David A Shoham1, Zhenxun Wang2, Sarah Lindberg2, Haitao Chu2, Linda Brubaker3, Sonya S Brady4, Tamera Coyne-Beasley5, Colleen M Fitzgerald6, Sheila Gahagan7, Bernard L Harlow8, Carol Joinson9, Lisa Kane Low10, Alayne D Markland11, Diane K Newman12, Ariana L Smith12, Ann Stapleton13, Siobhan Sutcliffe14, Amanda Berry15. 1. Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, IL. Electronic address: dshoham@luc.edu. 2. Department of Biostatistics, University of Minnesota, Minneapolis, MN. 3. Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, San Diego, CA. 4. Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN. 5. Division of Adolescent Medicine, University of Alabama at Birmingham Medical School, Birmingham, AL. 6. Department of Obstetrics and Gynecology, Loyola University Chicago Stritch School of Medicine, Chicago, IL. 7. Division of Academic General Pediatrics, University of California San Diego School of Medicine, San Diego, CA. 8. Boston University School of Public Health, Boston, MA. 9. University of Bristol, Bristol, United Kingdom. 10. University of Michigan School of Nursing, Women's Studies, Dept. Obstetrics and Gynecology, Ann Arbor, MI. 11. Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham School of Medicine and Birmingham VA Medical Center, Birmingham, AL. 12. Department of Surgery, Division of Urology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. 13. Department of Medicine, University of Washington, Seattle, WA. 14. Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO. 15. Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA; Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium, University of Minnesota, Minneapolis, MN.
Abstract
OBJECTIVES: To examine whether the school toilet environment at age 13, including bullying at toilets, is associated with female lower urinary tract symptoms (LUTS) at ages 13 and 19, as little is known about the association among school toilet environment, voiding behaviors, and LUTS in adolescent girls. METHODS: The sample comprised 3962 female participants from the Avon Longitudinal Study of Parents and Children. At age 13, participants reported on 7 school toilet environment characteristics and a range of LUTS items. At age 19, participants completed the Bristol Female Lower Urinary Tract Symptoms questionnaire. RESULTS: All toilet environmental factors were associated with at least 1 LUTS outcome at age 13. Holding behavior was associated with all school toilet environmental factors, with odds ratios ranging from 1.36 (95% confidence interval [CI]: 1.05, 1.76) for dirty toilets to 2.38 (95% CI: 1.60, 3.52) for feeling bullied at toilets. Bullying was associated with all daytime LUTS symptoms and nocturia; odds ratios ranged from 1.60 (95% CI: 1.04, 2.07) for nocturia to 2.90 (95% CI: 1.77, 4.75) for urgency. Associations between age 13 school toilets and age 19 LUTS were in the same direction as age 13 LUTS. CONCLUSION: This is the first examination of associations between school toilets and LUTS. Toileting environments were cross-sectionally associated with LUTS in adolescent girls. While further work is needed to determine whether these associations are causal, school toilet environments are modifiable and thus a promising target for LUTS prevention.
OBJECTIVES: To examine whether the school toilet environment at age 13, including bullying at toilets, is associated with female lower urinary tract symptoms (LUTS) at ages 13 and 19, as little is known about the association among school toilet environment, voiding behaviors, and LUTS in adolescent girls. METHODS: The sample comprised 3962 female participants from the Avon Longitudinal Study of Parents and Children. At age 13, participants reported on 7 school toilet environment characteristics and a range of LUTS items. At age 19, participants completed the Bristol Female Lower Urinary Tract Symptoms questionnaire. RESULTS: All toilet environmental factors were associated with at least 1 LUTS outcome at age 13. Holding behavior was associated with all school toilet environmental factors, with odds ratios ranging from 1.36 (95% confidence interval [CI]: 1.05, 1.76) for dirty toilets to 2.38 (95% CI: 1.60, 3.52) for feeling bullied at toilets. Bullying was associated with all daytime LUTS symptoms and nocturia; odds ratios ranged from 1.60 (95% CI: 1.04, 2.07) for nocturia to 2.90 (95% CI: 1.77, 4.75) for urgency. Associations between age 13 school toilets and age 19 LUTS were in the same direction as age 13 LUTS. CONCLUSION: This is the first examination of associations between school toilets and LUTS. Toileting environments were cross-sectionally associated with LUTS in adolescent girls. While further work is needed to determine whether these associations are causal, school toilet environments are modifiable and thus a promising target for LUTS prevention.
Authors: Paul F Austin; Stuart B Bauer; Wendy Bower; Janet Chase; Israel Franco; Piet Hoebeke; Søren Rittig; Johan Vande Walle; Alexander von Gontard; Anne Wright; Stephen S Yang; Tryggve Nevéus Journal: J Urol Date: 2014-02-04 Impact factor: 7.450
Authors: Abigail Fraser; Corrie Macdonald-Wallis; Kate Tilling; Andy Boyd; Jean Golding; George Davey Smith; John Henderson; John Macleod; Lynn Molloy; Andy Ness; Susan Ring; Scott M Nelson; Debbie A Lawlor Journal: Int J Epidemiol Date: 2012-04-16 Impact factor: 7.196