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Lifting the lid on toilet plume aerosol: a literature review with suggestions for future research.

Abstract

BACKGROUND

The potential risks associated with "toilet plume" aerosols produced by flush toilets is a subject of continuing study. This review examines the evidence regarding toilet plume bioaerosol generation and infectious disease transmission.

METHODS

The peer-reviewed scientific literature was searched to identify articles related to aerosol production during toilet flushing, as well as epidemiologic studies examining the potential role of toilets in infectious disease outbreaks.

RESULTS

The studies demonstrate that potentially infectious aerosols may be produced in substantial quantities during flushing. Aerosolization can continue through multiple flushes to expose subsequent toilet users. Some of the aerosols desiccate to become droplet nuclei and remain adrift in the air currents. However, no studies have yet clearly demonstrated or refuted toilet plume-related disease transmission, and the significance of the risk remains largely uncharacterized.

CONCLUSION

Research suggests that toilet plume could play a contributory role in the transmission of infectious diseases. Additional research in multiple areas is warranted to assess the risks posed by toilet plume, especially within health care facilities.

Links

Authors+Show Affiliations

Johnson DL

Department of Occupational and Environmental Health, University of Oklahoma College of Public Health, Oklahoma City, OK 73126-0901, USA. David-Johnson@ouhsc.edu

Mead KR

Lynch RA

Hirst DV

Source

American journal of infection control 41:3 2013 Mar pg 254-8

MeSH

Aerosols
Air Microbiology
Disease Transmission, Infectious
Humans
Risk Assessment
Toilet Facilities

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

23040490

Citation

Hirst, Deborah V L., et al. "Lifting the Lid On Toilet Plume Aerosol: a Literature Review With Suggestions for Future Research." American Journal of Infection Control, vol. 41, no. 3, 2013, pp. 254-8. Unbound PRIME, www.unboundmedicine.com/medline/citation/23040490/abstract/Lifting_the_lid_on_toilet_plume_aerosol:_A_literature_review_with_suggestions_for_future_research_. Accessed February 17, 2019.

Hirst DV, Johnson DL, Lynch RA, et al. Lifting the lid on toilet plume aerosol: a literature review with suggestions for future research. Am J Infect Control. 2013;41(3):254-8.  https://www.unboundmedicine.com/medline/citation/23040490/abstract/Lifting_the_lid_on_toilet_plume_aerosol:_A_literature_review_with_suggestions_for_future_research_. Accessed February 17, 2019.

Hirst, D. V., Johnson, D. L., Lynch, R. A., & Mead, K. R. (2013). Lifting the lid on toilet plume aerosol: a literature review with suggestions for future research. American Journal of Infection Control, 41(3), pp. 254-8. doi:10.1016/j.ajic.2012.04.330

Hirst DV, et al. Lifting the Lid On Toilet Plume Aerosol: a Literature Review With Suggestions for Future Research [Internet]. Am J Infect Control. 2013 [cited 2019 Feb 17];41(3):254-8. Available from: https://www.unboundmedicine.com/medline/citation/23040490/abstract/Lifting_the_lid_on_toilet_plume_aerosol:_A_literature_review_with_suggestions_for_future_research_ doi: 10.1016/j.ajic.2012.04.330

* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Lifting the lid on toilet plume aerosol: a literature review with suggestions for future research. AU - Johnson,David L, AU - Mead,Kenneth R, AU - Lynch,Robert A, AU - Hirst,Deborah V L, Y1 - 2012/10/05/ PY - 2012/02/24/received PY - 2012/04/13/revised PY - 2012/04/14/accepted PY - 2012/10/9/entrez PY - 2012/10/9/pubmed PY - 2013/8/13/medline SP - 254 EP - 8 JF - American journal of infection control JO - Am J Infect Control VL - 41 IS - 3 N2 - BACKGROUND: The potential risks associated with "toilet plume" aerosols produced by flush toilets is a subject of continuing study. This review examines the evidence regarding toilet plume bioaerosol generation and infectious disease transmission. METHODS: The peer-reviewed scientific literature was searched to identify articles related to aerosol production during toilet flushing, as well as epidemiologic studies examining the potential role of toilets in infectious disease outbreaks. RESULTS: The studies demonstrate that potentially infectious aerosols may be produced in substantial quantities during flushing. Aerosolization can continue through multiple flushes to expose subsequent toilet users. Some of the aerosols desiccate to become droplet nuclei and remain adrift in the air currents. However, no studies have yet clearly demonstrated or refuted toilet plume-related disease transmission, and the significance of the risk remains largely uncharacterized. CONCLUSION: Research suggests that toilet plume could play a contributory role in the transmission of infectious diseases. Additional research in multiple areas is warranted to assess the risks posed by toilet plume, especially within health care facilities. SN - 1527-3296 UR - https://www.unboundmedicine.com/medline/citation/23040490/abstract/Lifting_the_lid_on_toilet_plume_aerosol:_A_literature_review_with_suggestions_for_future_research_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-6553(12)00812-7 DB - PRIME DP - Unbound Medicine ER -