The closure of scores of public toilets across Britain has caused social isolation for some elderly and disabled people, leading nurses have warned.
The Royal College of Nursing (RCN) has launched a campaign for local governments to provide accessible public facilities "catering for a broad range of needs".
Cash-strapped councils have shut nearly 2,000 publicly funded toilets in the last 18 years and 10 across the UK do not provide any at all, the RCN said.
Speaking at its annual congress in Belfast on Sunday, RCN steward Phil Noyes said people with disabilities have "fared worse of all".
"The need to use the toilet is one thing the human race has in common, from royalty to rough sleepers," he added.
"Access to public toilets is a matter of hygiene and personal dignity, we need to make sure we support the needs of all."
He continued: "I have read accounts of parents who have had to change their disabled child on the floor of the toilet or in the back of a car in a public car park.
Some elderly people and those suffering from inflammatory bowel conditions, such as Crohn's disease, have to resort to "toilet mapping" or do not leave their house at all because of anxiety about lack of toilets, the congress heard.
"Access to toilets is access to society and we should not lock people out," Mr Noyes said.
Richard Lane, of disability charity Scope, said: "We know that disabled people and their families continue to campaign for more accessible loos.
"We back those calls, as being unable to go to the toilet can isolate disabled people and cause significant distress.
"All councils must consider the impact of their decisions on disabled people."
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