eThekwini Municipality Health Department, 9 Archie Gumede Place, 4001, Durban, South Africa.
School of Life Sciences, University of KwaZulu-Natal, KwaZulu-Natal, 4001, Durban, South Africa.
Environ Monit Assess. 2022 Feb 10;194(3):166. doi: 10.1007/s10661-022-09815-x.
Shared sanitation facilities have been hailed as an innovative approach to solve the challenge with sanitation access. However, these facilities may act as hotspots for disease transmission due to unhygienic conditions. In this study we used quantitative (based on Escherichia coli contamination) techniques to assess the health risks associated with the use of community ablution blocks (CABs). The most contaminated surfaces were the cistern handle (5.7 Log cfu/cm) and internal pull latch (5.8 Log cfu/cm). Based on the E. coli contamination, at least two people out of 100 CAB users might be potentially infected when they touch "hot" surfaces. These risks were modelled assuming transfer of potentially pathogenic E. coli from these surfaces to the mouth. The incorporation of risk-reduction measures, such as wiping of these surfaces or washing of hands, could potentially result in significant reduction of infection risks. The most significant risk-reduction intervention was determined to be wiping of the contact surfaces, especially twice prior to contact. A combination of risk-reduction interventions could further reduce the risks. This study shows that contamination of contact surfaces within shared CABs could lead to increased risks of infections, requiring measures aimed at reducing the associated risks. The risk assessment framework used in this study could therefore be applied in similar settings to estimate associated health risks with the use of such facilities.
共享卫生设施被称赞为解决卫生设施接入挑战的一种创新方法。然而，由于卫生条件不佳，这些设施可能成为疾病传播的热点。在这项研究中，我们使用定量（基于大肠杆菌污染）技术来评估使用社区盥洗室（CAB）相关的健康风险。污染最严重的表面是水箱手柄（5.7 Log cfu/cm）和内部拉钩（5.8 Log cfu/cm）。基于大肠杆菌污染，当 100 名 CAB 用户中的至少两个人触摸“热”表面时，他们可能会受到潜在的感染。这些风险是通过假设这些表面上的潜在致病大肠杆菌转移到口腔来建模的。如果采取减少风险的措施，如擦拭这些表面或洗手，可能会显著降低感染风险。最有效的减少风险的干预措施被确定为擦拭接触表面，特别是在接触之前擦拭两次。风险减少干预措施的组合可以进一步降低风险。本研究表明，共享 CAB 内接触表面的污染可能会导致感染风险增加，需要采取措施降低相关风险。因此，本研究中使用的风险评估框架可应用于类似环境中，以评估使用此类设施相关的健康风险。
