212991 Public toilets down the drain? Why privies are a public health concern

Monday, November 9, 2009: 1:10 PM

Ros Stanwell-Smith , London School of Hygiene and Tropical Medicine, UK, London, United Kingdom
Whether you call it the loo, john, privy, lavatory or toilet, this facility is essential wherever humans gather or live: toilet provision has even been called the barometer of civilisation. The modern development of public toilets dates from the late 19th century when sewer systems and water supplies provided hygienic means of dealing with waste, facilitated by public health legislation that also permitted local authorities to provide toilets in town centres. Yet the statutes in the United Kingdom, where the flushing toilet as we know it was invented, never went so far as to require provision of these facilities outside the home. Pressure on resources during the last 20 years has led to many public toilets being closed - 40% of those in London, for example - or to entry charges that reduce accessibility. At the same time an increasingly mobile population has made public toilets a crucial resource. Recent public inquiries into public toilet provision have revealed the impact of the paucity of facilities on the elderly, women, families with young children, ill health that increases the need for toilet use, visitors and poor or homeless members of the community. With street urination on the increase, and continued closure of toilets, it's time for public health to recognize a great need and to campaign to turn the tide on public toilet closures, with imaginative planning strategy and associated opportunities to encourage hand washing and other hygiene health promotion.

Learning Objectives:
Describe the history of the public toilet. Discuss the impact of improved water and sanitation on toilet design and provision and its impact on public health. Analyze the reasons for public toilet closures and lack of supportive legislation. Identify the modern role of the public toilet and its relevance to public health. Discuss possible strategies for improving and maintaining public toilet provision.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an expert on the public health of water and sanitation and have several years experience of academic and service public health and an honorary appointment as senior lecturer in the London School of Hygiene and Tropical Medicine.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.