ArticleAntimicrobial resistance and infection control2018
Bioaerosol concentrations generated from toilet flushing in a hospital-based patient care setting.
Article in Antimicrobial resistance and infection control, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
46 citing papers in PubMed, 3 syntheses or guidelines pooled it, 118 citations in OpenAlex.
- Transmission of COVID-19 and other infectious diseases in public washrooms: A systematic review.The Science of the total environment · 2022Pooled it
- Classification of aerosol-generating procedures: a rapid systematic review.BMJ open respiratory research · 2020Pooled it
- Persistent viral shedding of SARS-CoV-2 in faeces - a rapid review.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2020Pooled it
- New Delhi metallo-β-lactamase-1 -producingInfection prevention in practice · 2025Article
- Covering the biopsy hole check valve with "enzymolysis gauze" reduces bacterial contamination in the endoscopy room.World journal of gastroenterology · 2025Article
- Hospital toilets and drainage systems as a reservoir for a long-term polyclonal outbreak of clinical infections with multidrug-resistantInfection prevention in practice · 2025Article
- Toothbrush contamination by toilet plumes: A comparative study in Chennai, India.Bioinformation · 2025Article
- Evaluation of an automated far ultraviolet-C light technology for decontamination of surfaces and aerosolized viruses in bathrooms.Antimicrobial resistance and infection control · 2024Article
- Aerosol Transmission of Norovirus.Viruses · 2024Review
- Multidrug-Resistant Bacteria Contaminating Plumbing Components and Sanitary Installations of Hospital Restrooms.Microorganisms · 2024Review
- Inadequate sanitation in healthcare facilities: A comprehensive evaluation of toilets in major hospitals in Dhaka, Bangladesh.PloS one · 2024Article
- Bioaerosol assessment in indoor and outdoor environments: a case study from India.Scientific reports · 2023Article
- Sanitary installations and wastewater plumbing as reservoir for the long-term circulation and transmission of carbapenemase producing Citrobacter freundii clones in a hospital setting.Antimicrobial resistance and infection control · 2023Article
- Gastrointestinal Endoscopy in Patients with Coronavirus Disease 2019: Indications, Findings, and Safety.Gastroenterology clinics of North America · 2023Review
- Virus Emissions from Toilet Flushing: Comparing Urine-Diverting to Mix Flush Toilets.ACS ES&T water · 2023Article
- Healthcare-associated infections in the context of the pandemic.Frontiers in health services · 2023Article
- Commercial toilets emit energetic and rapidly spreading aerosol plumes.Scientific reports · 2022Article
- Transmission modes of severe acute respiratory syndrome coronavirus 2 and implications for infection control: a review.Singapore medical journal · 2022Review
- Aerosols and Bacteria From Hand Washing and Drying in Indoor Air.Frontiers in public health · 2022Article
- Importance of the Precautionary Principle With Regard to the Risk of Exposure to Aerosols Containing Viral Loads of SARS-CoV-2 Present in Feces: In Perspective.Frontiers in public health · 2022Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
Background: In the United States, 1.7 million immunocompromised patients contract a healthcare-associated infection, annually. These infections increase morbidity, mortality and costs of care. A relatively unexplored route of transmission is the generation of bioaerosols during patient care. Transmission of pathogenic microorganisms may result from inhalation or surface contamination of bioaerosols. The toilet flushing of patient fecal waste may be a source of bioaerosols. To date, no study has investigated bioaerosol concentrations from flushing fecal wastes during patient care. Methods: Particle and bioaerosol concentrations were measured in hospital bathrooms across three sampling conditions; no waste no flush, no waste with flush, and fecal waste with flush. Particle and bioaerosol concentrations were measured with a particle counter bioaerosol sampler both before after a toilet flushing event at distances of 0.15, 0.5, and 1 m from the toilet for 5, 10, 15 min. Results: Particle concentrations measured before and after the flush were found to be significantly different (0.3-10 μm). Bioaerosol concentrations when flushing fecal waste were found to be significantly greater than background concentrations ( Conclusions: This study is the first to quantify particles and bioaerosols produced from flushing a hospital toilet during routine patient care. Future studies are needed targeting pathogens associated with gastrointestinal illness and evaluating aerosol exposure reduction interventions.
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