Journal article
Bioaerosol concentrations generated from toilet flushing in a hospital-based patient care setting
Antimicrobial Resistance and Infection Control, Vol.7(1), 16
01/01/2018
DOI: 10.1186/s13756-018-0301-9
PMCID: PMC5787296
PMID: 29423191
Abstract
Background:
In the United States, 1.7 million immunocompromised patients contract a healthcare-associated infection, annually. These infections increase morbidity, mortality and costs of care. A relatively unexplored route of transmission is the generation of bioaerosols during patient care. Transmission of pathogenic microorganisms may result from inhalation or surface contamination of bioaerosols. The toilet flushing of patient fecal waste may be a source of bioaerosols. To date, no study has investigated bioaerosol concentrations from flushing fecal wastes during patient care.
Methods:
Particle and bioaerosol concentrations were measured in hospital bathrooms across three sampling conditions; no waste no flush, no waste with flush, and fecal waste with flush. Particle and bioaerosol concentrations were measured with a particle counter bioaerosol sampler both before after a toilet flushing event at distances of 0.15, 0.5, and 1 m from the toilet for 5, 10, 15 min.
Results:
Particle concentrations measured before and after the flush were found to be significantly different (0.3–10 μm). Bioaerosol concentrations when flushing fecal waste were found to be significantly greater than background concentrations (p-value = 0.005). However, the bioaerosol concentrations were not different across time (p-value = 0.977) or distance (p-value = 0.911) from the toilet, suggesting that aerosols generated may remain for longer than 30 min post flush. Toilets produce aerosol particles when flushed, with the majority of the particles being 0.3 μm in diameter. The particles aerosolized include microorganisms remaining from previous use or from fecal wastes. Differences in bioaerosol concentrations across conditions also suggest that toilet flushing is a source of bioaerosols that may result in transmission of pathogenic microorganisms.
Conclusions:
This study is the first to quantify particles and bioaerosols produced from flushing a hospital toilet during routine patient care. Future studies are needed targeting pathogens associated with gastrointestinal illness and evaluating aerosol exposure reduction interventions.
Details
- Title: Subtitle
- Bioaerosol concentrations generated from toilet flushing in a hospital-based patient care setting
- Creators
- Samantha D. Knowlton - University of IowaCorey L. Boles - University of IowaEli N. Perencevich - University of Iowa, Internal MedicineDaniel J. Diekema - University of Iowa, Internal MedicineMatthew W Nonnenmann - University of Iowa, Occupational and Environmental Health
- Contributors
- CDC Epicenters Program (Institution)
- Resource Type
- Journal article
- Publication Details
- Antimicrobial Resistance and Infection Control, Vol.7(1), 16
- Publisher
- BMC
- DOI
- 10.1186/s13756-018-0301-9
- PMID
- 29423191
- PMCID
- PMC5787296
- ISSN
- 2047-2994
- eISSN
- 2047-2994
- Copyright
- © 2018, Springer Nature
- Grant note
- Funding: This research was funded by cooperative agreement 1U54CK000448–01 from the Centers for Disease Control and Prevention (CDC). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors declare that they have no competing interests.
- Language
- English
- Date published
- 01/01/2018
- Academic Unit
- Occupational and Environmental Health
- Record Identifier
- 9983761199202771
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