Highlights
- •Toilet plume bioaerosols in healthcare and hospitality setting are uncharacterised.
- •The bioaerosols pose unquantified contact transmission and airborne transmission risks.
- •These risks increase the exposure to enteric and airborne pathogens.
- •There is a lack of national and international toilet plume bioaerosol sampling and exposure standards.
- •A quantitative risk assessment and related research is needed to investigate these transmission risks.
ABSTRACT
Background
The spread of some respiratory and gastro-intestinal infections has been linked to
the exposure to infectious bioaerosols released after toilet flushing. This represents
a health hazard and infection risk for immunocompromised patients, health workers
and the public, particularly within the healthcare and hospitality settings. This
systematic review provides current knowledge and identifies gaps in the evidence regarding
toilet plume bioaerosols and the potential contributing role in spreading infections
in healthcare and hospitality settings.
Methods
The PRISMA guidelines were used. Searches were run in PubMed, Scopus, and Google Scholar
from 1950 to 30th June 2021. Searches of global and regional reports and updates from
relevant international and governmental organisations were also conducted.
Results and Conclusion
The search yielded 712 results, and 37 studies were finally selected for this review.
There is a lack of national and international bioaerosol sampling and exposure standards
for healthcare and hospitality settings. Toilet plume bioaerosols are complex in nature,
thus, measured bioaerosol concentrations in these settings depend on many variables
and may differ for every pathogen responsible for a particular infectious disease.
The contact and airborne transmission risks posed by toilet plume bioaerosols also
remain unquantified. They are an important pathway that can increase the exposure
to enteric and airborne pathogens. Hence, quantitative risk assessment and related
research are needed to investigate these transmission risks.
Keywords
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Article Info
Publication History
Accepted:
July 8,
2022
Received in revised form:
July 7,
2022
Received:
February 17,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.
