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Citations from Articles
Sun, K. S., Lam, T. P., Tang, W. S., Chan, H. Y., Lam, K. F., Chow, E. C. Y., Wu, D., Zhou, X. D., Xu, J. Y., & Ho, P. L. (2021). Improving Public Toilet Environment and Hygiene Practices in an Asian City: Voices From Hong Kong Residents. Asia Pacific Journal of Public Health, 33(4), 378–387. https://doi.org/10.1177/1010539521993685

Toilet hygiene is an important preventive measure for infectious diseases, including severe acute respiratory syndrome (SARS) and COVID-19. This study explored public’s opinions on improving toilet environment and hygiene practices in Hong Kong.

In 2003, Hong Kong had experienced SARS, and people’s awareness and hygiene practices are improving. Seventeen years later, Hong Kong, China, and the world are experiencing another big public health crisis, the COVID-19. Basic toilet facilities, supplies, and poor maintenance were cited as major barriers to hygiene practices in Hong Kong’s public toilets. These are areas that require government resources and expertise to implement improvement measures that are all tangible. At the same time, education, awareness building, and health promotion, intangible they might be, are more urgent and worth investing as ever.

Val Curtis. (2019) Explaining the outcomes of the 'Clean India' campaign: institutional behaviour and sanitation transformation in India. BMJ Global Health 4:5, pages e001892.

In 2015, an estimated 2.4 billion people lacked access to improved sanitation facilities such as pour-flush toilets and pit latrines that hygienically separate human excreta from human contact, and 1.1 billion practiced open defecation (UNICEF/WHO 2015). Poor sanitation causes approximately 280,000 deaths per year, largely due to diarrheal diseases (Guiteras, Levinsohn, and Mobarak 2015). These preventable sanitation-related deaths are overwhelmingly among children in low income countries (Bartram and Cairncross 2010). In the last few decades, the problem of inadequate sanitation has received increased attention, funding, and resources from governments and development institutions. One of the Millennium Development Goal (MDG) targets was for 77 percent of the world’s population to have access to improved sanitation by 2015 (relative to a 1990 baseline of 54 percent). Since 1990, 2.1 billion people gained access to improved sanitation (UNICEF/WHO 2015; United Nations 2015a). Nonetheless, the MDG sanitation target was not met. Most of the deficit occurred in Sub-Saharan Africa and South Asia (United Nations 2015b). The ambitious Sustainable Development Goals (SDG) sanitation target is to achieve adequate and equitable sanitation and hygiene for all, and to end open defecation, by 2030.

Greed, C. (2006). The role of the public toilet: pathogen transmitter or health facilitator? Building Services Engineering Research and Technology, 27(2), 127–139. https://doi.org/10.1191/0143624406bt151oa

The elderly and people with disabilities may simply not go out for fear of there being no toilet when they need one. Those toilets that are available may be unusable. Lack of regulation or compulsory standards result in poor toilet design, inadequate maintenance and management, and unhygienic conditions, resulting in the spread of MRSA and other drug-resistant diseases. Recommendations are summarized for the provision of a spatial hierarchy of toilet provision that would both meet user needs and reduce the chances of the public toilets acting as epicentres of germ transmission.

Sustainable Development Goal (SDG) target 6.2 calls for ‘adequate and equitable sanitation for all’. In dense, rapidly urbanising cities, the challenge of providing household sanitation means that many countries include shared, community and public toilets in their national strategies to meet global goals. However, shared sanitation is associated with several problems including poor management and exclusion. This study examines shared sanitation access and use by using innovative mapping methods in compound house units in Fante New Town, Kumasi, Ghana. This study reveals that 56% of house units have at least one toilet. Of the 47% of people living in these house units, almost a third were excluded from using the toilet. Tenure status was the main driver for exclusion, with nearly half of people reporting non-usage ‘not allowed’ to use the toilet by the landlord. This study outlines key policy interventions to address broader institutional and regulatory barriers to shared sanitation. At the settlement level, this includes the provision of safe, well-managed public toilets and engagement with landlords to improve house unit toilet access. At the national and global level, this study calls for nuanced indicators to assess the quality of access and to ensure shared sanitation works for everyone.


 * Source 6: The History of Toilets in Japan - High-Tech Toilets


 * Kids web Japan. The History of Toilets in Japan - High-Tech Toilets - Hi-tech - Kids Web Japan - Web Japan. (n.d.). Retrieved November 15, 2021, from https://web-japan.org/kidsweb/hitech/toilet/toilet01.html#:~:text=The%20earliest%20known%20toilets%20in%20Japan%20date%20back%20about%201%2C300%20years.&text=Sewerages%20and%20seated%20toilets%20were,spread%20on%20a%20major%20scale.


 * This article explains the history of toilet in Japan and technology of toilet. After the war, Western-style toilets gradually gained favor in private homes, since it is less straining to sit on a seat than to squat. And in 1977 the number of Western-style toilets marketed in Japan surpassed that of Japanese-style toilets. The earliest known toilets in Japan date back about 1,300 years. Excavations have uncovered pits that were used as toilets, as well as more advanced toilets consisting of a ditch carrying water through part of the house to convey the waste outdoors. Since ancient times, there also existed toilets built over running streams. These types can be considered a primitive form of flush toilets.


 * Source 7: Japanese toilets are way too brilliant for us to handle.


 * Fluhr, S. (2017, December 7). Japanese toilets are way too brilliant for us to handle. HuffPost. Retrieved November 15, 2021, from https://www.huffpost.com/entry/flushing-sound-japanese-t_b_8950112.
 * This article explains the author's experience of using Japanese style toilet in Narita airport. This article talks about how toilet technology in Japan is brilliant and new for the author. The detail of each function that Japanese toilets have is explained with pictures.