The Bristol provisions are fairly representative of some of the principal problems urban authorities faced in regard to sanitation. They are part of a much larger set of over 50 by-laws that were to be proclaimed publicly every year, and thus a compilation, undated but probably written down in the 1450s. Much the same concerns are visible in the fourteenth century at Bristol and elsewhere, or even earlier. Yet the large number of provisions to deal with these problems in the fifteenth century may be more than just the fuller records of that period; it may reflect an increased determination to set and maintain standards of hygiene.

The later ordinance from York provides a general rationale for borough authorities' concern for sanitation. It was recognized that refuse left lying around near residential neighbourhoods was not only unpleasant by unhealthy. Edward I, after his government relocated temporarily to York in 1298, turned part of his attention to regulating the affairs of the town to be suitable to his own needs, including a provision for keeping the streets clean unsanitary activities away from areas where food was sold. Despite this, Edward III in 1332 complained of the stench in York, which he considered worse than in any other English town, and had ordered the citizens to keep their streets clean; but it was left to his grandson to legislate on the matter or unsanitary urban conditions, a few years after the York ordinance. It was the difficulty in persuading citizens to act responsibly in where they dumped wastes from households and businesses that gradually motivated boroughs to introduce or encourage garbage removal services.

Perhaps the worst offenders in this regard were butchers. It was the nature of their trade that unsanitary by-products were produced; they needed to be disposed of in a safe way. Furthermore the slaughtering of animals in public places resulted in a bloody mess that could become unsanitary or dangerous, as congealed blood made the pavement slippery. Some towns set up slaughterhouses – sometimes specialized, as in the case of that at Coventry (1423) which was only for pigs, butchers being ordered to slaughter cattle and sheep on their own property; but it was another matter to get the butchers to use them. Coventry's butchers were at the same time ordered to remove offal to a pit dug in the Poddycroft, immediately southwest of the walled city. At Worcester it was ordered (1466) that the by-products of slaughter – entrails and blood-pits – be cleaned up not during the daytime, but overnight. The number of ordinances, found in many towns, addressing these issues suggests that butchers tended to be very careless in this regard. Also ubiquitous were the ordinances aimed at discouraging pig-owners from letting their animals roam, whether in the streets or around the city's defensive ramparts.

Fishmongers were also quite often targets for regulation; in regard to Coventry's Saturday market, for example, it was ordered in 1494 that the entrails and other parts of fish that they cut off and dumped under their stalls were to be removed before 4 p.m., and the part of the street around the stalls to be cleaned, while the smelly water that was in the tubs they used to clean the fish was to be emptied into the gutters and then washed away with two buckets of clean water by 2 p.m. We should beware of assuming that fishmongers or butchers were universally careless about sanitation matters, but the need for regulations likely indicates that offences were not uncommon; sometimes occupational groups were fined as a whole for offences, which may (or may not) point to widespread poor practices.

The York ordinance concerning horses reveals a concern less commonly addressed. It can be imagined that one or more specific incidents involving injury to children playing in the streets would have given rise to this ordinance. The intent here seems to have been that all horses being led down to the river should be roped.