School toileting environment, bullying, and lower urinary tract symptoms (LUTS) in a population of adolescent and young adult girls: Preventing Lower Urinary Tract Symptoms Consortium (PLUS) analysis of Avon Longitudinal Study of Parents and Children (ALSPAC). Journal Article

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Authors: Shoham, DA; Wang, Z; Lindberg, S; Chu, H; Brubaker, L; Brady, SS; Camenga, DR; Coyne-Beasley, T; Fitzgerald, CM; Gahagan, S; Harlow, BL; Joinson, C; Low, LK; Markland, AD; Newman, DK; Smith, AL; Stapleton, A; Sutcliffe, S; Berry, A
Article Title: School toileting environment, bullying, and lower urinary tract symptoms (LUTS) in a population of adolescent and young adult girls: Preventing Lower Urinary Tract Symptoms Consortium (PLUS) analysis of Avon Longitudinal Study of Parents and Children (ALSPAC).
Abstract: OBJECTIVES: To examine whether the school toilet environment at age 13, including bullying at toilets, is associated with female LUTS at ages 13 and 19, as little is known about the association among school toilet environment, voiding behaviors, and lower urinary tract symptoms (LUTS) in adolescent girls. METHODS: The sample comprised 3962 female participants from the Avon Longitudinal Study of Parents and Children (ALSPAC). 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 (ICIQ-BFLUTS) questionnaire. RESULTS: All toilet environmental factors were associated with at least one LUTS outcome at age 13. Holding behavior was associated with all school toilet environmental factors, with odds ratios (ORs) ranging from 1.36 (95% 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; ORs 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. CONCLUSIONS: 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.
Journal Title: Urology
ISSN: 1527-9995; 0090-4295
Publisher: Elsevier Inc  
Date Published: 2020