Abstract：
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 Log10 cfu/cm2) and internal pull latch (5.8 Log10 cfu/cm2). 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.
摘要：
共享卫生设施被誉为解决卫生设施挑战的创新方法。然而,由于不卫生的条件，这些设施可能成为疾病传播的热点。在这项研究中，我们使用了定量（基于大肠杆菌污染）技术来评估与使用社区沐浴块（CAB）相关的健康风险。污染最严重的表面是水箱手柄(5.7Log10cfu/cm2)和内部拉锁(5.8Log10cfu/cm2)。基于大肠杆菌的污染,100名CAB用户中至少有2人在接触“热”表面时可能会被感染。假设潜在致病性大肠杆菌从这些表面转移到口腔,对这些风险进行建模。纳入降低风险的措施，例如擦拭这些表面或洗手，可能会导致感染风险的显着降低。最重要的风险降低干预措施被确定为擦拭接触表面，特别是在接触前两次。降低风险的综合干预措施可以进一步降低风险。这项研究表明，共用CAB内接触表面的污染可能导致感染风险增加，需要采取旨在降低相关风险的措施。因此，本研究中使用的风险评估框架可以在类似的环境中应用，以估计使用此类设施的相关健康风险。
