Transmission of COVID-19 and other infectious diseases in public toilets: a systematic review
DOI: https://doi.org/10.1016/j.scitotenv.2021.149932
Commentary
With respect to the risk of transmission of infectious diseases in public toilets, this systematic review assesses the risk of transmission of viral or bacterial infections via inhalation, surface contact, and fecal-oral routes in public washrooms in health care and non-health care settings.
The results identified 38 studies from 13 countries.
Thirty-three studies involved surface sampling, 15 involved air sampling, 8 involved water sampling, and 5 were risk assessments or outbreak investigations. The study included 14 studies.
The transmission of infectious diseases was studied in relation to
(a) toilets with flushing mechanisms
(b) Hand drying systems.
(c) Water faucets, sinks, and drains.
The study on COVID-19 infection examined only contaminated washrooms in healthcare settings.
Conclusion. Open-lid toilet flushing, ineffective hand washing or hand drying, substandard or infrequent surface cleaning, clogged drains, and uncovered garbage cans can cause extensive bacterial and/or viral contamination in washrooms. However, only a few cases of infections primarily related to fecal-oral infections originating from restaurant washrooms have been reported.
