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How Infectious Disease Defined the American Bathroom

Cholera and tuberculosis outbreaks transformed the design and technology of the home bathroom. Will Covid-19 inspire a new wave of hygiene innovation?
A state-of-the-art bathroom of the late 1800s, when concerns about hygiene and infectious disease began to reshape American homes.
A state-of-the-art bathroom of the late 1800s, when concerns about hygiene and infectious disease began to reshape American homes.New York Public Library

If Lloyd Alter were building a new house right now, he’d be sure to add one unusual feature: a bathroom sink in the front vestibule. “We're going to see a real resurgence of the vestibule, I think,” says Alter, a former architect and design historian who now teaches Sustainable Design at the Ryerson School of Interior Design. “This is a transition zone from the outside to the inside, where you take off your dirty stuff and you wash your hands before you go into the house.”

Alter predicted that disease-avoidance would rise to the fore of bathroom design a few years ago, when he observed the traumatizing effects of the 2003 SARS outbreak on Toronto, which killed 44 people. But home design in general — and bathroom design in particular — has long been influenced by infectious disease. This isn’t a linear narrative with clear causation, but rather a convergence of advancements in science, infrastructure, plumbing, sanitation and design trends. The modern bathroom developed alongside outbreaks of tuberculosis, cholera and influenza; its standard fixtures, wallcoverings, floorings, and finishes were implemented, in part, to promote health and hygiene in the home at a time of widespread public health concerns.