A systematic scoping review of environmental health conditions and hygiene behaviors in homeless shelters.

Homeless shelter Hygiene Sanitation Tuberculosis Ventilation Women's shelter

Journal

International journal of hygiene and environmental health
ISSN: 1618-131X
Titre abrégé: Int J Hyg Environ Health
Pays: Germany
ID NLM: 100898843

Informations de publication

Date de publication:
04 2019
Historique:
received: 19 09 2018
revised: 17 12 2018
accepted: 17 12 2018
pubmed: 26 12 2018
medline: 22 1 2020
entrez: 26 12 2018
Statut: ppublish

Résumé

There are well-established relationships between health and homelessness, and shelters can facilitate the transmission of diseases and contribute to their prevention. Adequate environmental health conditions and hygiene behaviors in homeless shelters are fundamental to the health of their clients, a marginalized population. We report the status of environmental health conditions and hygiene behaviors in homeless shelters and associated health outcomes; interventions to improve these conditions, behaviors, and outcomes; and obstacles to improvement. PubMed, Web of Science, Scopus, and EBSCOhost were searched for peer-reviewed studies, and additional sources for grey literature. Studies were included if they reported primary data on one or more environmental health condition or hygiene behavior in homeless shelters. Twenty-eight studies were included in the review. Insufficient ventilation systems, unhygienic bedding, and overcrowding were the most documented environmental health and hygiene deficiencies in homeless shelters, and tuberculosis infections and skin diseases were the most documented associated health outcomes among clients. Studies frequently recommended or described implementation of behavioral and administrative controls, ventilation system improvements, and ultraviolet germicidal irradiation fixtures. Most studies addressed airborne transmission of tuberculosis and were conducted in high-income countries, revealing an imbalance in the literature. Insufficient resources and the transience of clients are barriers to improving hygiene behaviors and environmental conditions in homeless shelters. Further investment and research into ensuring adequate hygiene and environmental health in this setting can protect and promote the health and well-being of people experiencing homelessness.

Sections du résumé

BACKGROUND
There are well-established relationships between health and homelessness, and shelters can facilitate the transmission of diseases and contribute to their prevention. Adequate environmental health conditions and hygiene behaviors in homeless shelters are fundamental to the health of their clients, a marginalized population. We report the status of environmental health conditions and hygiene behaviors in homeless shelters and associated health outcomes; interventions to improve these conditions, behaviors, and outcomes; and obstacles to improvement.
METHODS
PubMed, Web of Science, Scopus, and EBSCOhost were searched for peer-reviewed studies, and additional sources for grey literature. Studies were included if they reported primary data on one or more environmental health condition or hygiene behavior in homeless shelters.
RESULTS
Twenty-eight studies were included in the review. Insufficient ventilation systems, unhygienic bedding, and overcrowding were the most documented environmental health and hygiene deficiencies in homeless shelters, and tuberculosis infections and skin diseases were the most documented associated health outcomes among clients. Studies frequently recommended or described implementation of behavioral and administrative controls, ventilation system improvements, and ultraviolet germicidal irradiation fixtures.
DISCUSSION
Most studies addressed airborne transmission of tuberculosis and were conducted in high-income countries, revealing an imbalance in the literature. Insufficient resources and the transience of clients are barriers to improving hygiene behaviors and environmental conditions in homeless shelters. Further investment and research into ensuring adequate hygiene and environmental health in this setting can protect and promote the health and well-being of people experiencing homelessness.

Identifiants

pubmed: 30583994
pii: S1438-4639(18)30790-9
doi: 10.1016/j.ijheh.2018.12.004
pii:
doi:

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

335-346

Informations de copyright

Copyright © 2018 Elsevier GmbH. All rights reserved.

Auteurs

Michelle Moffa (M)

The Water Institute, University of North Carolina, Chapel Hill, NC, United States.

Ryan Cronk (R)

The Water Institute, University of North Carolina, Chapel Hill, NC, United States. Electronic address: rcronk@live.unc.edu.

Donald Fejfar (D)

The Water Institute, University of North Carolina, Chapel Hill, NC, United States.

Sarah Dancausse (S)

The Water Institute, University of North Carolina, Chapel Hill, NC, United States.

Leslie Acosta Padilla (LA)

The Water Institute, University of North Carolina, Chapel Hill, NC, United States.

Jamie Bartram (J)

The Water Institute, University of North Carolina, Chapel Hill, NC, United States. Electronic address: jbartram@unc.edu.

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Classifications MeSH