The elderly and people with disabilities may simply not go out for fear of there being no toilet when they need one. Those toilets that are available may be unusable. Lack of regulation or compulsory standards result in poor toilet design, inadequate maintenance and management, and unhygienic conditions, resulting in the spread of MRSA and other drug-resistant diseases. Recommendations are summarized for the provision of a spatial hierarchy of toilet provision that would both meet user needs and reduce the chances of the public toilets acting as epicentres of germ transmission. Unless compulsory legislation, increased funding, and improved management, maintenance and cleaning regimes are instigated, public toilet provision will continue to be a source of disease.

Perceptual quality of neighbourhood design and feelings of unsafety

“…As for subjective neighbourhood accessibility, older people who are dissatisfied with the number of public toilets and the condition of the sidewalks experience more feelings of unsafety. The first finding supports research that found that public toilets are essential for the creation of accessible, inclusive cities (Greed 2006). Greed (2006) suggests that inadequate public toilet provision may reduce mobility-behaviour.…”

Bacteriological Assessment of Toilet Seats in a Nigerian University

“…They may be situated in the markets, and transport centers, schools, eateries, hostels, offices, factories, schools, hospitals, factories, cinemas, bars, museums, restaurants, places of entertainment, railway stations, filling stations, etc [1]. These could be compartmented in a room or small building containing one or more toilets [2]. They could also be found as portable toilets at large outdoor events and demarcated into male, female and unisex sections [2].…”

“…These could be compartmented in a room or small building containing one or more toilets [2]. They could also be found as portable toilets at large outdoor events and demarcated into male, female and unisex sections [2].…”

A brief review on lavatory cleaning devices and their feasibility in public toilets in developing countries

“…These germs can spread from the toilet seat to body parts of the user and also to other surfaces to which the person is in contact with, spreading infectious diseases to other people (Gerhardts et al 2012;Ahmed 2018). Human excreta is a main source of transmission of many classical diseases including urinary, anal and vaginal infections (Greed 2006) and studies have shown that toilet seats are always contaminated with faecal bacteria (Mendes and Lynch 1976). Faecal borne bacteria such as Escherichia coli (E. coli), Shigella sonnei, Streptococcus, Staphylococcus, Salmonella, Yersinia and viruses such as norovirus, rotavirus, adenovirus, Torque teno virus spread from toilet surfaces (Gerhardts et al 2012;Greed 2006;Mendes and Lynch 1976;Sassi et al 2018) and can result in several serious health issues.…”

“…Human excreta is a main source of transmission of many classical diseases including urinary, anal and vaginal infections (Greed 2006) and studies have shown that toilet seats are always contaminated with faecal bacteria (Mendes and Lynch 1976). Faecal borne bacteria such as Escherichia coli (E. coli), Shigella sonnei, Streptococcus, Staphylococcus, Salmonella, Yersinia and viruses such as norovirus, rotavirus, adenovirus, Torque teno virus spread from toilet surfaces (Gerhardts et al 2012;Greed 2006;Mendes and Lynch 1976;Sassi et al 2018) and can result in several serious health issues. Flushing of toilets or cleaning lavatories using pressurized water jet streams can also result in aerosolization of the above mentioned bacteria and viruses which can cause transmission of infectious diseases such as Severe Acute Respiratory Syndrome (SARS) (Gerhardts et al 2012;Greed 2006;Mendes and Lynch 1976;Johnson et al 2013;Hamilton et al 2018).…”