ReviewThe Science of the total environment2021
What is the risk of acquiring SARS-CoV-2 from the use of public toilets?
Review in The Science of the total environment, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 55 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
- Poor air passenger knowledge of COVID-19 symptoms and behaviour undermines strategies aimed at preventing the import of SARS-CoV-2 into the UK.Scientific reports · 2023Article
- Pleiotropic Functions of Nitric Oxide Produced by Ascorbate for the Prevention and Mitigation of COVID-19: A Revaluation of Pauling's Vitamin C Therapy.Microorganisms · 2023Review
- Transmission of SARS-CoV-2 in the workplace: Key findings from a rapid review of the literature.Aerosol science and technology : the journal of the American Association for Aerosol Research · 2023Article
- Suitability of aircraft wastewater for pathogen detection and public health surveillance.The Science of the total environment · 2023Article
- An exploration into the challenges of managing the COVID-19 pandemic in mass education centers in Iran: A qualitative content analysis.Health promotion perspectives · 2023Article
- Commercial toilets emit energetic and rapidly spreading aerosol plumes.Scientific reports · 2022Article
- Gendered Impact of Age, Toilet Facilities, and Cooking Fuels on the Occurrence of Acute Respiratory Infections in Toddlers in Indonesia and the Philippines.International journal of environmental research and public health · 2022Article
- Ventilation reconstruction in bathrooms for restraining hazardous plume: Mitigate COVID-19 and beyond.Journal of hazardous materials · 2022Article
- A multi-layered strategy for COVID-19 infection prophylaxis in schools: A review of the evidence for masks, distancing, and ventilation.Indoor air · 2022Review
- Spread of SARS-CoV-2 aerosols via two connected drainage stacks in a high-rise housing outbreak of COVID-19.Journal of hazardous materials · 2022Article
- Article
- Transmission of SARS-CoV-2 infections and exposure in surfaces, points and wastewaters: A global one health perspective.Case studies in chemical and environmental engineering · 2022Article
- On male urination and related environmental disease transmission in restrooms: From the perspectives of fluid dynamics.Sustainable cities and society · 2022Article
- Healthcare-acquired clusters of COVID-19 across multiple wards in a Scottish health board.The Journal of hospital infection · 2022Article
- Article
- Assessment of potential for viral contamination of user and environmentFrontiers 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
- Reducing the risk of COVID-19 transmission in hospitals: focus on additional infection control strategies.Surgery (Oxford, Oxfordshire) · 2021Review
- Pandemic or Hurricanes? Service Quality Influence on Satisfaction in a Primary Health Care Public Clinic in Mexico.Quality management in health careArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Public toilets and bathrooms may act as a contact hub point where community transmission of SARS-CoV-2 occurs between users. The mechanism of spread would arise through three mechanisms: inhalation of faecal and/or urinary aerosol from an individual shedding SARS-CoV-2; airborne transmission of respiratory aerosols between users face-to-face or during short periods after use; or from fomite transmission via frequent touch sites such as door handles, sink taps, lota or toilet roll dispenser. In this respect toilets could present a risk comparable with other high throughput enclosed spaces such as public transport and food retail outlets. They are often compact, inadequately ventilated, heavily used and subject to maintenance and cleaning issues. Factors such as these would compound the risks generated by toilet users incubating or symptomatic with SARS-CoV-2. Furthermore, toilets are important public infrastructure since they are vital for the maintenance of accessible, sustainable and comfortable urban spaces. Given the lack of studies on transmission through use of public toilets, comprehensive risk assessment relies upon the compilation of evidence gathered from parallel studies, including work performed in hospitals and prior work on related viruses. This narrative review examines the evidence suggestive of transmission risk through use of public toilets and concludes that such a risk cannot be lightly disregarded. A range of mitigating actions are suggested for both users of public toilets and those that are responsible for their design, maintenance and management.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.