SynthesisThe Science of the total environment2022
Transmission of COVID-19 and other infectious diseases in public washrooms: A systematic review.
Synthesis in The Science of the total environment, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 61 citations in OpenAlex.
- Isolation and identification of microorganisms from public and semi-public multi-user video gamepads with respect to hygiene and disinfection measures.AIMS public health · 2026Article
- Targeted probe capture metagenomics-enabled surveillance of multidrug-resistant organisms and antimicrobial resistance genes in post-handwashing areas of public washrooms.Environmental microbiome · 2025Article
- A novel and validated 3D-printed method for the consistent and reproducible dry transfer of microorganisms for the determination of antimicrobial surface efficacy.Applied and environmental microbiology · 2025Article
- Pathogen Discovery in the Post-COVID Era.Pathogens (Basel, Switzerland) · 2024Review
- ATP-based assessments of recent cleaning and disinfection for high-touch surfaces in low-resource shared toilets.NPJ clean water · 2024Article
- Reduction of acute respiratory infections in day-care by non-pharmaceutical interventions: a narrative review.Frontiers in public health · 2024Review
- Internet-of-medical-things integrated point-of-care biosensing devices for infectious diseases: Toward better preparedness for futuristic pandemics.Bioengineering & translational medicine · 2023Review
- Aspects and problems associated with the water services to be considered in intensive care units.Journal of infection prevention · 2023Article
- Antimicrobial Performance of Innovative Functionalized Surfaces Based on Enamel Coatings: The Effect of Silver-Based Additives on the Antibacterial and Antifungal Activity.International journal of molecular sciences · 2023Article
- Review
- Commercial toilets emit energetic and rapidly spreading aerosol plumes.Scientific reports · 2022Article
- Risk factors for SARS-CoV-2 transmission in student residences: a case-ascertained study.Archives of public health = Archives belges de sante publique · 2022Article
- Biological Properties of SARS-CoV-2 Variants: Epidemiological Impact and Clinical Consequences.Vaccines · 2022Review
- 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
- Longitudinal, virological, and serological assessment of hospitalized COVID-19 patients.Journal of neurovirology · 2022Article
- Antimicrobial-ResistantFrontiers in microbiology · 2022Article
- Aerosols and Bacteria From Hand Washing and Drying in Indoor Air.Frontiers in public health · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe risk of infectious disease transmission in public washrooms causes concern particularly in the context of the COVID-19 pandemic. This systematic review aims to assess the risk of transmission of viral or bacterial infections through inhalation, surface contact, and faecal-oral routes in public washrooms in healthcare and non-healthcare environments.
methodsWe systematically reviewed environmental sampling, laboratory, and epidemiological studies on viral and bacterial infection transmission in washrooms using PubMed and Scopus. The review focused on indoor, publicly accessible washrooms.
resultsThirty-eight studies from 13 countries were identified, including 14 studies carried out in healthcare settings, 10 in laboratories or experimental chambers, and 14 studies in restaurants, workplaces, commercial and academic environments. Thirty-three studies involved surface sampling, 15 air sampling, 8 water sampling, and 5 studies were risk assessments or outbreak investigations. Infectious disease transmission was studied in relation with: (a) toilets with flushing mechanisms; (b) hand drying systems; and (c) water taps, sinks and drains. A wide range of enteric, skin and soil bacteria and enteric and respiratory viruses were identified in public washrooms, potentially posing a risk of infection transmission. Studies on COVID-19 transmission only examined washroom contamination in healthcare settings.
conclusionOpen-lid toilet flushing, ineffective handwashing or hand drying, substandard or infrequent surface cleaning, blocked drains, and uncovered rubbish bins can result in widespread bacterial and/or viral contamination in washrooms. However, only a few cases of infectious diseases mostly related to faecal-oral transmission originating from washrooms in restaurants were reported. Although there is a risk of microbial aerosolisation from toilet flushing and the use of hand drying systems, we found no evidence of airborne transmission of enteric or respiratory pathogens, including COVID-19, in public washrooms. Appropriate hand hygiene, surface cleaning and disinfection, and washroom maintenance and ventilation are likely to minimise the risk of infectious disease transmission.
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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.