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PubMed2002

Standards in school toilets--a questionnaire survey.

BACKGROUND: Children often say they have problems with their toilets in school. Educationalists and health workers need to be aware of potential difficulties, to try and improve these facilities for school children. The objective of this study was to assess the perception children have of the toilet facilities in their schools and whether or not this influences their use of them. METHODS: An interviewer-administered questionnaire was given to children attending community audiology clinics and their parents. RESULTS: Eighty-seven children from 65 schools were surveyed. Poorly maintained and unhygienic facilities were described to which access was restricted. A significant proportion of children were bullied or teased. Forty per cent would never open their bowels using the toilets in school. CONCLUSION: The same standards for toilet facilities in the workplace should apply to schools. Substandard facilities may contribute to the suppression of the 'call to stool', leading to chronic constipation. Infectious illnesses may be more easily spread.

Agonistic Behavior↗
PubMed2004

Socio-economic and behavioural factors affecting the prevalence of Ascaris infection in a low-country tea plantation in Sri Lanka.

The identification of the factors that affect the prevalences of geohelminthiases should help to maximize the effectiveness of programmes for the control of these diseases. In the present study, the relationships between the prevalence and intensity of human infection with Ascaris and the availability of sanitary facilities, socio-economic status and personal health habits have been explored in Sri Lanka. The 176 subjects, who lived on a low-country tea plantation, were aged 2-50 years (median = 13 years) and were investigated between the July and December of 2000. When the prevalence and intensity of Ascaris infection were determined, using Kato-Katz smears, 50.0% of the subjects were found to be secreting the eggs of the parasite. Almost all (96.6%) of the subjects lived in terraces of one-room houses built by the plantation owners, and only 30.7% had access to a latrine. Most (90.3%) obtained their drinking water from common taps, and 48.8% boiled their drinking water. The subjects who only drank water that had been boiled and those who washed their hands before meals were relatively unlikely to be infected (P < 0.05 for each). In congested living conditions with poor sanitary facilities, the level of faecal contamination of the environment is invariably high. Even under these conditions, however, good hygiene and the boiling of all drinking water can reduce the risks of Ascaris infection. In the study setting and in similar environments, regular anthelmintic therapy, improvements in housing conditions and sanitary facilities, and health education, to promote risk-reducing patterns of behaviour, would all be beneficial.

Adolescent↗
PubMed1990

The impact of inadequate sanitary conditions on health in developing countries.

One of the achievements of the International Drinking Water Supply and Sanitation Decade (1981-1990) is a better understanding of the relationship between poor sanitary conditions and health. This article reviews current knowledge of the major water- and excreta-related diseases and the potential impact of improved sanitary facilities on health. Four health indicators are considered--diarrhoeal diseases, soil-transmitted nematode infections, dracunculiasis (guinea-worm disease) and nutritional status. These constitute some of the major health problems in the developing world. Although there are large variations in morbidity and mortality rates both between and within geographical areas, some global estimates are presented. Children under 5 experience an average of 3.4 episodes of diarrhoea per year and a diarrhoeal mortality rate estimated at 12 per 1,000, leading to 4 million diarrhoea-associated deaths per year. Diarrhoea may also be associated with a sizeable proportion of adult deaths. Approximately 1,000 million people are believed to be infected with Ascaris lumbricoides, 900 million with hookworms and 500 million with Trichuris trichiura. Dracunculiasis, primarily occurring in remote rural areas, is known to be greatly underreported, but estimates suggest that 10 million people are infected each year. Malnutrition is widely prevalent and a common cause or associated cause of child death. The complex issues involved in measuring the health impact of improved sanitary facilities and the mechanisms by which these impacts may occur are discussed. These complexities, plus the differences in sanitary improvements and environmental settings, and the diverse nature of the health indicators considered, all contribute substantial variations in the health impact observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Recommended methods for the disposal of sanitary wastes from temporary field medical facilities.

Emergency field medical facilities constructed after a disaster are frequently managed by medical staff even though many of the day-to-day problems of hospital management are unrelated to medicine. In this paper we discuss the short-term management of one of these problems, namely the control and disposal of sanitary wastes. It is aimed at persons in the medical profession who may find themselves responsible for a temporary hospital and have little or no previous experience of managing such situations. The wastes commonly generated are excreta, sullage and refuse. In addition, surface water must also be considered because its inadequate disposal is a potential health hazard. The paper concentrates on short-term measures appropriate for the first six months of the hospital or clinic's existence. Facilities expected to last longer are recommended to install conventional waste management systems appropriate to the local community and conditions. In most situations, wastes should be disposed of underground either by burial (for solids) or infiltration (for liquids). The design, construction and management of appropriate disposal systems are described.

Disasters↗
PubMed1975

Ecology of enteroviruses in tropics. I. Circulation of enteroviruses in healthy infants in tropical urban area.

A continuing surveillance on enterovirus infection in healthy infants was conducted from October 1971 through February 1973 in urban areas in Ghana, West Africa. About 40 infants were visited in every two months for collection of faecal specimens and examined for infection. Enteroviruses were recovered in tissue culture. The overall isolation rate of enteroviruses was approximately 44%, and there was no seasonal difference between rainy and dry seasons. The rate of virus isolation in urban areas was significantly higher than in rural areas. Within the urban areas, however, no difference in the rate of virus isolation was detected between densely populated and sparsely populated areas. The results of virus identification revealed that all three types of Poliovirus, many types of Echovirus and a few Coxsackieviruses were isolated during the course of the study. It was observed that improvement of sanitary facilities decreased the frequency of virus infection among infants, but the condition of water supply did not influence the virus infection rate. Neither the age of infants nor the size of siblings showed any relation to the virus isolation rate. It was suggested from the results that many types of enteroviruses have been circulation continuously in the tropical urban community throughout the year.

Coxsackievirus Infections↗
PubMed1993

Involvement of a community in schistosomiasis control: a Kenyan experience.

This paper illustrates how community participation was achieved in a study that was carried out between 1983-1988 whose general objective was to reduce the transmission of schistosomiasis in a rice irrigation scheme in Kenya. A community of 2,219 people was mobilized through health education, to effect changes in behaviour regarding water contact, water use and faecal disposal. Health education, alternative water sources, latrines and mass chemotherapy with praziquantel were the schistosomiasis control strategies utilized in this study. By the end of 2 years, the canals were cleared of their thick vegetation, water, sanitation, bathing and washing facilities were constructed, water contact with infective waters was reduced, faecal contamination of water was reduced, the people's knowledge on schistosomiasis increased and the rate and intensity of schistosomiasis infection was reduced. The study demonstrated that it is possible to fully involve the community in disease control efforts.

Adult↗
PubMedDate not supplied

A decade of adult intensive care unit design: a study of the physical design features of the best-practice examples.

This article reports a study of the physical design characteristics of a set of adult intensive care units (ICUs), built between 1993 and 2003. These ICUs were recognized as the best-practice examples by the Society of Critical Care Medicine, the American Association of Critical Care Nurses, and the American Institute of Architects. This study is based on a systematic analysis of the materials found on these ICUs in the booklet and videos jointly published by the above organizations in 2005. The study finds that most of these examples of best-practice adult ICUs have the following negative characteristics: (1) they are built as renovation projects with more health and safety hazards during construction; (2) most of them are mixed-service units with more safety and staffing problems; (3) the overall layout and the layout of staff work areas in these ICUs do not have any common design solutions for improved patient and staff outcomes; and (4) in these ICUs, family space is often located outside the unit, and family access to the patient room is restricted, even though family presence at the bedside may be important for improved patient outcomes. Some of these negative characteristics are offset by the following positive characteristics in most ICUs: (1) they have only private patient rooms for improved patient care, safety, privacy, and comfort; (2) most patient beds are freestanding for easy access to patients from all sides; (3) they have handwashing sinks and waste disposal facilities in the patient room for improved safety; and (4) most patient rooms have natural light to help patients with circadian rhythms. The article discusses, in detail, the implications of its findings, and the role of the ICU design community in a very complicated design context.

Adult↗
PubMed1981

Environmental sanitation infection and nutritional status of infants in rural St. Lucia, West Indies.

About 75 babies in each of three valleys were followed up for two years. The valleys had different levels of water supplies and latrine facilities, whereas socio-economic conditions and feeding patterns were similar. Results show that the prevalence of diarrhoea and intestinal helminths reduced as sanitation improved. Ascaris and Trichuris infections dropped 30 and 50% respectively after water supplies and latrines were installed. The growth of the children was significantly better in the improved areas. The possibility of malnutrition being secondary to illness, rather than primary, is included in the discussion.

Ascariasis↗
PubMed1983

[From the Cloaca Maxima to current sewage treatment works--historical aspects of waste disposal].

According to calculations made by the well-known hygienist Max Rubner in 1890, the annual quantity of waste made up of excreta, urine, kitchen refuse, ashes and water for general use than ran to 7,300 kgs. Thus it appears quite obvious that as early as in the ancient high cultures special waste disposal plants existed. In the Old Testament cesspools were in use, in Ancient Egypt sliding boxes served the same purpose, the Cretan palace of Knossos was provided with a really sophisticated water closet system and there is evidence that a similar facility existed in Mesopotamia. The Roman Cloaca maxima which functioned as a sanitary system for the entire capital, has never ceased to impress. With the advent of the so-called "miasma theory", public health legislations also started to take care of waste disposal, and as a result, various lavatories, slaughter-house and waste water facilities were created. When bacteriology began to establish itself, close attention was devoted to the ground water and the rivers. The "squatting closet" in Roman countries contrasted with the flush closet in England. For waste disposal, the so-called "Heidelberg barrel system" or the "Kiel exchange bucket system" were introduced. Of more recent date are the digestion chambers, the flow settling tanks and the "trickling or oxydation system" on the sprinkling fields.

Drainage, Sanitary↗
PubMed2004

Hospital bathrooms and showers: a continuing saga of inadequacy.

Previous surveys of UK hospitals have highlighted many deficiencies in the standards of hospital inpatient washing and bathing facilities--especially inadequate access for wheelchair users, insufficient bathing equipment, and unsatisfactory cleanliness and privacy. We conducted a qualitative survey in three hospitals in the North of England to see whether these facilities have improved. There have been some improvements, particularly in the provision of bath hoists, adapted taps, alarm call systems, shower seats and wheelchair access to bathrooms. But many basic problems remain-absent locks and signs, inadequate heating, poor standards of privacy, insufficient bath aids, wet floors, and the inappropriate use of bathrooms as store rooms. The overall condition of hospital bathrooms and showers remains unsatisfactory. Too many hospital bathrooms are austere, cold, smelly and poorly maintained.

Baths↗
PubMed1985

Factors relating to the presence and use of sanitary facilities in rural Swaziland.

Findings related to latrine construction and use in a sample of rural homesteads in Swaziland are summarized from a larger, unpublished sample survey. Anthropological research techniques were also used to gain information on attitudes and beliefs. Pit latrines were found in 21% of the sampled homesteads. The most significant variables in predicting the presence of a latrine were respondent's education and the highest level of education achieved by anyone in the residential unit. Older people and small children were least likely to use a latrine; people with less education were least likely to even have a latrine.

Aged↗
PubMed1986

Some observations on a cholera outbreak at the Umvoti Mission Reserve, Natal.

Between November 1981 and January 1982 154 consecutive patients with cholera El Tor Inaba were hospitalized at Stanger Hospital, Natal. These cases were traced to 130 households in the Umvoti Mission Reserve, which were ranked according to socioeconomic condition, permanence of housing materials, ablution facilities and purity of water source. Significant associations were found between cholera incidence and both socio-economic conditions and water source; the latter two were also strongly associated. In a number of instances the outbreak did not follow the downstream flow of the rivers. Increased mobility and social gathering over the holiday season appears to have played a role in transmission. The atypical pattern of spread may also have resulted from non-water-borne, person-to-person transmission.

Cholera↗
PubMed2004

The struggle for sanitary reform in the Lancashire cotton mills, 1920-1970.

AIM: This paper reports one aspect of a larger study. The aim of this aspect was to explore the role of the "welfare officer" in promoting the health of cotton mill workers during this period. BACKGROUND: The paper considers one element of a broad exploratory study of the health of women cotton mill workers in the North West of England. The original purpose of the study, which was conducted in 2002 in two towns, Oldham and Ashton-under-Lyne, was to explore the women's own perceptions of the impact of their work on their health, and to find out what, if any, help and support they obtained. During the course of the study it was discovered that "welfare officers", some of whom were trained nurses, had an important role in promoting the health of these workers. The study was therefore expanded to incorporate data obtained directly from interviews with a small sample of welfare officers. The present paper focuses on the issue of sanitary reform and considers the role of the "welfare officer" in promoting public health in the workplace. METHODS: The study employed a combination of archive searches and oral history interviewing. In total, 31 interviews were undertaken between June 2001 and October 2002. The interpretive process focussed both on the ideological power structures which influenced the perspectives of participants, and on evidence for those aspects of participants' experiences which impacted on their health. FINDINGS: In considering their health, female cotton-mill workers recalled that the poor sanitary conditions in their workplaces during the middle years of the 20th century had been a source of some concern to them. They also observed that mill welfare officers took a hand in promoting improvement in available facilities. Welfare officers themselves recounted their own concern regarding the poor sanitary conditions in the mills, and their efforts to improve conditions for the mill workers. CONCLUSIONS: The paper demonstrates the role of a little-known group of health workers in the middle years of the 20th century, and demonstrates the importance of oral history work in re-capturing elements of nursing work and experience, which do not appear extensively in the written record. The study's relevance to contemporary practice lies in the insight it offers into the autonomy with which these occupational health workers defined their roles and performed their work.

England↗
PubMed1990

Effect of educational intervention on defaecation habits in an Indian urban slum.

The defaecation habits of 172 adults before and after a cholera epidemic in New Delhi in 1988 were investigated. Intensive educational activities were undertaken during the epidemic. A community latrine facility was constructed in this area in February 1988. A greater proportion of females than males were found to be exclusively using the latrines at both rounds of the investigation. A statistically significant relationship with age was observed (P less than 0.001), while literacy was not found to exert a statistically significant effect. Difference in usage habits were more marked in the second round of the investigation. Cost and distance were the main reasons cited for non-utilization of latrines. 91.4% of respondents stated that they had faced some problem in using latrines. Most children were found to be defaecating in the open around the dwelling units at both rounds of the investigation.

Adult↗
PubMed1966

The epidemiology of Schistosoma haematobium and S. mansoni infections in the Egypt-49 project area. 3. Prevalence of bilharziasis in relation to certain environmental factors.

The influence of the size and location of communities in relation to the different types of watercourse, the availability of a protected water supply, types of housing and the presence of other sanitary facilities on the prevalence of bilharziasis in the Egypt-49 project area has been studied. There is no direct relationship between the size of village and the prevalence of bilharziasis. Main drains and distributaries are potent sources of infection and, in terms of the total population exposed, distributaries play the most significant role in the transmission of infection. Of the other factors, the availability of a protected water supply seems to have the greatest effect on the prevalence. Although the presence of a latrine in the dwelling does not of itself influence the extent of schistosome infection, which is caught from polluted water, the installation of latrines assists in the cultivation of healthy habits, thereby lessening the prevalence not only of bilharziasis but also of certain other infections.

Adolescent↗
PubMed2000

Rural sanitation problems in Uganda--institutional and management aspects.

Rural Uganda faces a lot of problems caused by poor sanitation facilities such as pollution of water sources, a high rate of waterborne diseases, high expenditures on curative health care, and the threat of reduced educational performance of children through illness, early school drop out, especially of girls. Limited budgets and expenditures for the health sector, lack of staff, lack of accountability and transparency are important factors affecting sanitation status on the national level. Other restrictions can be found at the community level, e.g. taboos, cultural and customary beliefs, ignorance, poverty, or in soil conditions. To address the poor level of sanitation, the Government of Uganda has set up both a whole string of laws and guidelines and an institutional and management framework. One main emphasis was placed on the Participatory Hygiene and Sanitation Transformation Programme (PHAST) introduced in 1994 and since then adopted by several non-governmental organisations (NGO's).

Adult↗
PubMed2005

Skin infection, housing and social circumstances in children living in remote Indigenous communities: testing conceptual and methodological approaches.

BACKGROUND: Poor housing conditions in remote Indigenous communities in Australia are a major underlying factor in poor child health, including high rates of skin infections. The aim of this study is to test approaches to data collection, analysis and feedback for a follow-up study of the impact of housing conditions on child health. METHODS: Participation was negotiated in three communities with community councils and individual participants. Data were collected by survey of dwelling condition, interviews, and audit health centre records of children aged under seven years. Community feedback comprised immediate report of items requiring urgent repair followed by a summary descriptive report. Multivariate models were developed to calculate adjusted incidence rate ratios (IRR) for skin infections and their association with aspects of household infrastructure. RESULTS: There was a high level of participation in all communities. Health centre records were inadequate for audit in one community. The records of 138 children were available for development of multivariate analytic models. Rates of skin infection in dwellings that lacked functioning facilities for removing faeces or which had concrete floors may be up to twice as high as for other dwellings, and the latter association appears to be exacerbated by crowding. Younger children living in older dwellings may also be at approximately two-fold higher risk. A number of socioeconomic and socio-demographic variables also appear to be directly associated with high rates of skin infections. CONCLUSION: The methods used in the pilot study were generally feasible, and the analytic approach provides meaningful results. The study provides some evidence that new and modern housing is contributing to a reduction in skin infections in Aboriginal children in remote communities, particularly when this housing leads to a reduction in crowding and the effective removal of human waste.

Australia↗
PubMed1984

Longitudinal study of occurrence of diarrheal disease in day care centers.

Sixty day care centers (DCC) randomly selected from 736 licensed child care facilities in Harris County (Houston), Texas were surveyed for the incidence of diarrhea by periodic visits and weekly telephone calls over two years. A total of 2,708 episodes of diarrhea were reported in 3,800 children under 6 years of age, and 84 cases occurred in center staff. Overall incidence was 0.44 episodes/person/year among children and 0.14 among staff. Attack rates among the 60 DCC ranged from none to 3.64 cases/year in each child. The incidence for children under 36 months of age was 17 times higher than for the older group. Characteristics of DCC associated with higher rates of disease among children were the presence of young, non-bowel trained children, staff who both diapered infants and prepared food on a regular basis, DCC for profit management, and DCC whose only guidelines were provided by the State. The socioeconomic burden associated with DCC disease, its transmission, and control is considerable and needs to be further addressed.

Age Factors↗