What's in your pee? A smart toilet could revolutionize personal health but also pose privacy risks

Your toilet should be smarter.


That's the thinking of two scientists at the University of Wisconsin-Madison, Joshua Coon and Ian Miller, who believe a “smart toilet,” can become a tool to closely monitor your health, and eventually learn more about the early molecular signs of diseases like cancer and diabetes. 

Last month Coon and Miller published research, funded by the National Institute of General Medical Sciences, that showed the value of analyzing urine in real time. By analyzing 110 of their own samples over 10 days, they unveiled an evolving snapshot of their day-to-day health.

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“We think a lot about this idea of personalized medicine,” Coon said. “By looking at urine, you can really get a nice picture of what’s in the blood.”

From their samples, Coon and Miller found that the molecular makeup of their urine showed them how much they had slept, how much they exercised, how much alcohol or coffee they had drunk and when, and how much over-the-counter medication they had taken. 

With this toilet, users can preemptively detect urinary tract infections, kidney disease, diabetes and other metabolic disorders, before they show symptoms. According to Coon, frequent samples from a smart toilet could also help monitor how prescription or over-the-counter drugs are being metabolized, and allow users to adjust their dosage as needed.  

“Medicine is reactive, often responding to complaints,” said Coon, whose biomedical research lab, The Coon Group, is designing the toilet. “I think it can be more preventative.” 

The two scientists are designing a toilet that could be on the market within five yearsBut their ambition, to revolutionize how personal tech informs personal health, is tempered by the challenge of producing the toilets on a scale large enough to bring down the cost and make them as available as cars.

Coon’s concept of a smart toilet resembles a regular toilet, except it would include a briefcase-size screen above the tank,  along with a phone app for easy access to health information. The toilet would be able to differentiate between six to 12 users. The bowl itself would look something like what's in a compost toilet,  according to Coon, with an opening for collecting and separating any urine sample. 

The $8,000 Kohler Numi toilet is Alexa enabled © Jefferson Graham The $8,000 Kohler Numi toilet is Alexa enabled

Similar to an Apple Watch or a Fitbit, this smart toilet would produce a huge amount of health data that needs protecting. 

What are the privacy risks?

“Security is definitely something we’re thinking about,” said Miller, the co-author of the study. “There are going to be a lot of issues to consider as this kind of data becomes more available to consumers.”

The smart toilet could send a user's health information to their doctor to help them spot signs of disease. But the technology could also be used to pry into user's personal life.

In a scenario offered by Coon, an employer could secretly analyze the urine of a potential employee, and find out about his or her health and lifestyle. 

As of now, these security risks aren't stopping potential manufacturing partners from showing interest in Coon's design. 

Depending on one’s definition of a “smart toilet,” they have either existed for many years or are very new. For example, the Japanese toilet manufacturer Toto has been selling toilets that would be considered “smart,” at least by American standards, since 1980, when it released the Washlet, an electronic toilet seat that features a built-in bidet.

The Lixil smart toilet has a camera on the underside of the seat, seen here, that takes a picture of your waste and comes back flush with personal data. © Rob Pegoraro The Lixil smart toilet has a camera on the underside of the seat, seen here, that takes a picture of your waste and comes back flush with personal data.

More recently, Kohler released its Numi “intelligent toilet” in 2018, which includes ambient light settings, hands-free flushing, and a range of voice commands to control these features. 

Some smart toilets already possess health monitoring technology, such as Toto’s “Flowsky,” which is currently used in some Japanese hospitals. The “Flowsky” measures urinary flow and volume. Coon, however, views his toilet as something completely new.

“Our device is quite different in that we’re interested in targeting compounds in urine,” Coon said. “We want to go molecular.”

Checking molecules for trouble signs 

Unlike other smart toilets, Coon’s will use a mass spectrometer, a tool he describes as a “scale for molecules.” By sorting out the weight of thousands of molecules in a one microliter urine sample, the mass spectrometer can give users a thorough molecular analysis of their urine, and alert them to anything amiss, in about 10 minutes. 

Michael Snyder, professor and chair of genetics at Stanford University, has done similar work in personal health profiling. In 2019, he concluded a years-long study that followed the personal biology of a 109-person group. As part of the study, participants wore glucose monitors and smartwatches, and they intermittently gave samples of stool and blood.

Maybe we do: Do we really need an Alexa-powered toilet?

Over the course of the study, Snyder and other researchers discovered instances of high blood pressure, cardiomyopathy, and even early-stage cancer, before any of the participants showed symptoms. 

When talking about wearable health monitors, Snyder points to his own research as proof that the way medicine is practiced needs to change. 

“We measure people very infrequently, so the more information we can get with little effort the better,” said Snyder. “It’s kind of a no-brainer.”

Another feature of a health monitoring smart toilet is the potential to learn about the nature of diseases, and how signs of illness can show up in urine. Part of the challenge, or hope, is discovering what those clues could be on a molecular level. There could be signs of any number of diseases, even cancer, that show up in urine. But as of now, there isn't enough data to find out.

Like Apple's heart study using Apple Watches, a smart toilet could provide data that leads to the discovery of new diagnostic information.

"We need more markers for significant disease," Snyder said. "Even diabetes is probably 50 diseases."

Though Synder feels “very positive” about smart toilets and their potential for health monitoring, he believes that smartwatches are still the best, cheapest way to monitor one’s health, given the technology available now. 

The challenge of health-monitoring smart toilets is making them accessible. While a mass spectrometer is about as complicated to make as a car engine, according to Coon, they aren’t made on the same scale, which is why they are far more expensive. As technology stands right now, Coon said that one of his smart toilets would cost anywhere between $5,000-$10,000. 

“We know the technology exists,” Coon said. “It’s just a matter of building it.”

This article originally appeared on USA TODAY: What's in your pee? A smart toilet could revolutionize personal health but also pose privacy risks

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