The era of social media, online commerce, and door-to-door services has led to the provision of many novel services outside of the typical business environment. Recently, the media highlighted a company that rents out real-life dolls for family use. This is one of several such companies currently operating in Canada. These dolls consist of a fully hinged metal frame around which a softer material (silicone or thermoplastic elastomer [TPE]) is cast or molded. These dolls are roughly equivalent to the height (approximately 5 feet tall) and weight (70-130 pounds) of a human being. The customer orders the service online; the doll is then sent home, then recycled for cleaning and disinfection, and then rented out again.

Although the operator usually "requires" the use of condoms (usually recommended for safe use of sex toys, especially when sharing), it is reasonable to assume that the inner and outer surfaces of the doll are in contact with body fluids. Since subsequent users may also touch these surfaces through the mucosa, it is necessary to pay attention to the public health issues of disease transmission. Minor problems may include skin contact or inhalation of baby powder containing talcum powder or cornstarch, which is used to smooth the baby's skin after cleaning.

Sex doll rental is just one example of an increasing number of atypical services. Although these services are worthy of attention, they operate on the fringe of public health surveillance. Other examples include diversified products such as inflatable birthing pools, household hookah rentals, and children's toy subscription services (to name a few). Although all these rental products are not as irritating as sex dolls, they may come into contact with body fluids and need to be disinfected before being reused. However, because these activities take place at home, companies are usually not within the purview of public health inspectors—until a complaint occurs and public health may take action to correct the specific health hazard.

Can public health play a role in regulating the rental of dolls?

Rental services such as sex dolls do not belong to any specific public health portfolio. Although some provinces have expanded personal service legislation to cover activities that take place outside of traditional venues (for example, mobile stores, trade shows, etc.), activities such as sex doll rentals do not fully meet the definition of personal service. For example, in BC's personal service agency guidelines, personal service is defined as a service provided by one person (ie, human) to or to another person. Interaction with adult dolls does not meet this definition. Even if sex dolls are regarded as tools or tools, the definition of personal services may be based on activities (such as tattoos, massages), specific places (beauty salons, barber shops), or intentions (services are performed for beauty or cultural purposes, such as NFLD personal Service Law). These again rule out businesses that interact with sex dolls or rent them for home use. Other Canadian jurisdictions do not operate according to the official definition of personal service. So, for rental services such as sex dolls, how does the public health department "do", because its commercial activities have an undetermined risk of disease transmission?

Can the operators and the public "figure it out" by themselves?

Currently, there are no evidence-based public health guidelines for disinfecting sex toys. This is unfortunate because studies have shown that sharing sex toys may spread infections between male and female partners, and TPE-based sex toys may carry infectious agents for a longer period of time than silicone sex toys.

However, even in the absence of a sex toy guide, there is no shortage of online resources on cleaning and disinfecting body fluids on environmental surfaces, many of which come from personal service literature. Recent examples include guidance documents from the British Columbia Department of Health and Ontario’s Department of Public Health, which not only provide detailed information about cleansing body fluids, but also describe the types and appropriate use of disinfectants. These resources are read from start to finish and provide a lot of information about infection prevention and control, which is very useful for business owners who want to provide the safest services.

However, operators and the public may find it difficult to pick out reputable resources or encounter difficulties in interpreting them. Depending on the jurisdiction and the volume of body fluids involved, health authorities may recommend high-level or low-level disinfection, which may cause further confusion. Therefore, operators or the public are unlikely to have a full understanding of the hygiene of potentially risky leased products.

Adopt educational methods: help operators and the public understand the needs of disinfection

Public health inspectors play an extremely valuable role in educating operators and the public. Sex dolls are a good example, because the complex design of the product will bring real challenges to cleaning and disinfection. For example, dolls have 2-3 orifices (which may or may not be removable inserts); they also have seams, hair and eyelashes, and penis attachments. Material is also very important. Although silicone dolls are generally non-porous and heat-resistant, some types of TPE may be porous and/or hygroscopic, or they may be heat sensitive, which can pose challenges for disinfection.

There are also practical considerations. For the operator, it is important that the reprocessing does not unnecessarily wear or damage the surface of the doll and can be performed within a reasonable time frame. For customers, it is important to fully disinfect the doll (but do not leave a noticeable smell of disinfectant), and the disinfectant has been sufficiently rinsed to avoid subsequent irritation or allergies. In light of these standards, the expertise of public health inspectors is invaluable in the development of a disinfection protocol that will fully disinfect the product without damaging the product, and will not leave (or cause) harm to the next user.

Communicate with the public on atypical services

In addition to advising operators on disinfection issues, public health inspectors and health authorities can play an important role in actively communicating with the public on atypical services. As far as sex dolls are concerned, obvious health issues may lead some members of the public to believe that health authorities are actively participating in or monitoring business operations in some way. This highlights the need for increased communication regarding the role of health authorities, and the need for consumers to be vigilant and aware of hygiene.

Generalize

Given the wide range of new products and services available through social media and online markets, it may be difficult for operators and the public to find resources to safely use or provide these services. Public health must also expand its online influence and find creative and attractive ways to educate the public about the risks of their choices. Consumers must also be aware that businesses that provide services or deliver products to households may never enjoy the benefits of consulting a public health inspector. When it comes to the hygiene of sex dolls, buyers should be careful. There are many styles of sex dolls nowadays, including full-size sex dolls and torso sex dolls. You have to choose the real doll you want according to your hobbies.