The fall of the Western Roman Empire in 476 AD led to a dramatic decline in public sanitation across Europe. The collapse of Roman infrastructure resulted in the deterioration of sewers, baths, and hygiene practices that had been hallmarks of Roman civilization. This decline contributed to the spread of disease and poor living conditions during the subsequent Middle Ages, highlighting the importance of public health systems in urban societies.

The decline of public sanitation after the fall of Western Rome in 476 led to a stark contrast in medieval literature, where poets often used filth metaphors to critique moral decay. This thematic shift is evident in works that lament the loss of classical ideals and the rise of a more chaotic society.