Deficient hand washing facilities in public toilets in the time of the COVID-19 pandemic: A survey in one high-income country
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Abstract
Aims
To identify the extent of the provision of water and soap for hand washing in public toilets at the time of the COVID-19 pandemic. To also make comparisons with a pre-pandemic survey that included a sample of the same facilities.
Methods
We collected data from 400 toilets that were open to the public; all those in three contiguous city council territories (228) and a further convenience sample of 172 around the rest of New Zealand. Comparisons were made with the data on the same facilities included in a 2012/2013 survey.
Results
For all the toilets in this survey, 2.5% had no water for hand washing and 14.8% had no soap. There was COVID-19 related health messaging signage in 19.5% of toilets, with posters of the COVID-19 QR code used to facilitate contact tracing in 12.3%, and generic hand washing signage in 1.8%. The hand washing water had “no touch” activation at 28.0% of toilets and at 18.5% for toilet bowl flushing. Toilet bowl lids were not present at 32.8%, and 2.3% of toilets had damage which would impair their functionality (eg, broken toilet seats). For the 128 sites that had also been examined in the previous survey, this new survey found significantly increased provision of soap (risk ratio = 1.47; 95%CI: 1.25 to 1.72), but no increased provision of water.
Conclusions
Despite the serious threat of the COVID-19 pandemic, the majority of hand washing facilities in public toilets sampled required tap touching, and did not have health messaging. Nevertheless there has been some modest improvements in soap (but not water) provision since the previous survey eight years before.
Article activity feed
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SciScore for 10.1101/2021.01.19.21250124: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Study strengths and limitations: This is the largest such survey to date in New Zealand that we know of, and it was able to compare a sub-sample of the same facilities after an eight year period. It was also conducted at a time …
SciScore for 10.1101/2021.01.19.21250124: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Study strengths and limitations: This is the largest such survey to date in New Zealand that we know of, and it was able to compare a sub-sample of the same facilities after an eight year period. It was also conducted at a time where there was greatly heightened need for hygiene due to the COVID-19 pandemic. Nevertheless, the study was limited by only being comprehensive in three contiguous council areas, with the rest being convenience sampling. This was owing to this being an unfunded study with no budget for travel. The convenience sampling is likely to have involved surveying facilities that were more accessible to the researchers by being on main roads. These may be relatively newer and have a better maintenance schedule than facilities in small rural towns. This may have resulted in some under-estimation from the convenience sample of the extent of the problems outside urban areas (eg, with water and soap availability). Potential research and policy implications: A fundamental research issue is to better quantify the risks of infectious disease transmission associated with use of public toilets (eg, from any aerosolisation of faeces and from touching contaminated surfaces). This is not only relevant to SARS-CoV-2, but also other infectious diseases (eg, norovirus infection and seasonal influenza). Nevertheless, surveys such as this could be improved upon by making them fully random at the national level and collecting additional data on the facilities to compare them wi...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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