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There has been a collapse in the number of public toilets in UK cities. Austerity cuts, a lack of legal requirements, and a failure to prioritise sanitation has led to significant health and equality impacts. Research on public toilets in the Global North focuses on their historical production, contemporary design, or on the experience of particular social groups, with less work bringing governance and social experience together. We argue for a focus on the “ungoverning” of sanitation, on how residents “learn” sanitation in the city, and on the need for radical transformation in sanitation approaches and delivery. Drawing on research in London, we set out the challenges for public toilet provision and make a case for a sanitation revolution in British cities. We focus on the experience of delivery drivers and residents with health concerns in order to illustrate the inequalities in provision and their consequences. [ABSTRACT FROM AUTHOR]

Background: Bacteria are present on all surfaces, to which they were carried by many direct and indirect methods of transmission. A toilet is simply a receptacle into which both solid and liquid waste of human origin, in the form of urine and excreta are discharged. In public toilets, complete strangers mix and use the same sanitary facilities, with all the related risks of bodily fluid exchange, contamination and organism transmission. Unhygienic use of the toilet's facilities may cause urine and fecal residues after use to serve as a major reservoir or source of human pathogen, which may in turn bring about disease outbreak. Aim: This study aimed at Identification of Bacteria from Public Toilets of Modern Market (Goico) In Musanze Town, Rwanda Method: This cross-sectional study was conducted to identify bacteria from GOICO market toilets. About 40 samples; 20 from male and 20 from female toilets were collected and transported to INES-clinical microbiology laboratory for microbiological analysis. Laboratory techniques including culture, gram stain, biochemical tests and antibiogram were performed. Results: The most predominant bacteria isolated was S. aureus (31.43%), followed by S. typhi (20%), Streptococcus(15.71%), E. coli(12.86%), P. aeuriginosa(10%), P. mirabilis(7.14%), C. freundi(1.43%), S. epidermidis (1.43%). It was noted that female toilets were more contaminated (51.43%) than male toilets (48.57%). All gram positive and gram-negative bacteria were sensitive to Gentamicin. Almost all bacteria except P. mirabilis were sensitive to Norfloxacin, gram negative showed a resistance to Vancomycin and Novobiocin. Conclusion: These results should alert public toilets users that extreme caution must be executed while using these toilets, as they may be a source of pathogenic bacteria. The best way to keep a toilet and its seat free of bacteria is to clean it with bleach. Otherwise, keep the bacteria at bay by washing your hands, and if you just don't trust that toilet seat, wipe it down with a disinfectant or antibacterial wipe before you sit. [ABSTRACT FROM AUTHOR]

In modern society, people engage in social interactions and activities outside their own home. When in public settings people may need to eliminate bodily waste, so public toilets are required. Accessibility, availability and adaptability are essential principles for safe, private, and purposeful visits to public toilets. A diverse range of individuals use public toilets: various age profiles, all gender groups, vulnerable individuals and people with additional needs. Public toilets essentially need to be a place of privacy, safety and cleanliness to facilitate elimination of urine, evacuation of faeces, management of menstruation, and changing/disposing of continence wear products in a secure environment. [ABSTRACT FROM AUTHOR]

Background: Bacteria are present on all surfaces, to which they were carried by many direct and indirect methods of transmission. A toilet is simply a receptacle into which both solid and liquid waste of human origin, in the form of urine and excreta are discharged. In public toilets, complete strangers mix and use the same sanitary facilities, with all the related risks of bodily fluid exchange, contamination and organism transmission. Unhygienic use of the toilet's facilities may cause urine and fecal residues after use to serve as a major reservoir or source of human pathogen, which may in turn bring about disease outbreak. Aim: This study aimed at Identification of Bacteria from Public Toilets of Modern Market (Goico) In Musanze Town, Rwanda Method: This cross-sectional study was conducted to identify bacteria from GOICO market toilets. About 40 samples; 20 from male and 20 from female toilets were collected and transported to INES-clinical microbiology laboratory for microbiological analysis. Laboratory techniques including culture, gram stain, biochemical tests and antibiogram were performed. Results: The most predominant bacteria isolated was S. aureus (31.43%), followed by S. typhi (20%), Streptococcus(15.71%), E. coli(12.86%), P. aeuriginosa(10%), P. mirabilis(7.14%), C. freundi(1.43%), S. epidermidis (1.43%). It was noted that female toilets were more contaminated (51.43%) than male toilets (48.57%). All gram positive and gram-negative bacteria were sensitive to Gentamicin. Almost all bacteria except P. mirabilis were sensitive to Norfloxacin, gram negative showed a resistance to Vancomycin and Novobiocin. Conclusion: These results should alert public toilets users that extreme caution must be executed while using these toilets, as they may be a source of pathogenic bacteria. The best way to keep a toilet and its seat free of bacteria is to clean it with bleach. Otherwise, keep the bacteria at bay by washing your hands, and if you just don't trust that toilet seat, wipe it down with a disinfectant or antibacterial wipe before you sit. [ABSTRACT FROM AUTHOR]

The issue of urban resilience plays great significance and value for the sustainable development of cities, which has attracted increasing attention from scholars and governments, especially in the western region of China. Based on the Production-Living-Ecological (PLE) system, this study attempts to describe urban resilience by the combination system that contains with P,L,E subsystem. The integrated approach including FAHP-EM,GRA-TOPSIS, CCDM, and ODM is proposed to reveal the urban resilience level and seek out the key constraints' indicators. Then, an empirical analysis of panel data of 18 cities in Sichuan Province from 2011 to 2021 was conducted to analyze the development process. The valuation results suggested that:(1)for urban resilience level, most cities at the moderate imbalance level and basically maintained at this level, only Chengdu is reaching the basic coordination level since in 2013.(2)The insufficient development of P,L,E subsystem is the reason for the moderate imbalance development, especially the key limiting factor is the P subsystem's low development level.(3)the most prominent obstacle indicators are x1(per capita local financial expenditure on science and technology), x2(per capita of R&D spending), x8(total export-import per capita), x14(number of people with basic medical insurance), x22(length of urban drainage pipeline), x23(number of public toilets per person) and the contribution values reach 7.56%,7.49%,11.02%, 9.14%,12.53%, 12.60% respectively. The detailed reference suggestions and effective measures put forwarded for policy makers and planners to promote urban resilience in Western China. [ABSTRACT FROM AUTHOR]

Background/Objectives: LUTS and voiding dysfunctions are prevalent in urology clinics, with uroflowmetry and IPSS as the prevailing diagnostic methods. Nevertheless, objective assessment can be constrained by age, gender, and variability in the test conditions. Portable (home) uroflowmetry addresses these limitations, allowing for more natural urinary flow recordings beyond clinic confines. This study aims to characterize spontaneous voiding patterns in healthcare professionals, exploring gender differences, variability in repeated measurements, and correlations among voiding parameters, IPSS, age, and BMI. Methods: This cross-sectional study was conducted during the SIU 43rd Congress in Istanbul using smart uroflow devices such as the Oruba Oruflow Uroflow Recorder, which were installed in public toilets. A total of 431 healthcare professionals participated by providing demographic information and completing the IPSS questionnaire. The data analysis included uroflowmetric parameters such as maximum flow rate (Qmax), average flow rate (Qave), and voided volume (VV), in addition to IPSS and demographic data to assess the possible associations with IPSS, age, BMI, and gender differences. Results: Of the participants, 76% were male and 24% female, with a higher prevalence of LUTS in women. Despite no significant gender difference in voided volume, men with lower volumes demonstrated more severe LUTS. Notably, women exhibited higher Qmax and Qave rates irrespective of their IPSS scores, contrasting with men whose flow rates declined with age and LUTS severity. In men, the total IPSS score was inversely associated with uroflowmetric performance, particularly impacting voiding symptoms over storage symptoms. Repeated measurements revealed noteworthy variability in Qmax and VV, without any influence from gender, BMI, age, or symptom severity. Conclusions: Our findings highlight the importance of gender-specific considerations in evaluating voiding complaints through uroflowmetry and IPSS. The significant variability observed in repeated uroflowmetry studies underlines the need for multiple measurements. Overall, this research emphasizes the significance of portable (home) uroflowmetry and calls for a reassessment of normal voiding standards in (non) clinical settings. [ABSTRACT FROM AUTHOR]

This study selected 24 highly popular pocket parks in Beijing and conducted field research to collect data on park use during weekdays and weekends. SPSS correlation analysis and the development of a decision tree model were used to rank the key factors that influence the flexibility and intensity of park use on weekdays and weekends. The findings indicated that the key factors impacting the flexibility and intensity of park use on weekdays, in order of importance, are seat density, recreation facilities density, land use entropy (LUE), distance to a public toilet, POI density, and 5-min accessibility. On the other hand, the main factors influencing the flexibility and intensity of park use on weekends are 5-min accessibility, seat density, POI density, fitness facilities density, distance to the bus stop, distance to a public toilet, and life service facilities density. These findings offer valuable insights for the study of pocket parks in other cities. [ABSTRACT FROM AUTHOR]

In recent years, under the influence of multiple factors such as traditional ideas and living economic conditions, the aging population in China continues to increase. Most of the elderly are more inclined to aged at home, and the first places for elderly activities are communities and the surrounding environment, which greatly affects the convenience of life and happiness of the elderly. In this paper, Changxindian area in Fengtai District of Beijing was as the research object, and detailed calculation and analysis were carried out by using POI data and arcGIS software. The relative location of residential areas and surrounding public toilets was explored, and the best location of public toilets in the daily walking area under the model of community home-based care for the elderly was further studied. [ABSTRACT FROM AUTHOR]

It is common to observe the epidemic risk perception (ERP) and a decline in subjective well-being (SWB) in the context of public health events, such as Corona Virus Disease 2019 (COVID-19). However, there have been few studies exploring the impact of individuals' ERP within living space on their SWB, especially from a geographical and daily activity perspective after the resumption of work and other activities following a wave of the pandemic. In this paper, we conducted a study with 789 participants in urban China, measuring their ERP within living space and examining its influence on their SWB using path analysis. The results indicated that individuals' ERP within their living space had a significant negative effect on their SWB. The density of certain types of facilities within their living space, such as bus stops, subway stations, restaurants, fast food shops, convenience shops, hospitals, and public toilets, had a significantly negative impact on their SWB, mediated by their ERP within living space. Additionally, participation in out-of-home work and other activities not only increased individuals' ERP within living space, but also strengthened its negative effect on their SWB. [ABSTRACT FROM AUTHOR]

The United States is a public toilet nightmare. Truly public toilets are a rarity, while the restrooms provided by private businesses are inconsistently available via “customer only” policies and the discriminatory actions of owners and their employees. Some jurisdictions have made tepid attempts at providing more bathrooms, but all have failed. The result: an accumulation of entirely preventable public health harms, including outbreaks of infectious disease, illness, and dignitary harms. This Article is the first to provide a comprehensive review of U.S. toilet law—the laws and policies that determine where bathrooms are provided and who has access to them—and diagnose its failings. Despite municipal, state, and federal actors’ efforts to expand availability, members of the public are too often forced to rely on the private provision of bathrooms. It is clear that the status quo has failed to address this most basic human biological necessity. This Article makes the case that recognizing a state constitutional right to public bathrooms is the best way to address this problem. Drawing from recent developments in international human rights, it sets forth the basis on which courts could recognize a right to public toilets as part of a state constitution’s public health provision. [ABSTRACT FROM AUTHOR]

For people experiencing homelessness, lack of access to public bathroom facilities often forces the humiliating need to urinate or defecate in public. The bathroom options available to those experiencing homelessness do not meet the population's needs. One solution that scholars and local leaders have proposed is to ban customers-only bathroom policies. Such bans pose difficult legal and political questions. Most significantly, the recent Supreme Court case Cedar Point Nursery v. Hassid--which expanded takings doctrine and made government regulation of access rights more difficult--creates a complex legal roadblock for local lawmakers seeking to ban customers-only bathrooms. The academics, lawmakers, and activists who have discussed limitations or bans on customers-only bathrooms have yet to address the challenge posed by Cedar Point. This Note seeks to fill that gap by analyzing the landscape of takings jurisprudence after Cedar Point. It reaches two related conclusions. First, banning customers-only bathrooms would likely not be a taking. While Cedar Point ostensibly limited a host of access-rights regulations, it carved out several exceptions. Bans on customers-only bathrooms would likely fall into one such exception. The Court's broad holding may thus be less exacting than it appears. Second, regardless of whether these bans are takings, municipal leaders can best serve the public by providing just compensation for the access rights these bans carve out. This solution avoids the indeterminacies of Cedar Point, softens the political blow to business owners, and centers the experience and dignity of those living in homelessness. [ABSTRACT FROM AUTHOR]

Intelligent toilets can effectively remove odors and harmful substances from exhaust gases and wastewater, maintaining a fresh and clean indoor atmosphere, which is beneficial to the indoor environment and human health. Currently, research on intelligent toilets conducted by sanitary ware manufacturers is still in its early stages. Many of the intelligent toilets available on the market exhibit issues such as an excessive oscillation amplitude of the cleaning spray bar, premature breakdown of the water column, and inadequate air intake. The present study involves the analysis and redesign of a cleaning spray bar model for intelligent toilets. Additionally, several optimization schemes concerning the flow channel of the cleaning spray bar are proposed in order to enhance the performance of the liquid–air ejector. The computational fluid dynamics (CFD) technique is utilized to analyze the water flow characteristics within the cleaning spray bar of the intelligent toilet and to compare and evaluate the proposed schemes. The calculation results indicate that, for the same inlet flow rate, the optimal structure the block with a length of L = 1.5 mm and the block positioned (4). The swirl numbers of these two optimized models are 14.8% and 8.3% of the protype, respectively, while their air intake is 133% and 131% of the protype, respectively. The optimized solutions exhibited significant performance improvements when compared to the prototype. The computational results offer valuable insights for optimizing the flow characteristics of the enhanced product. [ABSTRACT FROM AUTHOR]

Purpose: The present study intends to highlight the issues and challenges pertinent to sanitation practices among urban slum women in India. Design/methodology/approach: The primary qualitative data has been collected from 100 households sampled by stratified random and purposive sampling through in-depth interviews, and a structured interview schedule and themes were developed accordingly. Findings: The main theme-based results of the study included the challenges of open defecation in slums, public toilets as an alternative, sanitation-related stress in slum women, compromised state of health of women and children, menstrual hygiene among women in slums and increasing burden on women in terms of water management. The study recommends the creation of toilets in every slum locality with maintenance and awareness to be raised. Originality/value: Urban sanitation has received less research than rural sanitation. The present study focused on the issues of urban sanitation, which are often neglected. To ensure the study's uniqueness, researchers visited and mentioned each open defecation site to understand the situation. Peer review: The peer-review history for this article is available at: https://publons.com/publon/10.1108/IJSE-12-2022-0782 [ABSTRACT FROM AUTHOR]

This paper endeavours to tackle the challenges of poor sanitation and water conservation in public toilets. Inspired by real-world experiences and the critical need to enhance sanitation while conserving essential resources--such as water, human resources, cleaning materials, and time--an IoT device has been conceptualized. The proposed solution is a 'Microcontroller-Based SMART Urinal cum Disinfectant Flush System,' which operates similarly to a sensor-based urinal and also offers automatic cleaning. Moreover, its smartness allows extensive possibilities for further enhancement. It uses microcontrollers (ESP2866, ESP32), Time of Flight (ToF) sensors, Latching Solenoids, Solenoid Drivers, a DC motor, a water flow sensor, a sound recording cum player, and a speaker. The ESP2866 microcontroller continuously measures distance via a ToF sensor installed at the urinal. Suppose a person remains within proximity to the urinal for over 5 seconds. In that case, it triggers the microcontroller to confirm the person's presence and initiate water flushing for a specific duration after leaving. In addition, if the ESP2866 microcontroller detects the presence of any person, it triggers playing customized announcements. Simultaneously, the ESP32 microcontroller oversees water flow using a water flow sensor. If water flow exceeds a specified duration, the ESP32 microcontroller activates a buzzer to indicate potential water leakage. Programmed timings enable the ESP32 to control the central water supply solenoid, turning it OFF, and the ESP2866 activates the urinal flush solenoid and the DC motor submerged in disinfectant flushes disinfectant in the urinal for a set period. After disinfectant flushing, the ESP32 turns ON the central solenoid to restore the main water supply. At the same time, the ESP2866 deactivates the Urinal Flush Solenoid to halt water flow in the urinal and starts performing the routine. The flushing cycle can be changed from post-urination to pre- & post-urination, and it can be customized. Parameters such as the person-sensing distance, water flow duration, disinfectant flushing time and duration, etc, are customizable. The functionality of automated Urinal Flush, Disinfectant Flush, and a customized announcement system were tested using the designed embedded electronic IoT device. Arduino IDE was used to program Microcontrollers ESP32 and ESP2866. [ABSTRACT FROM AUTHOR]

BackgroundOpen defecation due to a lack of access to sanitation facilities remains a public health issue in the United States. People experiencing homelessness face barriers to accessing sanitation facilities, and are often forced to practice open defecation on streets and sidewalks. Exposed feces may contain harmful pathogens posing a significant threat to public health, especially among unhoused persons living near open defecation sites. The City of San Francisco's Department of Public Works implemented the Pit Stop Program to provide the unhoused and the general public with improved access to sanitation with the goal of reducing fecal contamination on streets and sidewalks. The objective of this study was to assess the impact of these public restroom interventions on reports of exposed feces in San Francisco, California.MethodsWe evaluated the impact of various public restroom interventions implemented from January 1, 2014 to January 1, 2020 on reports of exposed feces, captured through a 311 municipal service. Publicly available 311 reports of exposed feces were spatially and temporally matched to 31 Pit Stop restroom interventions at 27 locations across 10 San Francisco neighborhoods. We conducted an interrupted time-series analysis to compare pre- versus post-intervention rates of feces reports near the restrooms.ResultsFeces reports declined by 12.47 reports per week after the installation of 13 Pit Stop restrooms (p-value = 0.0002). In the same restrooms, the rate of reports per week declined from the six-month pre-intervention period to the post-intervention period (slope change = -0.024 [95% CI = -0.033, -0.014]). In a subset of restrooms, where new installations were made (Mission and Golden Gate Park), and in another subset of restrooms where restroom attendants were provided (Mission, Castro/Upper Market, and Financial District/South Beach), feces reports also declined.ConclusionsIncreased access to public toilets reduced feces reports in San Francisco, especially in neighborhoods with people experiencing homelessness. The addition of restroom attendants also appeared to have reduced feces reports in some neighborhoods with PEH. These interventions should be audited for implementation quality, observed utilization data, and user experience at the neighborhood level in order to tailor sanitation interventions to neighborhood-specific needs.

Sexual violence against female students in public toilets is one of the major concerns for educational institutes. With the advent of smart technologies and smart campuses, educational institutes are making the best of their efforts to prevent such events from occurring. Existing approaches have shortcomings such as a low recognition time, locating errors, and alarming latency. In this study, we aim to propose an Artificial Intelligence (AI) inspired framework to prevent sexual violence in public toilets of educational institutions with the improvisation of gender recognition from gait sequences by collecting the data from IoT devices installed at the public toilets. Gait recognition provides the ability to observe an individual unremarkably, without any direct cooperation from the human. In this study, we have used the fusion of Speeded-Up Robust Features (SURF) and Convolutional Neural Networks (CNN) for feature extraction and Support Vector Machine (SVM) as a classifier. The performance of the proposed framework is compared with other state-of-the-art approaches. The results indicate that the proposed framework outperforms all other considered approaches, and attained a higher accuracy (95.7%). [ABSTRACT FROM AUTHOR]

According to previous research, the toilet and bathroom are the most common locations where injuries and accidents involving elderly people occur. Thus, the purpose of this paper is to investigate the issues and challenges of existing toilets and bathrooms among the Malaysian elderly and to identify appropriate solutions for them. The Focus Group Discussion (FGD) and Quality Function Deployment (QFD) sessions were implemented in this study, which involved a total of nineteen respondents, including elderly aged 60 years and above, their caregivers/family members, and agencies/authorities related to housing planning/development and technologies as well as researchers/experts. The recorded data were transcribed into text and organized systematically in the House of Quality (HoQ) for technical analysis. The focus group findings revealed that the four categorized issues raised by respondents in this study were quality, design, cost, and function. Furthermore, based on the HoQ analysis, it indicated that the top five highest ranks of customer requirements (CRs) for a new bathroom and toilet design requirement were comfortable (Rank 1), safety (Rank 2), affordable price (Rank 3), easy to enter bathroom/toilet (Rank 4) and anti-slippery floor (Rank 5). Meanwhile, the top five highest rank of technical requirements (TRs) refer to the existing OKU toilet design (Rank 1), anti-slip ramp & small drain under toilet door (Ranks 2 and 3), relocating existing toilet accessories, e.g., sink bow (Rank 4) and categories the cost according to the minor, major or new design (Rank 5). The information gathered could be used to develop appropriate bathrooms and toilets for the elderly in Malaysia. [ABSTRACT FROM AUTHOR]

Facility management services are essential for maintaining the effective functioning and safety of buildings. Soft facility management services aim to enhance the work environment by improving efficiency and safety. Poor toilet hygiene due to inadequate care poses a threat to human health and safety. The objectives are to measure the effect of public toilet cleanliness based on the number of people and to analyse the relationship between the level of toilet cleanliness and the number of people. Observation methods were employed to monitor the number of people and evaluate toilet cleanliness from 9:00 a.m. to 17:30 p.m. at R&R X and Y. Linear regression analysis were conducted to determine R² values for each location and using a one-way ANOVA. The R² values represent the relationship between the star rating and the number of people. The result shows the R² values for men’s and women’s toilets at R&R X on weekdays and weekends are R² = 0.7643, R² = 0.7784, R² = 0.2479, and R² = 0.2245. For men’s and women’s toilets at R&R Y on weekdays and weekends, R² = 0.1733, R² = 0.2583, R 2 = 0.5591, and R² = 0.6939. In conclusion, it was found that the R² values on the men’s toilets at R&R X and the women’s toilets at R&R Y had a strong and moderate relationship to the number of people and star rating. Meanwhile, women’s toilets at R&R X and men’s toilets at R&R Y have a weak relationship between the number of people and the star rating. It important to maintain the cleanliness, user comfort and safety, as well as the overallsatisfaction of use, to maintain 5-star rating to ensure that users who use public toilets feel comfortable. [ABSTRACT FROM AUTHOR]

'Public' toilets are crucial to our social and geographical landscape, and access to them has become prominent in recent public and academic debates. Drawing on a qualitative study based on 25 daily diaries and follow-up interviews with people living with the common health condition irritable bowel syndrome (IBS), this paper explores toilet access through the lens of mundane mobilities. Planning journeys, mapping toilets, a reliance on commercial toilets and intersections with travel were key themes emerging from the study. Through the lens of IBS, we see how navigations of seemingly everyday mobilities are problematised through the bodily precarity of unpredictable symptoms intertwined with the availability, comfort and knowledge of 'public' toilets. This paper works at demonstrating the interdependency between everyday mobilities and toilet access. IBS offers a particularly useful insight in which the common but often hidden nature of the condition demonstrates the multiplicities of 'public' toilet access and how the unpredictability of access meets with, and is embodied, by those with the condition. This paper contributes to interdisciplinary toilet scholarship by engaging in mundane and embodied geographies and centralises toilets as a site of connection for those studying everyday mobilities. [ABSTRACT FROM AUTHOR]

Abstract Background Hygiene behaviors in public toilets are important to prevent the transmission of infectious diseases, especially during the pandemic. All through the novel coronavirus (COVID-19) pandemic, governments in many countries published guidance on personal hygiene for the general population to prevent disease transmission. This study aimed to investigate improvements in residents’ hygiene awareness and behaviors in public toilets before and during the pandemic. Methods We recruited 316 residents between November and December 2018 before the pandemic, and 314 residents between December 2020 and January 2021 during the pandemic in the same study sites in Hangzhou, a well-developed city in China. Residents’ hygiene behaviors in public toilets, hygiene awareness, risk perception, and sociodemographic factors were collected. Bivariate analysis and multivariable logistic regressions were used to test the differences between the two rounds. We conducted an observational study to record the provision of hygiene amenities at toilets during the pandemic. Results After controlling for sociodemographic factors (gender, marital status, age, education level, and monthly household income), compared with respondents recruited before the pandemic, respondents recruited during the pandemic were more likely to perceive the risks of infection when using public toilets (aOR = 1.77, 95%CI [1.20, 2.60]), and were more likely to be aware of the risks of touching contaminated toilet facilities (aOR = 1.72, 95%CI [1.17, 2.54]) and the risks of not using soap to wash one’s hands after using the toilet (aOR = 1.93, 95%CI [1.38, 2.72]). They were more likely to always clean their toilet seat with alcohol (aOR = 1.88, 95%CI [1.01, 3.51]), wash hands with soap (aOR = 1.52, 95%CI [1.09, 2.10]) and dry their hands with a dryer (aOR = 1.78, 95%CI [1.16, 2.71]), but they were less likely to always wash their hands after using the toilets (aOR = 0.57, 95%CI [0.32, 1.00]). Among 70 public toilets observed, 9 provided alcohol for toilet seat disinfection, 52 provided soap, 33 provided paper towels, and 41 had working hand dryers. Conclusions Despite the overall improvement, residents’ hygiene behaviors in public toilets and the supply of hygiene amenities were still suboptimal during the pandemic. Further hygiene education and an adequate supply of hygiene amenities in public toilets are needed to promote residents’ hygiene behaviors.

Abstract Background Open defecation due to a lack of access to sanitation facilities remains a public health issue in the United States. People experiencing homelessness face barriers to accessing sanitation facilities, and are often forced to practice open defecation on streets and sidewalks. Exposed feces may contain harmful pathogens posing a significant threat to public health, especially among unhoused persons living near open defecation sites. The City of San Francisco’s Department of Public Works implemented the Pit Stop Program to provide the unhoused and the general public with improved access to sanitation with the goal of reducing fecal contamination on streets and sidewalks. The objective of this study was to assess the impact of these public restroom interventions on reports of exposed feces in San Francisco, California. Methods We evaluated the impact of various public restroom interventions implemented from January 1, 2014 to January 1, 2020 on reports of exposed feces, captured through a 311 municipal service. Publicly available 311 reports of exposed feces were spatially and temporally matched to 31 Pit Stop restroom interventions at 27 locations across 10 San Francisco neighborhoods. We conducted an interrupted time-series analysis to compare pre- versus post-intervention rates of feces reports near the restrooms. Results Feces reports declined by 12.47 reports per week after the installation of 13 Pit Stop restrooms (p-value = 0.0002). In the same restrooms, the rate of reports per week declined from the six-month pre-intervention period to the post-intervention period (slope change = -0.024 [95% CI = -0.033, -0.014]). In a subset of restrooms, where new installations were made (Mission and Golden Gate Park), and in another subset of restrooms where restroom attendants were provided (Mission, Castro/Upper Market, and Financial District/South Beach), feces reports also declined. Conclusions Increased access to public toilets reduced feces reports in San Francisco, especially in neighborhoods with people experiencing homelessness. The addition of restroom attendants also appeared to have reduced feces reports in some neighborhoods with PEH. These interventions should be audited for implementation quality, observed utilization data, and user experience at the neighborhood level in order to tailor sanitation interventions to neighborhood-specific needs.

Using a dataset of more than 51,000 US lakes, we estimated the relationship between summertime lake visits, lake water clarity, landscape features, and other amenities, where visits were estimated with counts of geo‐located photographs. Given the size and complexity of our dataset, we used a combination of machine learning techniques, imputation techniques, and a Poisson count model to estimate these relationships. We found that every additional meter of average summertime Secchi depth was associated with at least 7% more summertime lake visits, all else equal. Second, we found that lake amenities, such as beaches, boat launches, and public toilets, were more powerful predictors of visits than water clarity. Third, we found that visits to a lake were strongly influenced by the lake's accessibility and its distance to nearby lakes and the amenities the nearby lakes offered. Our research highlights the need for (1) a better understanding of how representative social media data are of actual recreational behavior, (2) the development of best practices to account for nonrandom patterns in missing natural feature data, and (3) a better understanding of the potential endogeneity in the lake visit–water quality relationships. [ABSTRACT FROM AUTHOR]

Justice-involved women face myriad challenges as they negotiate the terms of community supervision and manage the long-term implications and stigma of living with a criminal record. Major tasks that women juggle include securing safe, affordable housing, finding and retaining employment, accessing physical and mental health care (including substance use treatment), and handling relationships with family, friends, children, and intimate partners. In addition to these responsibilities, women must meet their basic physiological needs to eat, sleep, and use the toilet. Women's ability to safely meet their personal care needs may impact their capacity to manage their criminal-legal challenges. This study uses qualitative methods to understand justice-involved women's lived experiences related to urination. Specifically, the study reports on a thematic analysis of 8 focus groups conducted with justice-involved women (n = 58) and the results of a toilet audit conducted in the downtown areas of the small city in the United States where the focus group participants were living. Findings suggest that women had limited access to restrooms and reported urinating outside. Lack of restroom access impacted their engagement with social services support and employment and their ability to travel through public spaces. Women perceived their public toilet options as unsafe, increasing their sense of vulnerability and reinforcing the idea that they did not have full access to citizenship in the community because of their criminal-legal involvement. The exclusion and denial of women's humanity that is perpetuated by a lack of public toilet access impacts women's psychosocial outcomes. City governments, social service agencies, and employers are encouraged to consider how lack of toilet access may impact their public safety and criminal-legal objectives and expand opportunities for people to access safe restroom facilities. [ABSTRACT FROM AUTHOR]

Parcopresis is a condition where individuals have trouble (or inability) defecating in restrooms due to the perceived scrutiny of others. The aim of the current research was to identify the prevalence of public toilet avoidance and explore if an extended socio-cognitive model of parcopresis predicts toilet avoidance. Seven-hundred and fourteen university students (73.2% female; mean age = 28.79 years) met criteria to participate and completed a series of questionnaires and ten restroom vignettes. On average 80.00% (gender adjusted 82.54%) of the participants chose to use an available toilet, while 16.78% (gender adjusted 14.44%) avoided a toilet for non-contamination fears. A further 3.22% (gender adjusted 3.01%) participants on average avoided using a toilet due to fears of contamination. Males were significantly more likely to use and not avoid toilets than females across all vignettes. A structural equation model (SEM) indicated the data supported the proposed model well (χ2p value =.185, CMIN/df = 1.359, CFI =.998, TLI =.995, RMSEA =.023, SRMR =.0207) with significant direct relationships being found between: dysfunctional attitudes influencing fear of positive and negative evaluation and fear of social reprisal, and fear of positive and negative evaluation influencing fear of social reprisal and social anxiety symptoms. Social anxiety symptoms had a direct significant influence on parcopresis symptoms, while in turn parcopresis symptoms had a direct significant influence on toilet avoidance. The current study provides evidence that toilet avoidance is underpinned by social anxiety processes and affects at least 14.44% of university students. [ABSTRACT FROM AUTHOR]

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Background: Since the outbreak of the SARS-CoV-2 virus in December 2019, the COVID-19 pandemic continues to threaten global stability. Transmission of SARS-CoV-2 is mostly by respiratory droplets and direct contact but viral RNA fragments have also been detected in the faecal waste of patients with COVID-19. Cleanliness and effective sanitation of public toilets is a concern, as flushing the toilet is potentially an aerosol generating procedure. When the toilets are of the squatting type and without a cover, there exists a risk of viral contamination through the splashing of toilet water and aerosol generation. Objective: This study aims to determine whether the cleanliness of public toilets was a concern to the general population during the COVID-19 pandemic, and whether a squatting toilet was preferred to a seated design. Methods: A questionnaire was designed and posted on “WeChat” contact groups of the investigators. Results: The survey showed that 91% of participants preferred squatting toilets, but that 72% were apprehensive of personal contamination when using public toilets. Over 63% of the respondents had encountered an incidence of water splash and would prefer public toilets to be covered during flushing and 83% of these respondents preferred a foot-controlled device. Conclusion: This survey suggests that consideration should be given to the installation of a simple foot-controlled device to cover public squatting toilets to help restrict potential COVID-19 contamination and to meet hygienic expectations of the public.

Menstruation research has largely focused on addressing menstrual management barriers facing cisgender women and girls in low and middle-income countries. Scant literature has assessed the menstrual management needs of trans and non-binary people assigned female at birth. To better understand these frequently invisibilised menstruation-related needs, we conducted a multi-method qualitative study in New York City which included: 17 in-depth interviews across trans and non-binary people (n = 10) and health care providers who serve them (n = 7); and seven anonymous post-interview participatory writing responses with trans and non-binary participants to further elucidate their lived experiences with menstrual management. Lack of health care provider transgender competency, public toilet design (i.e. gaps in cubicle doors and lack of in-cubicle menstrual product disposal bins), and the social dynamics of public toilets (i.e. work and school) were identified as significant barriers to managing menstruation safely and accessibly for trans and non-binary people. These findings have important implications for healthcare policy, public toilet legislation and advancing menstrual equity in the USA. [ABSTRACT FROM AUTHOR]

Background: Hygiene behaviors in public toilets are important to prevent the transmission of infectious diseases, especially during the pandemic. All through the novel coronavirus (COVID-19) pandemic, governments in many countries published guidance on personal hygiene for the general population to prevent disease transmission. This study aimed to investigate improvements in residents' hygiene awareness and behaviors in public toilets before and during the pandemic.Methods: We recruited 316 residents between November and December 2018 before the pandemic, and 314 residents between December 2020 and January 2021 during the pandemic in the same study sites in Hangzhou, a well-developed city in China. Residents' hygiene behaviors in public toilets, hygiene awareness, risk perception, and sociodemographic factors were collected. Bivariate analysis and multivariable logistic regressions were used to test the differences between the two rounds. We conducted an observational study to record the provision of hygiene amenities at toilets during the pandemic.Results: After controlling for sociodemographic factors (gender, marital status, age, education level, and monthly household income), compared with respondents recruited before the pandemic, respondents recruited during the pandemic were more likely to perceive the risks of infection when using public toilets (aOR = 1.77, 95%CI [1.20, 2.60]), and were more likely to be aware of the risks of touching contaminated toilet facilities (aOR = 1.72, 95%CI [1.17, 2.54]) and the risks of not using soap to wash one's hands after using the toilet (aOR = 1.93, 95%CI [1.38, 2.72]). They were more likely to always clean their toilet seat with alcohol (aOR = 1.88, 95%CI [1.01, 3.51]), wash hands with soap (aOR = 1.52, 95%CI [1.09, 2.10]) and dry their hands with a dryer (aOR = 1.78, 95%CI [1.16, 2.71]), but they were less likely to always wash their hands after using the toilets (aOR = 0.57, 95%CI [0.32, 1.00]). Among 70 public toilets observed, 9 provided alcohol for toilet seat disinfection, 52 provided soap, 33 provided paper towels, and 41 had working hand dryers.Conclusions: Despite the overall improvement, residents' hygiene behaviors in public toilets and the supply of hygiene amenities were still suboptimal during the pandemic. Further hygiene education and an adequate supply of hygiene amenities in public toilets are needed to promote residents' hygiene behaviors. [ABSTRACT FROM AUTHOR]

There have been some approaches in tackling Open defecation both locally and globally, but nevertheless open defecation still exists. Goaland Objectives: This study aimed at spatially assessing the practice of open defecation in the study area which serves as one of the ways towards achieving an Open Defecation Free (ODF) city. The data used in the study include primary and secondary data. These are; the coordinates of Open Defecation sites, public toilets, markets and schools which was acquired with the aid of Global Positioning System (GPS) and 2020 google earth satellite imagery. The coordinates acquired were plotted in ArcGIS 10.3 software to determine their spatial distribution. Methodology: Hotspot analysis was applied to examine the level of practice of open defecation in the study area. Inverse Distance Weighted (IDW) interpolation was used to identify the spread of practice of Open Defecation. Results: The result shows that most dump sites has been converted to Open Defecation sites and are found to be very close to places with influx of people such as markets. In addition, the study shows that the existing public toilets are not sufficient and as a result, three new toilets were proposed. Furthermore, the study shows specifically that Araromi, Sabo, Stadium road, Imuagan, Odo Ikoyi, Oja Oshodi, Odo ikoyi, Ijemikin and Ajaye street were the major hotspots where open defecation is practiced in the study area. This study recommends a quick attention on the identified hotspot locations in the study area by the government and agencies working towards Open Defecation Free (ODF) city. [ABSTRACT FROM AUTHOR]

Public toilets fulfil an essential need for all human beings. In the context of India, the diversity of population implies a diverse set of complex barriers in the public toilet experience. Inclusion and the contextual translation of universal design becomes crucial, considering the distinct socio-cultural dimensions. This study intends to enquire the above-mentioned perspective and contribute towards an understanding of inclusion and universal design in public toilets. The methodology is a three-part process including literature review, experiential case reflections and ethnographic field perspectives. The gathered data is mapped thematically and assessed qualitatively, based on the existing principles of universal design. The insights from the assessment highlight the need for contextualization of existing universal design principles, bringing out a multi-dimensional complexity of inclusion across human needs, behaviour, physical, planning and service aspects. This study paves a way forward for evolving design directions by raising further questions through fresh perspectives on inclusion & accessibility in public toilets. The raised questions contribute to a dilemma of standardisation versus contextual customisation around the understanding of inclusion and universal design, focusing on the scenario of Indian public toilets.

This coproduced study drew on the United Nations Convention on the Rights of Persons with Disabilities to inform a Human Rights-based design. Using photographic images and reflective diaries, twelve participant co-researchers investigated the quality of public toilets when travelling in Scotland for people with dementia and other physical and cognitive impairments. Data were analysed using constant comparison and critically reflexive, group enquiry to produce contextualised evidence of toilet utility from the user perspective. Essential themes revealed major challenges associated with toilet accessibility, usability and design, emphasising the distressing sensory experience of the user when confronted with an inadequate or inaccessible toilet. Substantial overlap in needs was demonstrated but a few unique requirements aligned with specific disabilities were recorded for attention. Our findings highlight two key issues: 1) existing Standards are often unmet; 2) current Standards require review and endorsement by people who represent the full range of access needs. This article reports on a co-production study that researched the critical Human Rights issue of accessible toilet provision for disabled people and carers when travelling. As integral team researchers, disabled people (including people with dementia) and carers played a catalytic role in directing the research outcomes demonstrating the meaningful involvement of seldom heard groups in research. Findings accentuate the high emotional costs of inadequate toilet provision. We identified substantial overlap in the experience and needs of people with different impairments seeking to find and use toilets when travelling but detected a few unique requirements aligned with specific disabilities. [ABSTRACT FROM AUTHOR]

The text presents a new approach to the Memoir from the Warsaw Uprising by Miron Białoszewski – an analysis from the perspective of anality. The article suggests that wartime suspends the usual taboo of the “privatisation of shit,” and public toilets in shelters become new “agoras,” a function which they used to perform in antiquity. Białoszewski’s quasi-anthropological account of the Uprising actually mentions toilets and the organisation of physiological life in every new place to which he and his company move during the period of two months. War is anal because it is a mass production of “waste” (corpses). However, the most important scene also connects anality to writing poetry by two young gay poets. This scene, here called Urszene, is analysed as a desublimation of homosexuality. [ABSTRACT FROM AUTHOR]