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The integration of a solar septic tank (SST) system with an economically viable solar water-heating apparatus comprising polyethylene (PE) and copper (Cu) pipes, as well as a lightweight structural framework, has been conceptualized and implemented. Two variants of low-cost SSTs were subjected to empirical scrutiny within authentic settings, encompassing public toilets and residential establishments in Cambodia. Both the PE pipe and Cu pipe solar water-heating devices demonstrated efficacy in consistently maintaining temperatures within the system above ambient levels. Although the parameters do not conform to Cambodia's effluent requirements, the results of this study suggest that the SST is effective in reducing organic loads and provides a significant improvement over conventional septic tank effluent. This underscores the potential applicability of the developed system for the treatment of toilet wastewater, thereby mitigating pollution concerns and public health risks. Harnessing solar energy to elevate septic tank temperature, this system's cost varies but includes materials, tools, and miscellaneous components, with a total estimated cost ranging from $600 to $2500, depending on size and complexity. HIGHLIGHTS An innovative solar water heating system, using PE and Cu pipes, efficiently raises water temperature and maintains it above ambient levels, ensuring optimal functionality.; Tested in Cambodia's diverse environments, the low-cost tanks provide consistent heating and adhere to standards, showing potential for eco-friendly treatment and reducing public health risks.;

Background: One of the sustainable development goals (SDGs) is universal access to clean water and basic sanitation by 2030. Water, sanitation, and hygiene (WASH) support SDG targets such as eliminating poverty and improving health and education. Methods: The sample of this study amounted to 30 schools consisting of 10 elementary schools, 10 junior high schools, and 10 senior high schools. Sampling was based on stakeholder decisions on several issues related to washing. Results: This study was conducted by directly observing schools regarding the amount of drinking water, number of toilets, bathrooms, handwashing facilities alone, and handwashing facilities with water and soap. The results showed that elementary and junior high schools have insufficient toilet facilities and low handwashing facilities with water and soap. The average number of handwashing facilities with water and soap in schools in Bekasi City, Indonesia, was 1 for elementary schools, followed by junior high schools and high schools for 4-5 points. Conclusion: As soap is still unavailable in many Bekasi City schools, and there are inadequate handwashing facilities, it is recommended that handwashing facilities must be available with soap and water.

Access to adequate and secure sanitation to prevent and reduce disease occurrence and improve people's health has been a longstanding global concern. Toilet standardization is immensely important for the promotion of sanitation in China. At present, China has more than 200 toilet-related standards, including national, industrial, provincial, association, and enterprise standards. In addition, there are many existing problems with the standard system, such as standards lagging, standards deficiency, and cross-repetition of standards content. This study analyzed the toilet standards utilizing a six-dimensional structure of the standardized system engineering methodology. A framework for the toilet standard system, which consists of six components, is proposed: basic general standard, public toilet standard, household toilet standard, toilet hardware standard, environmental health and safety standard, and toilet accessory standard and standard toilet peripherals. Additionally, the study suggests approaches for improving standardization including cultivating and developing association and enterprise standards, establishing a standardization technical committee, strengthening standard publicizing and implementation, and linkages with international standards. HIGHLIGHTS A six-level framework of the toilet standard system in China is presented and elaborated.; Problems and potential barriers for toilet standardization in China are analyzed.; We suggest establishing a technical standardization committee, standardization organization coordination mechanism, etc. to promote toilet standardization.; This study provides insights that will guide the formation of effective policies and strategies to enhance sanitation in China.;

Toilets are political spaces: inadequate toilet access means limited access to wider space and community. Between 2015 and 2018 I led a series of interdisciplinary research projects collectively known as Around the Toilet (http://aroundthetoilet.com), which centred the experiences of trans, queer and disabled people to explore what makes a safe and accessible toilet space. The research sought to consolidate commitments to feminist, queer, trans and disability politics. In this article, I interrogate the repercussions of doing work at these political intersections by focusing not so much on the research findings themselves, but on the ways in which the project has been responded to within a context which is anti-expert, anti-'woke' and one of perceived scarcity. I reflect on my experiences as a trans person, leading a public-facing research project which centres trans lives, within a context of increasing trans hostility. I will show how Around the Toilet has at once been understood as too mundane (a waste of taxpayers' money; a humorous thing to be researching); a fascination (a good journalistic 'hook'; focus on particular aspects of the work, whilst ignoring others); and a threat to social order. I argue that – during a time where 'impact' is valued and academics are expected to be 'public-facing' – universities need to recognise harms that can come from this, and resource the labour that it takes to mitigate these harms (if the risk is deemed worth taking). I also outline ways in which universities and those with varying degrees of institutional power can help to make the academy a more sustainable place to work for those targeted in current culture wars. [ABSTRACT FROM AUTHOR]

Background: One of the sustainable development goals (SDGs) is universal access to clean water and basic sanitation by 2030. Water, sanitation, and hygiene (WASH) support SDG targets such as eliminating poverty and improving health and education. Methods: The sample of this study amounted to 30 schools consisting of 10 elementary schools, 10 junior high schools, and 10 senior high schools. Sampling was based on stakeholder decisions on several issues related to washing. Results: This study was conducted by directly observing schools regarding the amount of drinking water, number of toilets, bathrooms, handwashing facilities alone, and handwashing facilities with water and soap. The results showed that elementary and junior high schools have insufficient toilet facilities and low handwashing facilities with water and soap. The average number of handwashing facilities with water and soap in schools in Bekasi City, Indonesia, was 1 for elementary schools, followed by junior high schools and high schools for 4-5 points. Conclusion: As soap is still unavailable in many Bekasi City schools, and there are inadequate handwashing facilities, it is recommended that handwashing facilities must be available with soap and water. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to quantify the impact of smartphone use while sitting on the toilet on the spinal flexion angles and the time effect. Methods: Measurements of the spinal flexion angles in the sagittal plane were made by thirty participants while they sat on the toilet for 10 min, using a smartphone in either one, both, or neither hand. The individual's forehead, cervical, thoracic and lumbar spinal areas were each fitted with five different inertial motion sensors. SPSS 26.0 software was used to statistically evaluate all of the data. Results: People who used smartphones with both hands had considerably larger (P < 0.05) cervical and spinal flexion angles than those who did not. A statistically significant (P < 0.001) association was observed by regression analysis between time and spinal flexion angle (r = 0.747 for no smartphone, r = 0.793 for a smartphone used in one hand and r = 0.855 for a smartphone used in both hands). Consequently, when using the smartphone with both hands, the flexion angle of the spine entered a more stable state of angles. Conclusions: The results showed that the cervical region's flexion angles change when using a smartphone while sitting on the toilet. Even when not using a smartphone, the flexion angle of the spine when sitting on the toilet will progressively increase. [ABSTRACT FROM AUTHOR]

Immunocompromised patients are at an increased risk of severe legionella infections. We present the results of an outbreak investigation initiated following a fatal case of hospital-acquired legionellosis linked to contaminated water from a toilet-flushing cistern. Additionally, we provide experimental data on the growth of Legionella spp. in flushing cisterns and propose a straightforward protocol for prevention. We monitored the growth of Legionella spp. in the building's hot- and cold-water systems using quantitative bacterial culture on selective agar. Molecular typing of Legionella pneumophila isolates from the infected patient and the water system was conducted through core-genome multi-locus sequence typing (cgMLST). Legionella contamination in the hospital building's cold-water system was significantly higher than in the hot-water system and significantly higher in toilet flushing cistern's water compared with cold water from bathroom sinks and showers. Isolates from the patient and from the flushing cistern of the patient's bathroom were identical by cgMLST. In an experimental setting, daily toilet flushing for a period of 21 days resulted in a 67% reduction in the growth of Legionella spp. in the water of toilet flushing cisterns. Moreover, a one-time disinfection of cisterns with peracetic acid, followed by daily flushing, decreased legionella growth to less than 1% over a period of at least seven weeks in these setting. One-time disinfection of highly contaminated cisterns with peracetic acid and daily toilet flushing as short-term measure can significantly reduce legionella contamination in flushing cisterns. These measures may aid in preventing legionella infection among immunocompromised patients. [ABSTRACT FROM AUTHOR]

In hospital environments, droplets generated by urination within shared toilets may represent a route of dissemination for bacteria such as vancomycin-resistant Enterococcus faecium (VREfm), which contributes significantly to the burden of hospital-acquired infections. We investigated the potential activity of a foam in preventing the generation of droplets containing Enterococcus spp. during urination. A uniform layer of foam was deposited in the inner walls and at the bottom of an experimental toilet contaminated with suspensions of Enterococcus strains (including a VREfm strain). Human urination was simulated, and colonies of Enterococcus were recovered through a toilet lid where agar plates had been placed. Results showed that the foam was able to suppress production of droplets containing Enterococcus spp. generated by a liquid hitting inner toilet walls. Conversely, Enterococcus colonies were recovered in absence of foam. Moreover, the foam did not show antibacterial activity. We propose a new non-antimicrobial approach aimed at limiting transmission of multidrug-resistant bacteria, particularly in healthcare settings. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) poses several issues concerning the management of hospital-acquired infections, leading to increasing morbidity and mortality rates and higher costs of care. Multidrug-resistant (MDR) bacteria can spread in the healthcare setting by different ways. The most important are direct contact transmission occurring when an individual comes into physical contact with an infected or colonized patient (which can involve healthcare workers, patients, or visitors) and indirect contact transmission occurring when a person touches contaminated objects or surfaces in the hospital environment. Furthermore, in recent years, toilets in hospital settings have been increasingly recognised as a hidden source of MDR bacteria. Different sites in restrooms, from toilets and hoppers to drains and siphons, can become contaminated with MDR bacteria that can persist there for long time periods. Therefore, shared toilets may play an important role in the transmission of nosocomial infections since they could represent a reservoir for MDR bacteria. Such pathogens can be further disseminated by bioaerosol and/or droplets potentially produced during toilet use or flushing and be transmitted by inhalation and contact with contaminated fomites. In this review, we summarize available evidence regarding the molecular features of MDR bacteria contaminating toilets of healthcare environments, with a particular focus on plumbing components and sanitary installation. The presence of bacteria with specific molecular traits in different toilet sites should be considered when adopting effective managing and containing interventions against nosocomial infections potentially due to environmental contamination. Finally, here we provide an overview of traditional and new approaches to reduce the spreading of such infections. [ABSTRACT FROM AUTHOR]

Achieving safely managed sanitation (SMS) in rural areas has spurred innovation in toilet designs that provide on-site treatment of fecal sludge (FS), including the development of International Development Enterprise (iDE)’s alternating dual-pit latrine upgrade (ADP). ADPs treat FS by inactivating pathogens using storage treatment with lime; however, ADPs’ reduction in pathogenicity (and thus their associated public health benefit) has not yet been described in real-world pits at scale. We thus enumerate the fecal indicator bacteria Escherichia coli (E. coli) and fecal coliforms in 147 pits after two years of storage treatment with lime and compare detected concentrations to relevant standards. E. coli and fecal coliform concentrations indicated a risk to human health in 31% and 42% of sampled pits, respectively. Regression models described relationships between fecal indicator bacteria concentrations and measured factors (e.g., sludge pH, temperature) but did not reveal any meaningful associations. High rates of pit ineligibility also indicate that many ADPs are not operated as recommended. Results indicate a one-in-three chance that a household emptying their own pit would be exposed to health hazards and call into question the effectiveness of the standard two-year storage treatment in real-world applications. To improve rural SMS, various evidence-based recommendations are made. HIGHLIGHTS Fecal sludge stored in real-world alternating dual-pit latrines after treatment were enumerated for fecal indicator bacteria.; E. coli and fecal coliform concentrations indicated a risk to human health in 31% and 42% of sampled pits, respectively.; Households emptying pits after treatment have a one-in-three chance of being exposed to health hazards.; Many ADPs were not operated as recommended, reducing pathogen inactivation.;

Latrines are an effective way for people in low- and middle-income countries to move away from open defecation. Guidelines are used to provide a recommended horizontal setback distance from a latrine to a downgradient well to ensure the safety of the well from subsurface contaminants. We collected 107 journal papers, books, and reports to critically review the recommended setback distances and how these recommendations are derived. It was discovered that the four most common guidelines/reviews are all based principally on just four field studies, all of which were conducted over 40 years ago, which casts doubt on a frequently used one-size-fits-all approach. More recent methods for latrine siting use both field data and some sort of modeling component to account for the different site conditions, but these models have not been verified for use outside their respective studies. They are also limited in how they consider the hydraulic connection between the latrine and the well. We recommend that future siting guidelines should focus more on vertical separation, include chemical contamination, and be based on models describing how latrines and wells are hydraulically connected, along with the fate and transport of potentially harmful contaminants. HIGHLIGHTS Most common guidelines are based on four field studies, conducted over 40 years ago.; Latrine-siting guidelines must account for the vertical transport of pollutants.; Siting guidelines should account for the distinct features of loadings and transport of bacteria and viruses.; In situ treatment technologies and resource recovery strategies may influence pollutant loadings.; Models can assist with site-specific siting.;

The cleanliness of the restroom is critical in keeping customers interested in returning. Therefore, maintaining the cleanliness of the toilet is important to provide comfort to customers. The toilet area is cleaned regularly by outsourced employees and then checked periodically by the relevant leader in the area to determine the level of cleanliness of the toilet. The design of the system in this study was carried out by making a sitemap, flowchart, database schema, table structure, and designing the user interface of the system to be built. Based on the results of the analysis and design of the best toilet determination system using the Tsukamoto fuzzy method, it can be concluded that the Tsukamoto fuzzy method can be used in determining the best toilet based on toilet data using 3 criteria, namely: toilet area, closet, and sink. The calculation results are determined from the rules used in fuzzy. [ABSTRACT FROM AUTHOR]

Many primary school children withhold urine and stool whilst at school for various reasons. Limited toilet access and the failure to provide safe, sanitary toilets are putting children at risk for toilet avoidance behavior. We aimed to examine personal hygiene, environmental conditions, the perception of these on children, and their toilet use in primary schools. Children aged 6–12 and their parents were asked to complete a self-report questionnaire regarding toilet behavior and the perception of school toilet standards. The main findings are listed below using the data from the questionnaire. We found that 9% and 63% of the children avoided urination and defecating at school, respectively. Similar results were reported previously. The participants' perceptions regarding the environmental conditions of school toilets and conditions revealed that 34% of the children felt that the toilets were dirty or very dirty. Around one-third of them reported a lack of toilet paper sometimes or most of the time. These unsatisfying hygienic conditions of school toilets can be easily solved. Unfortunately, 46% of the children in our study experienced bullying in school toilets. These worrisome data are seldom reported in other studies. The urination habits of the girls, who mostly preferred to partially squat or stand may lead to dysfunctional voiding and incomplete bladder emptying. Our study was limited by the relatively small population, the subjectiveness of the self-reporting questionnaire, and the voiding and defecation habits of the investigated children during school hours. These hours do not necessarily reflect the children's habits after school hours and during the weekends. Despite these limitations, the discussed issues regarding personal hygiene and the environmental conditions in the sampled primary schools are extremely important. Nearly half of the school children had negative perceptions of school toilets. This should raise awareness and concern for school staff to consider and investigate potential facilities improvement in light of the impact observed here. Implementation of appropriate education and a better environment of toilet facilities and security is important for the children's well-being. Summary table. Summary table Number of children 102 Female 59 Means of personal hygiene teaching Parents 79 Teachers 34 Nurse/school counselor 10 Reasons for avoiding Dirty/very dirty toilets 38 The teacher does not allow to leave the classroom 28 Do not want to waste break time 17 Urination method in girls Whilst sitting 31 "On air" 24 Bullying in school toilets 47 Avoidance behavior Stools 27 Urine 5 Availability of school toilet Yes 74 No 13 Sometimes 15 The general degree of toilet cleanliness Very clean 6 Medium clean 42 Not clean 22 Very dirty 13 [ABSTRACT FROM AUTHOR]

The status of water, sanitation and hygiene (WASH) facilities was investigated in sixty schools in seven local government areas of Enugu State, Nigeria. A total of sixty schools comprising of twenty-four (24) private schools, twenty (20) government schools and Sixteen (16) mission schools were investigated in this study. Using questionnaire and on-the-spot assessment, WASH facilities in the selected schools were subjected to in-depth scrutiny. The highest number of schools that do not have a water source within the school premises are government schools (10), followed by private schools (7) and then mission schools (2). About seventy-one percent (71%) of the schools investigated rely on self-help water supply sources such as water vendors, rainwater harvesting and private boreholes. Fifty-seven (57) or 95% of the sixty (60) schools of all the schools have toilet facilities ranging from improved pit latrine (10%), flush toilet (31.7%) and pour flush toilet (53.3%). With respect to toilet cleaning, 33%, 17% and 50% of private, government and mission school clean their toilets every day. Fifty-five percent (55%) of all schools always provide handwashing facilities while 13.3% never provide handwashing facilities. Based on school category, the distribution of schools that provide handwashing facilities are as follows: private schools - 54.2%, government schools - 40% and mission schools - 75%. There was a significant correlation (r = 0.85) between availability of toilet facilities and provision of handwashing facilities. There was also a significant correlation (r = 0.555) between the provision of handwashing facilities and the provision of soap. [ABSTRACT FROM AUTHOR]

Stunting is a growth disorder or condition of failure to thrive in children due to lack of nutrition and repeated infections in the first 1000 days of life, causing the child to be shorter than his age. This study aims to determine the risk factors associated with stunting in toddlers in Pulo Ampel District in 2021. This study uses an observational study with approach case control. The instruments used are questionnaires and observation sheets. Sample in this study consisted of 72 case and 72 control by using purposive sampling technique. From the results of the univariate test in the stunting toddler group, it was found that the knowledge of mothers was not good (90,3%), low economic status (98,6%), the availability of clean water facilities that did not meet the requirements (8,3%), latrines were not available (13,9%), and poor feeding patterns (76,4%). Statistical test using Chi Square, obtained the results of mother's knowledge (Pv = 0,000), economic status (Pv = 0,000), availability of clean water facilities (Pv = 0,012), availability of latrines (Pv=0,003), and feeding patterns (Pv = 0,000) has a significant relationship with the incidence of stunting in toddlers. Suggestions from this research are expected for the Puskesmas to provide counseling with video media and booklets about stunting and nutritious eating for toddlers. [ABSTRACT FROM AUTHOR]

According to previous research, the toilet and bathroom are the most common locations where injuries and accidents involving elderly people occur. Thus, the purpose of this paper is to investigate the issues and challenges of existing toilets and bathrooms among the Malaysian elderly and to identify appropriate solutions for them. The Focus Group Discussion (FGD) and Quality Function Deployment (QFD) sessions were implemented in this study, which involved a total of nineteen respondents, including elderly aged 60 years and above, their caregivers/family members, and agencies/authorities related to housing planning/development and technologies as well as researchers/experts. The recorded data were transcribed into text and organized systematically in the House of Quality (HoQ) for technical analysis. The focus group findings revealed that the four categorized issues raised by respondents in this study were quality, design, cost, and function. Furthermore, based on the HoQ analysis, it indicated that the top five highest ranks of customer requirements (CRs) for a new bathroom and toilet design requirement were comfortable (Rank 1), safety (Rank 2), affordable price (Rank 3), easy to enter bathroom/toilet (Rank 4) and anti-slippery floor (Rank 5). Meanwhile, the top five highest rank of technical requirements (TRs) refer to the existing OKU toilet design (Rank 1), anti-slip ramp & small drain under toilet door (Ranks 2 and 3), relocating existing toilet accessories, e.g., sink bow (Rank 4) and categories the cost according to the minor, major or new design (Rank 5). The information gathered could be used to develop appropriate bathrooms and toilets for the elderly in Malaysia. [ABSTRACT FROM AUTHOR]

Abstract Background Bladder overdistension in labor may lead to prolonged postpartum urinary retention. We hypothesized that nulliparas mobilizing to toilet is more likely to achieve satisfactory micturition. Methods One hundred sixteen (58 in each arm) term nulliparas in labor with filled bladders were randomized to mobilizing to the toilet or using bedpan to micturate. Primary outcome was satisfactory micturition defined as ultrasound derived post-void bladder volume

Background: Accumulating evidence shows a role of the hospital wastewater system in the spread of multidrug-resistant organisms, such as carbapenemase producing Enterobacterales (CPE). Several sequential outbreaks of CPE on the geriatric ward of the Ghent University hospital have led to an outbreak investigation. Focusing on OXA-48 producing Citrobacter freundii, the most prevalent species, we aimed to track clonal relatedness using whole genome sequencing (WGS). By exploring transmission routes we wanted to improve understanding and (re)introduce targeted preventive measures. Methods: Environmental screening (toilet water, sink and shower drains) was performed between 2017 and 2021. A retrospective selection was made of 53 Citrobacter freundii screening isolates (30 patients and 23 environmental samples). DNA from frozen bacterial isolates was extracted and prepped for shotgun WGS. Core genome multilocus sequence typing was performed with an in-house developed scheme using 3,004 loci. Results: The CPE positivity rate of environmental screening samples was 19.0% (73/385). Highest percentages were found in the shower drain samples (38.2%) and the toilet water samples (25.0%). Sink drain samples showed least CPE positivity (3.3%). The WGS data revealed long-term co-existence of three patient sample derived C. freundii clusters. The biggest cluster (ST22) connects 12 patients and 8 environmental isolates taken between 2018 and 2021 spread across the ward. In an overlapping period, another cluster (ST170) links eight patients and four toilet water isolates connected to the same room. The third C. freundii cluster (ST421) connects two patients hospitalised in the same room but over a period of one and a half year. Additional sampling in 2022 revealed clonal isolates linked to the two largest clusters (ST22, ST170) in the wastewater collection pipes connecting the rooms. Conclusions: Our findings suggest long-term circulation and transmission of carbapenemase producing C. freundii clones in hospital sanitary installations despite surveillance, daily cleaning and intermittent disinfection protocols. We propose a role for the wastewater drainage system in the spread within and between rooms and for the sanitary installations in the indirect transmission via bioaerosol plumes. To tackle this problem, a multidisciplinary approach is necessary including careful design and maintenance of the plumbing system. [ABSTRACT FROM AUTHOR]

Norms and behaviors about toileting in prison can expand understanding of women's lived experience of incarceration. Knowledge about this subject is significant because access to clean, safe toilets is a human rights issue, and toilet habits can impact social, mental, and physical outcomes. Three focus groups were conducted with 15 incarcerated women about their quotidian prison toilet experiences. While the toilet was physically available, institutional regulations, social norms, and women's individual psychologies limited their access and utilization. The ways in which toilet use was negotiated with self, peers, and are described, and the implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

'Public' toilets are crucial to our social and geographical landscape, and access to them has become prominent in recent public and academic debates. Drawing on a qualitative study based on 25 daily diaries and follow-up interviews with people living with the common health condition irritable bowel syndrome (IBS), this paper explores toilet access through the lens of mundane mobilities. Planning journeys, mapping toilets, a reliance on commercial toilets and intersections with travel were key themes emerging from the study. Through the lens of IBS, we see how navigations of seemingly everyday mobilities are problematised through the bodily precarity of unpredictable symptoms intertwined with the availability, comfort and knowledge of 'public' toilets. This paper works at demonstrating the interdependency between everyday mobilities and toilet access. IBS offers a particularly useful insight in which the common but often hidden nature of the condition demonstrates the multiplicities of 'public' toilet access and how the unpredictability of access meets with, and is embodied, by those with the condition. This paper contributes to interdisciplinary toilet scholarship by engaging in mundane and embodied geographies and centralises toilets as a site of connection for those studying everyday mobilities. [ABSTRACT FROM AUTHOR]

In the past decade, experts have conducted parasitological research on archaeological specimens in Korea to collect historical parasite infection data. In these studies, parasitologists successfully described the infection pattern of each parasite species in history. However, in the first half of the 20th century, archaeoparasitological reports have been scant. In 2021, we conducted a parasitological examination of a toilet-like structure that emerged in the early 20th century. This structure was built by stacking 2 wooden barrels; and in the study samples, we found ancient Trichuris trichiura, Ascaris lumbricoides (unfertilized), and Taenia spp. eggs and therefore proposed a higher possibility that the barrels could have been used as a toilet at the time. To understand how the antihelminthic campaign since the 1960s helped reduce parasite infection rates in Korea, more research should focus on early-20th-century toilet ruins. [ABSTRACT FROM AUTHOR]

BACKGROUND: When flushed, uncovered hospital toilets have been shown to generate aerosols potentially containing bacteria, viruses, and hazardous drugs, which can be inhaled by healthcare workers and contaminate surfaces. Guidelines recommend placing a plastic-backed absorbent pad (PBP) over the toilet, although no studies have evaluated the effectiveness of this intervention. OBJECTIVES: The purpose of this study was to evaluate the effectiveness of using a PBP versus the Splashblocker®, a solid, reusable engineering barrier control, to reduce post-flush aerosol particles. METHODS: Aerosol measurements were taken with an optical particle counter in a bathroom testing chamber equipped with a commercial hospital toilet and flushometer valve. Three tests were performed at a height of 16 inches above the floor and 40 inches above the floor. FINDINGS: Both the PBP and the Splashblocker significantly reduced the number of post-flush particles by more than 99% at 16 inches above the floor and 40 inches above the floor. The results indicate that both interventions are equally beneficial in reducing aerosols after flushing a hospital toilet. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) poses several issues concerning the management of hospital-acquired infections, leading to increasing morbidity and mortality rates and higher costs of care. Multidrug-resistant (MDR) bacteria can spread in the healthcare setting by different ways. The most important are direct contact transmission occurring when an individual comes into physical contact with an infected or colonized patient (which can involve healthcare workers, patients, or visitors) and indirect contact transmission occurring when a person touches contaminated objects or surfaces in the hospital environment. Furthermore, in recent years, toilets in hospital settings have been increasingly recognised as a hidden source of MDR bacteria. Different sites in restrooms, from toilets and hoppers to drains and siphons, can become contaminated with MDR bacteria that can persist there for long time periods. Therefore, shared toilets may play an important role in the transmission of nosocomial infections since they could represent a reservoir for MDR bacteria. Such pathogens can be further disseminated by bioaerosol and/or droplets potentially produced during toilet use or flushing and be transmitted by inhalation and contact with contaminated fomites. In this review, we summarize available evidence regarding the molecular features of MDR bacteria contaminating toilets of healthcare environments, with a particular focus on plumbing components and sanitary installation. The presence of bacteria with specific molecular traits in different toilet sites should be considered when adopting effective managing and containing interventions against nosocomial infections potentially due to environmental contamination. Finally, here we provide an overview of traditional and new approaches to reduce the spreading of such infections.

The World Health Organization recognizes access to clean and safe toilets as crucial for public health. This study explored U.S. adolescent and adult cisgender womens lived experiences accessing toilets in schools, workplaces, and public spaces. As part of the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium, we conducted 44 focus groups with female participants (n = 360; ages 11-93). Focus groups were stratified by age (11-14, 15-17, 18-25, 26-44, 45-64, 65+) and conducted across 7 geographically diverse U.S. sites from July 2017-April 2018. Using a transdisciplinary approach, we conducted conventional qualitative coding informed by our PLUS conceptual framework and used content analysis processes to identify salient themes. Across settings, toilet access was restricted by gatekeepers (i.e., individuals who control access to toilets). In contrast, self-restricting toilet use (deciding not to use the toilet despite biologic need to urinate) was based on internalized norms to prioritize school and job responsibilities over urination. In public spaces, self-restricting use was largely in response to lack of cleanliness. Across the life course, participants perceived gender disparities in the ability to easily access public toilets. Further research is needed to determine if and how these factors impact bladder health across the life course.

Public toilets may increase the risk of COVID-19 infection via airborne transmission; however, related research is limited. We aimed to estimate SARS-CoV-2 infection risk through respiratory transmission using a quantitative microbial risk assessment framework by retrieving SARS-CoV-2 concentrations from the swab tests of 251 Thai patients. Three virus-generating scenarios were investigated: an infector breathing, breathing with a cough, and breathing with a sneeze. The infection risk (95th percentile) was as high as 10−1 with breathing and increased to 1 with a cough or a sneeze. No significant gender differences for toilet users (receptors) were noted. The highest risk scenario, namely breathing with a sneeze, was further evaluated for risk mitigation measures. Mitigation to a lower risk under 10−3 succeeded only when the infector and the receptor both wore N95 respirators or surgical masks. Ventilation of up to 20 air changes per hour (ACH) did not decrease the risk. However, an extended waiting time of 10 min between an infector and a receptor resulted in approximately 1.0-log10 further risk reduction when both wore masks with the WHO-recommended 12 ACH. The volume of expelled droplets, virus concentrations, and receptor dwell time were identified as the main contributors to transmission risk. HIGHLIGHTS The use of public toilets poses a risk of SARS-CoV-2 respiratory transmission.; No gender differences in risk by counteracting dwell times and inhalation rates.; Ventilation alone did not reduce risk at 20 ACH with immediate receptor entrance.; 10-min waiting time further mitigated risks beyond face masks at 12 ACH ventilation.; N95 and surgical masks offer the most effective risk mitigation to toilet users.;

Background: Open defecation is the leading cause for malnutrition and diarrhoeal deaths in low- and middle-income countries. The negative public health impacts of open defecation could be neutralized by toilet usage. However, the usage of improved sanitation facilities is unsatisfactory in rural India. Objectives: The study was carried out to find the psycho-social barriers among households for not having toilets and for not using the owned toilets and to develop and find out the effect of Behaviour Change Communication (BCC) strategy on toilet construction and usage. Methods: A community-based Embedded Experimental Mixed Methods study was undertaken in the four field practice villages of Urban Health Training Centre, Villupuram. For baseline and end-line surveys, 422 independent sample households who were not having or not using the toilets were selected by Simple Random Sampling. After IEC clearance, interviews and direct observation of the toilets were undertaken. Context-specific multi-faceted BCC strategy was employed through community participation. The data were analyzed in SPSS software. Chi-square test was used to determine the significance of difference and effect size was calculated to estimate the size of the difference between the baseline and end-line data. Results: Toilet ownership and utilization improved by 21.3% and 23.3% points, respectively. There was a significant reduction in households' perceived psychosocial barriers in toilet adoption. Conclusion: Our intervention demonstrated considerable improvements in both toilet construction and usage surpassing the psycho-social barriers. Future sanitation promotion interventions should focus more on community participation and the key messages should be reinforced multiple times using different channels.

Public toilets are essential infrastructure to guarantee the right to sanitation in public spaces and, in more general terms, the right to inclusive and sustainable cities. Moreover, since the equipment has a direct user interface, it is important to understand their demands and needs. Given this, the present research aims to understand the perspective of public toilet users on the Pampulha Lake Shore (PLS), a public touristic place in Belo Horizonte, Brazil. For that, observations and semi-structured interviews were carried out with different public toilet users. In addition, comments posted on the Google Local Guides tool of Google Maps were used as a secondary database for understanding users' experience of PLS toilets. The analysis made it possible to identify aspects related to availability, quality (health and hygiene), security, and accessibility. Collected data showed how the conflicting choice of whether or not to use the toilet was directly related to the health and conservation of the urban equipment and interfered with social and leisure prospects. On the whole, the importance of the user's perspective was highlighted in this study with emphasis on elaborating adequate urban planning with regard to health, sanitation, and accessibility issues. HIGHLIGHTS Public toilets are essential to guarantee the right to sanitation in cities.; Users' experience was found crucial for implementing effective public equipments.; The case study was used to link users’ experience and human rights to sanitation.; Availability, accessibility, and quality/safety were the main concerns of users.; Google Local Guides was shown as a useful tool to complement users' opinions.;

Nutrient recovery and recycling are of great importance in sustainable development. Blackwater (BW) refers to wastewater from toilets, which contains feces, urine, water, and toilet paper from flush toilets. The highly concentrated nutrients of blackwater could be collected through source separation and treated adequately to recover nutrients efficiently and economically. The review intends to give an overview of the characteristics of BW and different techniques to recover nutrients and other valuable products. A number of these technologies are currently under development or being tested at laboratory or pilot scale. The perspective for blackwater nutrient recovery technologies is very positive due to their great potential. For application of source-oriented sanitation infrastructure and systems, there is still a long way to go for development of commercial technologies and valuable products.

Aim: Infectious diseases continue to be a significant impediment in the attainment of sustainable development goals related to health. A lack of essential household amenities and social determinants are the primary cause behind the outbreak of infectious diseases in LMICs. The current study aimed to examine the socio-demographic determinants of infectious diseases vis-à-vis basic household amenities in India. Subject and methods: This study was based on nationally representative data of 'Key indicators of Social Consumption in India: Health' conducted by the National Sample Survey Organisation between July 2017 and June 2018. The study measured the inicidence of various infectious diseases across basic household amenities and socio-demographic variables. Multivariate logistic regression is employed to analyse the association between the likelihood of a particular infectious disease and various intersectional variables. Results: The study findings reveal that the lack of household amenities such as access to a toilet, clean drinking water, garbage disposal and socio-economic determinants such as area of residence, gender, poverty and age have a significant impact on the incidence of infectious diseases in India. Among various infectious diseases jaundice, malaria and others, including tuberculosis and typhoid, dengue fever and chikungunya, have a relatively higher incidence. Approximately 22.32% of the population do not have proper toilet facility, 45.56% have proper tap water facility, while 50% either use water from spring/well or other unprotected sources and about half of the population do not have any arrangement for garbage disposal. Among socio-demographic determinants, incidence of infections is relatively higher in rural areas, other backward classes (OBCs), males, children, and adults. Conclusions: The study findings outlined that there is a need for better government interventions towards reducing the burden of infectious diseases in India, particularly in rural areas. [ABSTRACT FROM AUTHOR]

Background: Bladder overdistension in labor may lead to prolonged postpartum urinary retention. We hypothesized that nulliparas mobilizing to toilet is more likely to achieve satisfactory micturition.Methods: One hundred sixteen (58 in each arm) term nulliparas in labor with filled bladders were randomized to mobilizing to the toilet or using bedpan to micturate. Primary outcome was satisfactory micturition defined as ultrasound derived post-void bladder volume < 150 ml. Following unsatisfactory micturition, participants crossover to the opposed intervention. Participants were catheterized if after crossover, residual bladder volume was ≥250 ml.Results: Satisfactory micturition rates were 55/58 (95%) vs. 43/58 (74%) RR 1.28 95%CI 1.08-1.51 NNTb 4.8 95%CI 3.0-12.4 P = 0.008, failure to micturate 1/58 (2%) vs. 8/58 (14%) RR 0.13 95%CI 0.02-0.97 NNTb 8.3 95%CI 4.6-38.7 P = 0.047. After cross over following unsatisfactory bladder voiding, satisfactory micturition rates were 0/3 (0%) vs 13/15 (87%) P = 0.024, bladder catheterization rates were 3/58 (5%) vs. 2/58 (4%) RR 95%CI 1.5 (0.26-8.65) P = 0.648, maternal satisfaction with allocated intervention 55/58 (95%) vs. 9/58 (16%) RR 95%CI 6.1 (3.3-11.2) NNTb 95%CI 1.3 (1.1-1.5) P <  0.0001 and preference for mobilizing to the toilet if micturition was needed again during labor 55/58 (95%) vs. 53/58 (92%) for mobilizing to the toilet compared to bedpan use arms respectively. Labor and neonatal outcomes were similar.Conclusion: Satisfactory micturition was more frequently achieved with mobilization to the toilet than bedpan use. Women in both arms overwhelmingly prefer to mobilize to the toilet to urinate.Trial Registration: This study was registered with ISRCTN on 17/07/2019 with trial identification number: ISRCTN17787339 . First participant was recruited on 31/07/2019. The last patient was recruited on 18/12/2019. [ABSTRACT FROM AUTHOR]

We highlight an overlooked channel of disease transmission in developing countries: dirty drains. We make the case that sanitation efforts should move to improve the condition of drains to build on increased toilet provision since they are a key transmission channel for waterborne diseases. We develop an economic model of sanitation externalities that incorporates the role of drains and then empirically examine the relationship between the sanitary quality of neighborhood drains and household ill‐health incidence using a primary survey of 1,530 households from rural Uttarakhand, India. We find a strong and positive association between household ill‐health incidence and dirty neighborhood drains, controlling for household toilet usage, community‐level toilet availability, and an array of other household attributes. We employ a variety of robustness checks to validate our findings. Our findings suggest that bringing the policy focus to overall sanitation infrastructure will have substantial health returns. [ABSTRACT FROM AUTHOR]

Abstract Background In the health care setting, infection control actions are fundamental for containing the dissemination of multidrug-resistant bacteria (MDR). Carbapenemase-producing Enterobacterales (CPE), especially Klebsiella pneumoniae (CR-KP), can spread among patients, although the dynamics of transmission are not fully known. Since CR-KP is present in wastewater and microorganisms are not completely removed from the toilet bowl by flushing, the risk of transmission in settings where toilets are shared should be addressed. We investigated whether urinating generates droplets that can be a vehicle for bacteria and explored the use of an innovative foam to control and eliminate this phenomenon. Methods To study droplet formation during urination, we set up an experiment in which different geometrical configurations of toilets could be reproduced and customized. To demonstrate that droplets can mobilize bacteria from the toilet bowl, a standard ceramic toilet was contaminated with a KPC-producing Klebsiella pneumoniae ST101 isolate. Then, we reproduced urination and attached culture dishes to the bottom of the toilet lid for bacterial colony recovery with and without foam. Results Rebound droplets invariably formed, irrespective of the geometrical configuration of the toilet. In microbiological experiments, we demonstrated that bacteria are always mobilized from the toilet bowl (mean value: 0.11 ± 0.05 CFU/cm2) and showed that a specific foam layer can completely suppress mobilization. Conclusions Our study demonstrated that droplets generated from toilets during urination can be a hidden source of CR-KP transmission in settings where toilets are shared among colonized and noncolonized patients.

People in developing nations, like INDIA, INDONESIA, MALAYSIA, BANGLADESH, SRILANKA, AFRICA, THAILAND and Developing Countries etc., face a great deal of issues as far as sewage the executives. This is on the grounds that sanitation arrangement is horribly insufficient. A great many people don’t approach clean toilets, and a lot of fecal waste are released to the earth without satisfactory treatment. In perspective on this, an investigation was done with the point of surveying information, practices, observations, and encounters of family unit on sanitation and sewage the executives in Chennai. The aim of this project is to treat the waste water and reuse the waste water for domestic purpose such as flushing and gardening with minimum cost. The family unit overview results demonstrate that the sewage system stays immature, and there is no reasonable vision to improve the framework created in the family unit isn’t re- utilized, it is for the most part discharged outside. In the tempest water seepage framework legitimately. Sewage treatment from the treatment plants is depleted into surface water bodies, for example, waterways and the sea.

In COVID-19 infection, the emissions of droplets and aerosols produced by the respiratory tract of contaminated subjects may represent a high risk of spreading the SARS-COV-2 virus in the environment. Thus, studies have shown that there is, at least, another source of droplets and aerosols in which viral particles of SARS-COV-2 can be found. It happens after flushing of toilet to dispose of the stools of a patient who has contracted COVID-19. The presence of viral particles of SARS-COV-2 in the stool could be linked to the concentration of angiotensin-converting enzyme 2 (ACE2) found on the surface of intestinal cells. Therefore, there is a reason to wonder whether the emission of viral particles by activating a toilet flush could represent an important potential risk of contamination for health care workers. To investigate this hypothesis, we have correlated different studies on the production of droplets and aerosols as well as the presence of viral particles following flush of toilet. This pooling of these studies led to the following conclusion: the precautionary principle should be applied with regard to the potential risk represented by viral particles of SARV-COV-2 in the stool when flushing the toilet.

Public toilets are essential infrastructure to guarantee the right to sanitation in public spaces and, in more general terms, the right to inclusive and sustainable cities. Moreover, since the equipment has a direct user interface, it is important to understand their demands and needs. Given this, the present research aims to understand the perspective of public toilet users on the Pampulha Lake Shore (PLS), a public touristic place in Belo Horizonte, Brazil. For that, observations and semi-structured interviews were carried out with different public toilet users. In addition, comments posted on the Google Local Guides tool of Google Maps were used as a secondary database for understanding users' experience of PLS toilets. The analysis made it possible to identify aspects related to availability, quality (health and hygiene), security, and accessibility. Collected data showed how the conflicting choice of whether or not to use the toilet was directly related to the health and conservation of the urban equipment and interfered with social and leisure prospects. On the whole, the importance of the user's perspective was highlighted in this study with emphasis on elaborating adequate urban planning with regard to health, sanitation, and accessibility issues. [ABSTRACT FROM AUTHOR]

Abstract Sanitation problems faced by the humanity are tightly coupled with the ever-growing water problems. Better sanitation infrastructures ensure sustainable solutions to the health and water issues faced by the majority of the urban population on the planet. In this study, we investigated sanitation status for squatter settlements in Mumbai, a major global megacity. We observe that capacity building in terms of adequate toilet infrastructure alone cannot eliminate open defecation. There is a huge need for more toilet blocks in Mumbai’s wards, even after considering unusable public and community toilets into account, since 71–99% out of 8417 toilets are not in good condition. We contend that the normal perception regarding more toilet infrastructures and its alleviating effect on open defecation is not always directly correlated and is an emerging as well as a complex urban issue. We corroborate the need for addressing associated governance issues along with capacity building, which will help stakeholders to identify the prevailing sanitation scenario towards further policy amendments. Further, effectively identifying the trends and processes entangled in the urban sanitation issues can ensure a more sustainable resource utilization situation and a better standard of living for the urban poor.

Context: Constructing latrines and getting people to use them is one of the most effective means of improving public health and saving lives. However, building toilets alone cannot eliminate open defecation. Aims: The aim was to estimate the prevalence of open defecation and factors associated with open defecation in rural areas of a district of Haryana. Settings and Design: This community-based cross-sectional study was carried out in a rural field practice area attached to the department of community medicine of a rural medical college. Subjects and Methods: The study was carried out from July to October 2019. The data were collected from 368 randomly selected households on a pretested semi-structured proforma. Ethical approval was obtained from the institutional ethics committee. Statistical Analysis Used: The data were analyzed using the software R, version 3.6.2. Chi-square, Fisher's exact test, crude odds ratio, adjusted odds ratio with 95% confidence interval, and P value were calculated. Results: The prevalence of open defecation was 30.97% despite having a household toilet. Among the study participants practicing open defecation, the prevalence of open defecation was significantly higher among scheduled caste (64.9%), illiterates (42.7%), laborers (56.6%), and low family income (41.5%). The participants who have constructed latrine recently, i.e.,

The goal of good toilet hygiene is minimizing the potential for pathogen transmission. Control of odours is also socially important and believed to be a societal measure of cleanliness. Understanding the need for good cleaning and disinfecting is even more important today considering the potential spread of emerging pathogens such as SARS‐CoV‐2 virus. While the flush toilet was a major advancement in achieving these objectives, exposure to pathogens can occur from failure to clean and disinfect areas within a restroom, as well as poor hand hygiene. The build‐up of biofilm within a toilet bowl/urinal including sink can result in the persistence of pathogens and odours. During flushing, pathogens can be ejected from the toilet bowl/urinal/sink and be transmitted by inhalation and contaminated fomites. Use of automatic toilet bowl cleaners can reduce the number of microorganisms ejected during a flush. Salmonella bacteria can colonize the underside of the rim of toilets and persist up to 50 days. Pathogenic enteric bacteria appear in greater numbers in the biofilm found in toilets than in the water. Source tracking of bacteria in homes has demonstrated that during cleaning enteric bacteria are transferred from the toilet to the bathroom sinks and that these same bacteria colonize cleaning tools used in the restroom. Quantitative microbial risk assessment has shown that significant risks exist from both aerosols and fomites in restrooms. Cleaning with soaps and detergents without the use of disinfectants in public restrooms may spread bacteria and viruses throughout the restroom. Odours in restrooms are largely controlled by ventilation and flushing volume in toilet/urinals. However, this results in increased energy and water usage. Contamination of both the air and surfaces in restrooms is well documented. Better quantification of the risks of infection are needed as this will help determine what interventions will minimize these risks. [ABSTRACT FROM AUTHOR]

Background: In the health care setting, infection control actions are fundamental for containing the dissemination of multidrug-resistant bacteria (MDR). Carbapenemase-producing Enterobacterales (CPE), especially Klebsiella pneumoniae (CR-KP), can spread among patients, although the dynamics of transmission are not fully known. Since CR-KP is present in wastewater and microorganisms are not completely removed from the toilet bowl by flushing, the risk of transmission in settings where toilets are shared should be addressed. We investigated whether urinating generates droplets that can be a vehicle for bacteria and explored the use of an innovative foam to control and eliminate this phenomenon. Methods: To study droplet formation during urination, we set up an experiment in which different geometrical configurations of toilets could be reproduced and customized. To demonstrate that droplets can mobilize bacteria from the toilet bowl, a standard ceramic toilet was contaminated with a KPC-producing Klebsiella pneumoniae ST101 isolate. Then, we reproduced urination and attached culture dishes to the bottom of the toilet lid for bacterial colony recovery with and without foam. Results: Rebound droplets invariably formed, irrespective of the geometrical configuration of the toilet. In microbiological experiments, we demonstrated that bacteria are always mobilized from the toilet bowl (mean value: 0.11 ± 0.05 CFU/cm2) and showed that a specific foam layer can completely suppress mobilization. Conclusions: Our study demonstrated that droplets generated from toilets during urination can be a hidden source of CR-KP transmission in settings where toilets are shared among colonized and noncolonized patients. [ABSTRACT FROM AUTHOR]

The specific sanitation needs of children aged five to 11 years old—those too old to use small potties, but usually too young to safely and confidently use adult latrines during both the day and night, and including children in this age range with disabilities—have often been overlooked in the provision of emergency sanitation. There are multiple reasons to provide sanitation specifically for this age group. They represent a large number of beneficiaries; legal principles and the moral obligations of humanitarian actors should drive their inclusion. Failure to consider their needs results in increased risk of injuries, abuse and/or exploitation when using unsuitable locations to urinate or defecate, and negative health impacts arising from being unable to manage personal hygiene. We have critically reviewed existing guidance for the provision of emergency sanitation for children aged five to 11 and subsequently presents a new disability-inclusive framework: CHILD-SAN. CHILD-SAN is an acronym representing key factors for the water, sanitation and hygiene (WASH) sector to consider in emergency sanitation programmes: child participation, heights, user-friendly, location, décor, scaled-down, accessibility, and monitoring and evaluation. The CHILD-SAN framework recommends (a) safe and meaningful child participation in emergency WASH preparedness planning and emergency WASH programming as a means to develop contextually-appropriate facilities, (b) specific design considerations for child-friendly toilets (that is, they meet the needs of a child), and (c) the collection of sex-, age- and disability-disaggregated data against contextually appropriate indicators to determine the prevalence of child-friendly facilities and their use. We found few examples of emergency WASH programmes adhering to elements of the CHILD-SAN framework, but the implementation of CHILD-SAN would contribute to the WASH sector's aims of achieving universal sanitation and maximising opportunities for good health, dignity, comfort and safety for all. [ABSTRACT FROM AUTHOR]

Billions are faced with poor sanitation in developing countries, forcing United Nations' to miss sanitation targets over the years. This is mainly due to the poor condition of sanitation in the global-south comprising mostly developing countries. International and national organizations are mainly focused on building sanitation infrastructure to target the Sustainable Development Goal 6.2 (i.e., eradicating open defecation by 2030). But the service delivery in terms of monitoring & maintenance along with other governance issues is often overlooked in most cases. How can we arrange sustainable monitoring of a global sanitation community? In this paper, we discuss how information and communications technology (ICT) may be used to address sanitation governance. We outline the necessary governance criteria found in our field-observations and then explore ICT options to address these issues. We conceptualized and created 'Find A Loo' – a mobile application designed to be a 'good-governance' enabler. We tested this application with the help of System Usability Scale (SUS) and Potential Capability Scale (PCS), where it appeared as 'Good' with an 'A Grade' score, based on evaluators' satisfaction on usability and capability. Overall the evaluation affirms that the application is not only useful and ready to use, but also capable of helping in addressing governance issues in sanitation. This work will be of interest to policy & decision-makers, researchers, service providers, NGOs and people working in the sanitation space. Further, such a system lends itself to analytics that helps optimize the performance of sanitation infrastructure. [ABSTRACT FROM AUTHOR]

To provide systematic guidance on resource recovery from domestic wastewater in rural areas, our study reviewed the techniques of resource-oriented toilet use and conducted a cost-benefit analysis combined with life cycle assessment to reveal the economic and environmental benefit of toilet systems under seven different scenarios（A：traditional water closed latrine; B1~B2：resource-oriented toilet, recovery from urine only; C1~C4：resource-oriented toilet, recovery from both urine and feces, i. e. black water）. The result showed that scenario B1~B2 were similar to scenario A considering the economic benefit whereas economic net present value of scenario C1~C4 were higher than that of scenario A（CNY 7.296 × 105 ; CNY 4.965 × 105 ; CNY 5.228 × 105 ; CNY 2.405 × 105 separately）. Moreover, the environmental benefits of scenario C1~C4 were higher than those of scenario A considering all studied impact categories except terrestrial ecotoxicity potential. The conclusion indicates that the toilet system resource recovery in both urine and feces has more economical and environmental benefits than the toilet system of only recovering resource in urine and the traditional water closed latrine. [ABSTRACT FROM AUTHOR]