sanitation

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Sanitation is a basic, as well as a long-standing, public health issue. When early peoples settled in communities and started to cultivate crops and raise animals, sanitation became a primary concern for society. The Book of Leviticus, in the Torah, includes specific guidelines regarding the disposal of wastes, the placement and disinfection of wells, and related issues. Today, as urban areas grow, more pressure has been put on local water supplies, for the quality of the water that is available to a community greatly impacts all aspects of health. Worldwide, 40 percent of the population does not have ready access to clean, safe drinking water, and approximately 60 percent does not have satisfactory facilities for the safe disposal of human waste. Infectious agents in drinking water and food cause the diarrheal deaths of several million children annually.

In the United States, every person uses almost 100 gallons of drinking water per day, though only a small portion of this amount is actually used for drinking. Other uses include toilet flushing, bathing, cooking, cleaning, and lawn watering.

Sources of Water

Water sources are manifold. Many communities get their water from reservoirs. In 500 B.C.E., the Greeks supplemented local city wells with water supplied from the mountains as far as ten miles away. In later times, the Romans built aqueducts that were many miles long—there are more than two hundred that are still standing in the year 2001. Cities and other communities often provide for their water supply by allocating an open area that is pristine and protected as a watershed. The water is usually of high quality and free from chemical and microbial contamination. These sources are referred to as surface water sources and include lakes, streams, and rivers. Some surface water requires extensive treatment before it can be distributed for human consumption.

In other parts of the country, water is supplied to communities from groundwater sources through deep wells, often many thousands of feet down. Water from these sources is also usually free of chemical and microbial contamination. Groundwater is the main source of drinking water for almost half of the population in the United States. While it is usually free of solids and bacteria, as well as other chemical pollutants, it has often become contaminated by disposal of liquid waste and agricultural runoff. Groundwater is relatively inexpensive, but it is limited in volume and irreplaceable if depleted. By providing protection to the source, either through buffers from the reservoirs or by protecting the well head for the deep wells, water is available without much treatment.

Because of the increasing population and the increased use of water by each individual in the United States, there are less uncontaminated water supplies available. Many sources of water must be treated prior to consumption. Disinfection is an important step in the water treatment process to destroy pathogenic bacteria and other harmful agents. Most water is treated with chlorine, as it is a very effective and economical method of treatment. An important advantage to using chlorine is that it has residual properties and continues to provide germ-killing potential as the water travels from the distribution point to the end users. There are concerns, however, about the formation of disinfection by-products from the reaction of the chlorine with humic substances in the water. These by-products are referred to as trihalomethanes, or THMs. The most common THM is chloroform, which is a carcinogen.

Sanitation includes the appropriate disposal of human and industrial wastes and the protection of the water sources. Waterborne agents are the cause of many diseases in the United States and elsewhere in the world. These diseases may be caused by bacteria, viruses, and protozoans. Bacterial diseases include typhoid, shigellosis, and cholera. Viral agents cause diseases such as include polio and hepatitis. Parasites include the protozoa Entamoeba histolytica and Giardia lambdia, which cause amebiasis and giardiasis, respectively. For the last decade the primary agents in waterborne disease outbreaks in the United States have been the protozoal parasite Giardia, and the bacteria Shigella. Another common agent is Cryptosporidium.

Another example of sanitation as it relates to waterborne diseases globally is schistosomiasis. Schistosomiasis is a chronic debilitating disease with significant morbidity and mortality that affects more than 200 million people worldwide. Sanitation and water supply are important issues in an integrated schistosomiasis control program.

Sanitation and Water Pollution

Sanitation is directly related to water quality and water pollution. Water quality usually describes the level of certain compounds that could present a health risk. The quality of water is usually defined by guideline values of what is suitable for human consumption and for all usual domestic purposes, including personal hygiene.

In relating sanitation to water pollution, one must examine both point and nonpoint source pollution, as these are the two routes of entry of the pollution into the water supply. Point-source pollutants enter the waterways at well-defined locations, such as a pipe or a sewer outflow. The discharges are usually even and continuous. Industrial factories, sewage treatment plants, and storm sewer outflows are common point sources of pollution. Nonpoint sources enter the water system from broad areas of land. It is estimated that 98 percent of the bacterial contamination and 73 percent of biological oxygen demand are due to nonpoint sources.

Wastewater

Water containing human waste is generally referred to as wastewater. In the United States, the disposal of human waste must be handled in a sanitary manner. Usually, this waste is disposed of via a sewer system that uses water as the vehicle for the disposal. Treatment of wastewater is required to prevent pollution of pristine surface waters and groundwater sources. Wastewater treatment consists of physical, chemical, and biological processes. In a typical suburban or urban setting, wastewater from the home enters a domestic or sanitary sewer system. The sanitary sewer is a system of pipes that collects the wastewater, and the waste is transported to a wastewater treatment plant. The water goes through a series of processes that removes the solids from the water. Solids are composted or removed and disposed of via landfill or land application as fertilizer. Sewage consists of more than 99.9 percent water by weight, and the average domestic sewage contains 600 ppm of total solids. The amount of solids present in water has been one of the major water pollution control criteria, due to the relationship of the solids to the oxygen demand.

Water reuse is an important concept that has only recently gained attention and interest in the United States. Water that is reused, commonly known as "gray water," cannot be used on food crops or in any type of domestic use. This water can be used to water landscape and turf. Water reuse will continue to expand as water resources become more and more limited.

Since approximately 1950, a common method of disposal of solids in the United States has been the use of a sanitary landfill. The landfill, which typically is located outside a populated area, is a place where wastes are dumped, compacted, and buried. Special care in siting the landfill must be taken to avoid runoff and leaching of the waste materials into surface water and groundwater. Landfills that are properly designed with the correct engineering and liners can provide adequate protection. In many locations in the United States, these landfills have been sited on marginal land that was unsuitable for industry or agriculture. Many of these sites are sensitive wetland areas that serve as habitat for plants and animal species.

The 1974 Safe Drinking Water Act established a set of primary standards to protect human health. These standards consist of maximum contaminant levels for specific inorganic contaminants, volatile organic chemicals, and radioactive materials, as well as limits for turbidity and coliform organisms. Secondary standards are set for temperature, color, taste, and odor. The Environmental Protection Agency has identified treatment via conventional coagulation, sedimentation, and filtration as effective processes in removing or reducing the levels of contaminants. Societal concerns for the quality of water resources continue as many streams and coastal waters do not meet water quality goals. States report that 40 percent of the waters surveyed are too contaminated for drinking, fishing, and swimming. Since the Clean Water Act was signed in 1972, it is estimated that more than $5 trillion has been spent on water pollution control in the United States.

(SEE ALSO: Ambient Water Quality; Biological Oxygen Demand; Chlorination; Clean Water Act; Disinfection By-Products in Drinking Water; Groundwater; Landfills, Sanitary; Municipal Solid Waste; Pollution; Wastewater Treatment; Water Quality; Water Reuse; Water Treatment; Waterborne Diseases)

Bibliography

McKenzie, J., and Pinger, R. (1997). An Introduction to Community Health. Sudbury, MA: Jones and Bartlett.

Merson, M.; Black, R.; and Mills, A., eds. (2001). International Public Health: Diseases, Programs, Systems, and Policies. Gaithersburg, MD: Aspen Publishers.

Morgan, M. T. (1997). Environmental Health. Madison, WI: Brown and Benchmark.

— MARK G. ROBSON

Sanitation The word "sanitation" only entered the English language in the nineteenth century, and the term is inextricably linked with integrated water and sewer systems. Lacking such technologies, early modern Europeans are often reckoned to have lived without sanitation. Their epidemiology of the time might seem to support this contention: three out of every ten babies born in Geneva between 1580 and 1739 died by their first birthday and the infant mortality rate in late seventeenth-century London was over one in four. Many of these deaths were caused by dirt-related infections like infantile diarrhea—what contemporaries termed "griping in the guts." Moreover, there are many vivid complaints of noxious conditions in early modern cities—one account of 1670s Edinburgh, for instance, claimed that one could not step anywhere in the streets without treading on turds.

Appearing in an Englishman's denunciation of all things Scottish, this claim was designed to promote prejudice. The charge also reveals how early modern people did indeed discriminate between cleanliness and dirt. Their sanitary technology rarely consisted of more than cesspits, chamber pots, and carts to carry ordure from their communities, but early modern Europeans possessed notions of public health and collective salubrity. Furthermore, scholars are now revealing the extent to which they sought to regulate and cleanse their environments.

Urban Dirt and Urban Order

Such efforts were rarely entirely successful—early modern utopian writing appreciatively delineated the cleanliness of the ideal community—but civic authorities regularly commanded that streets be swept and nuisances removed. Such sanitary regulation was linked to wider conceptions of order. Noxious wastes shaped social and symbolic geographies. Offensive trades such as butchers and tanners were generally confined to particular districts, often downstream or outside city walls. In Paris the bodies of condemned criminals were buried in the municipal dump at Montfaucon. In central Europe the emptying of cesspits and the removal of waste were associated with other "dishonorable" trades. Between the sixteenth and nineteenth centuries, for instance, the "night-king" (chief latrine-cleaner) of Augsburg had to share a residence with the city executioner. Furthermore, precepts for cleansing streets often coincided with drives to rid communities of vagrants and "disorderly persons."

Mire and Medicine

Medical beliefs further encouraged sanitary care. Throughout the early modern period it was generally believed that plague and other epidemic diseases were caused or spread by corrupt airs or miasma produced by rotting organic matter. Environmental regulation thus sought to prevent evil smells. Perfumes and fumigants were used to purify infected spaces; street cleaning often intensified in periods of epidemic. In late-sixteenth- and early-seventeenth-century London, for instance, householders were required to sweep in front of their houses every morning and evening. During the early seventeenth century the boards of health of northern Italian states energetically sought to remove dunghills and other sources of miasma from the towns and villages under their jurisdiction.

Early modern doctors knew of "miasma" from a range of classical works, especially those of the ancient Greek physician Hippocrates. From the mid-seventeenth century medical authors became preoccupied with one strand of his work—the relation between epidemics and the airs, waters, and weather of particular places. Population statistics derived from bills of mortality and parish registers revealed geographical variations in the incidence of fevers and other fatal diseases; eighteenth-century analyses of air by natural philosophers like the English chemist Joseph Priestley sought to isolate mephitic substances that caused disease. Many eighteenth-century doctors proposed ways of reducing mortality by draining marshes, ventilating buildings, and reorganizing the environments and the ways in which people lived. Such interventions in the physical environment were often associated with proposals for the police of national populations. The term "police" had wider connotations than does its modern usage. It expressed a desire for the regulation of all aspects of life in order to achieve a smoothly functioning polity and (crucially) a healthy and productive population. The work of the German professor Johann Peter Frank exemplified the scale of this concept. His six-volume System of Medical Police (1779–1817) recommended the regulation of everything from midwifery and marriage to water supply and street cleaning.

The impact of medical police was less than the ambition of its advocates. Nevertheless, eighteenth-century Europe did see medically inspired reforms of daily life. In the 1750s, for instance, the British physicians Stephen Hales and John Pringle oversaw the installation of ventilators in the notoriously disease-ridden London prison of Newgate. In the 1780s the French Royal Society of Medicine not only declared that the Cemetery of the Holy Innocents in Paris was so full that it was a threat to public health but also had it closed and all human remains removed from it. More generally there was a considerable extension of new forms of sanitation, bathing and hygiene in hospitals, barracks, and similar institutions.

Water Supplies

These reforms were restricted by the general scarcity of water in preindustrial Europe. Clearly, this was a pressing problem in arid regions like southern Spain, where elaborate systems of water regulation were developed during the Middle Ages. But water was also a limited and costly resource in northern European communities not associated with drought. In eighteenth-century Paris, for example, a cubic meter of water would have cost a laborer more than two days' wages. Households spent much time and energy fetching water from rivers, streams, and wells. Communal life literally revolved around water sources. In larger urban centers public authorities maintained wells and sponsored schemes to pipe water to public fountains or conduits. In 1585–1587, for instance, Pope Sixtus V established the Acqua Felice, redeveloping the waters of an ancient aqueduct, the Aqua Alexandrina, in order to supply the eastern districts of Rome. Princely and aristocratic fountains like those at Louis XIV's palace of Versailles were, by contrast, ostentatious displays of conspicuous consumption.

The comparative scarcity of water remained a structural characteristic of European society throughout the early modern period. However, the sixteenth and seventeenth centuries saw the establishment of the first water companies piping supplies to the houses of private paying customers. The London Bridge Water Company (established 1582) and New River Company, which began supplying London in 1613, were among the first such concerns. They soon had imitators. By around 1700 one could rent a piped water supply in nine of the ten largest English provincial towns. Such companies were unevenly spread across Europe—no water company operated in Paris until after the French Revolution—and the supplies they offered were unreliable and intermittent. However, they did pioneer new technology. Eighteenth-century water companies were among the first users of steam power, and thus laid the foundations for the subsequent industrialization of urban water supplies. In the nineteenth century the intellectual heritage of medical police combined with such technological developments to produce the public reforms that are conventionally associated with the term sanitation.

Bibliography

Corbin, Alain. The Foul and the Fragrant: Odor and the French Social Imagination. Cambridge, Mass., 1986.

Jenner, Mark S. R. "From Conduit Community to Commercial Network? Water in London 1500–1725." In Londinopolis: Essays in the Cultural and Social History of Early Modern London. Edited by Paul Griffiths and Mark S. R. Jenner. Manchester, U.K., and New York, 2000.

Riley, J.C. The Eighteenth-Century Campaign Against Disease. Basingstoke, U.K., and London, 1987.

Roche, D. "Le temps de l'eau rare: Du Moyen Age à l'Epoque Moderne." Annales: Economies, sociétés, civilisations 39 (1984): 383–399.

Rosen, George. A History of Public Health. Reprint. New York, 1993. Chaps. 3–5.

Stuart, Kathy. Defiled Trades and Social Outcasts: Honor and Ritual Pollution in Early Modern Germany. Cambridge, U.K., and New York, 1999.

For a website devoted to the history of the water supply of the city of Rome: http://www.iath.virginia.edu/waters/.

—MARK JENNER

The establishment of conditions favorable to health, especially with respect to infectious diseases. Includes disposal of infective materials, especially carcasses, discharges and excrement, application of disinfectants and general cleaning to make disinfection effective, isolation of infective animals and improvement in ventilation of buildings, improving feeding and watering arrangements to avoid fecal and urinary contamination of food and water.

The science of maintaining a healthful, disease- and hazard-free environment.

For other uses, see Sanitization (classified information).

E. coli bacteria under magnification

Sanitation is the hygienic means of promoting health through prevention of human contact with the hazards of wastes. Hazards can be either physical, microbiological, biological or chemical agents of disease. Wastes that can cause health problems are human and animal feces, solid wastes, domestic wastewater (sewage, sullage, greywater), industrial wastes and agricultural wastes. Hygienic means of prevention can be by using engineering solutions (e.g. sewerage and wastewater treatment), simple technologies (e.g. latrines, septic tanks), or even by personal hygiene practices (e.g. simple handwashing with soap).

The World Health Organization states that:

"Sanitation generally refers to the provision of facilities and services for the safe disposal of human urine and feces. Inadequate sanitation is a major cause of disease world-wide and improving sanitation is known to have a significant beneficial impact on health both in households and across communities. The word 'sanitation' also refers to the maintenance of hygienic conditions, through services such as garbage collection and wastewater disposal.^[1]

The term "sanitation" can be applied to a specific aspect, concept, location or strategy, such as:

• Basic sanitation - refers to the management of human faeces at the household level. This terminology is the indicator used to describe the target of the Millennium Development Goal on sanitation.
• On-site sanitation - the collection and treatment of waste is done where it is deposited. Examples are the use of pit latrines, septic tanks, and Imhoff tanks.
• Food sanitation - refers to the hygienic measures for ensuring food safety.
• Environmental sanitation - the control of environmental factors that form links in disease transmission. Subsets of this category are solid waste management, water and wastewater treatment, industrial waste treatment and noise and pollution control.
• Ecological sanitation - an approach that tries to emulate nature through the recycling of nutrients and water from human and animal wastes in a hygienically safe manner.

Contents 1 History 2 Wastewater 2.1 Wastewater collection 2.2 Wastewater treatment 2.2.1 On-site treatment 2.2.2 Reuse of wastewater 2.3 Ecological sanitation 2.4 Sanitation and public health 2.5 Global access to improved sanitation 3 Solid waste disposal 4 Food preparation 5 Improving access 6 Regulation 7 See also 8 References 9 External links

History

Further information: History of water supply and sanitation

The earliest evidence of urban sanitation was seen in Harappa, Mohenjo-daro and the recently discovered Rakhigarhi of Indus Valley civilization. This urban plan included the world's first urban sanitation systems. Within the city, individual homes or groups of homes obtained water from wells. From a room that appears to have been set aside for bathing, waste water was directed to covered drains, which lined the major streets.

Roman cities and Roman villas had elements of sanitation systems, delivering water in the streets of towns such as Pompeii, and building stone and wooden drains to collect and remove wastewater from populated areas - see for instance the Cloaca Maxima into the River Tiber in Rome. But there is little record of other sanitation in most of Europe until the High Middle Ages. Unsanitary conditions and overcrowding were widespread throughout Europe and Asia during the Middle Ages, resulting periodically in cataclysmic pandemics such as the Plague of Justinian (541-42) and the Black Death (1347–1351), which killed tens of millions of people and radically altered societies.^[2]

Very high infant and child mortality prevailed in Europe throughout medieval times, due not only to deficiencies in sanitation but to an insufficient food supply for a population which had expanded faster than agriculture.^[3] This was further complicated by frequent warfare and exploitation of civilians by autocratic rulers.

Wastewater

Wastewater collection

For more details on this topic, see Wastewater.

The standard sanitation technology in urban areas is the collection of wastewater in sewers, its treatment in wastewater treatment plants for reuse or disposal in rivers, lakes or the sea. Sewers are either combined with storm drains or separated from them as sanitary sewers. Combined sewers are usually found in the central, older parts or urban areas. Heavy rainfall and inadequate maintenance can lead to combined sewer overflows or sanitary sewer overflows, i.e. more or less diluted raw sewage being discharged into the environment. Industries often discharge wastewater into municipal sewers, which can complicate wastewater treatment unless industries pre-treat their discharges.^[4]

The high investment cost of conventional wastewater collection systems are difficult to afford for many developing countries. Some countries have therefore promoted alternative wastewater collection systems such as condominial sewerage, which uses smaller diameter pipes at lower depth with different network layouts from conventional sewerage.

Wastewater treatment

For more details on this topic, see Sewage treatment.

Sewage treatment plant, Australia.

In developed countries treatment of municipal wastewater is now widespread,^[5] but not yet universal (for an overview of technologies see wastewater treatment). In developing countries most wastewater is still discharged untreated into the environment. For example, in Latin America only about 15% of collected sewerage is being treated (see water and sanitation in Latin America)

On-site treatment

Main article: Septic tank

In many suburban and rural areas households are not connected to sewers. They discharge their wastewater into septic tanks or other types of on-site sanitation. On-site systems include drain fields, which require significant area of land. This makes septic systems unsuitable for most cities.

Reuse of wastewater

The reuse of untreated wastewater in irrigated agriculture is common in developing countries. The reuse of treated wastewater in landscaping, especially on golf courses, irrigated agriculture and for industrial use is becoming increasingly widespread.

Ecological sanitation

For more details on this topic, see Ecological sanitation.

Ecological sanitation is sometimes presented as a radical alternative to conventional sanitation systems. Ecological sanitation is based on composting or vermicomposting toilets where an extra separation of urine and feces at the source for sanitization and recycling has been done. It thus eliminates the creation of blackwater and eliminates fecal pathogens. If ecological sanitation is practiced municipal wastewater consists only of greywater, which can be recycled for gardening. However, in most cases greywater continues to be discharged to sewers.

Sanitation and public health

The importance of the isolation of waste lies in an effort to prevent diseases which can be transmitted through human waste, which afflict both developed countries as well as developing countries to differing degrees. It is estimated that up to 5 million people die each year from preventable water-borne disease,^[6] as a result of inadequate sanitation and hygiene practices. The effects of sanitation have also had a large impact on society. The results of studies published in Griffins Public Sanitation show that better sanitation produces an enhanced feeling of wellbeing.^{[citation needed]}

Relevant disease include:

• Waterborne diseases, which can contaminate drinking water
• Diseases transmitted by the fecal-oral route
• Hookwork, where eggs can survive in the soil

Global access to improved sanitation

The Joint Monitoring Program for water and sanitation of WHO and UNICEF has defined improved sanitation as

• connection to a public sewer
• connection to a septic system
• pour-flush latrine
• simple pit latrine
• ventilated improved pit latrine^[7]

According to that definition, 62% of the world's population has access to improved sanitation in 2008, up by 8% since 1990.^[8] Only slightly more than half of them or 31% of the world population lived in houses connected to a sewer. Overall, 2.5 billion people lack access to improved sanitation and thus must resort to open defecation or other unsanitary forms of defecation, such as public latrines or open pit latrines.^[9] This includes 1.2 billion people who have access to no facilities at all.^[10] This outcome presents substantial public health risks as the waste could contaminate drinking water and cause life threatening forms of diarrhea to infants. Most cities can neither afford a sewage drainage system, nor a sewage treatment system, as Sunita Narain spelled out in the magazine D+C Development and Cooperation. Improved sanitation, including hand washing and water purification, could save the lives of 1.5 million children who die from diarrheal diseases each year.^[10]

In developed countries, where less than 20% of the world population lives, 99% of the population has access to improved sanitation and 81% were connected to sewers.

Solid waste disposal

For more details on this topic, see Waste management.

Hiriya Landfill, Israel.

Disposal of solid waste is most commonly conducted in landfills, but incineration, recycling, composting and conversion to biofuels are also avenues. In the case of landfills, advanced countries typically have rigid protocols for daily cover with topsoil, where underdeveloped countries customarily rely upon less stringent protocols.^[11] The importance of daily cover lies in the reduction of vector contact and spreading of pathogens. Daily cover also minimises odor emissions and reduces windblown litter. Likewise, developed countries typically have requirements for perimeter sealing of the landfill with clay-type soils to minimize migration of leachate that could contaminate groundwater (and hence jeopardize some drinking water supplies).

For incineration options, the release of air pollutants, including certain toxic components is an attendant adverse outcome. Recycling and biofuel conversion are the sustainable options that generally have superior life cycle costs, particularly when total ecological consequences are considered.^[12] Composting value will ultimately be limited by the market demand for compost product.

Food preparation

Modern restaurant food preparation area.

Sanitation within the food industry means the adequate treatment of food-contact surfaces by a process that is effective in destroying vegetative cells of microorganisms of public health significance, and in substantially reducing numbers of other undesirable microorganisms, but without adversely affecting the food or its safety for the consumer (U.S. Food and Drug Administration, Code of Federal Regulations, 21CFR110, USA). Sanitation Standard Operating Procedures are mandatory for food industries in United States, which are regulated by 9 CFR part 416 in conjunction with 21 CFR part 178.1010. Similarly, in Japan, food hygiene has to be achieved through compliance with food sanitation law.^[13]

Additionally, in the food and biopharmaceutical industries, the term sanitary equipment means equipment that is fully cleanable using clean-in-place (CIP) and sterilization-in-place (SIP) procedures: that is fully drainable from cleaning solutions and other liquids. The design should have a minimum amount of deadleg^[14] or areas where the turbulence during cleaning is insufficient to remove product deposits. In general, to improve cleanability, this equipment is made from Stainless Steel 316L, (an alloy containing small amounts of molybdenum). The surface is usually electropolished to an effective surface roughness of less than 0.5 micrometre to reduce the possibility of bacterial adhesion.

Improving access

The United Nations Millennium Development Goals (MDGs) include a target to reduce by half the proportion of people without access to basic sanitation by 2015. In December 2006, the United Nations General Assembly declared 2008 'The International Year of Sanitation', in recognition of the slow progress being made towards the MDGs sanitation target.^[15] The year aims to develop awareness and action to meet the target. Particular concerns are:

• Removing the stigma around sanitation, so that the importance of sanitation can be more easily and publicly discussed.
• Highlighting the poverty reduction, health and other benefits that flow from better hygiene, household sanitation arrangements and wastewater treatment.

Research from the Overseas Development Institute suggests that sanitation and hygiene promotion needs to be better 'mainstreamed' in development, if the MDG on sanitation is to be met. At present, promotion of sanitation and hygiene is mainly carried out through water institutions. The research argues that there are, in fact, many institutions that should carry out activities to develop better sanitation and hygiene in developing countries. For example, educational institutions can teach on hygiene, and health institutions can dedicate resources to preventative works (to avoid, for example, outbreaks of cholera).^[16]

The Institute of Development Studies (IDS) coordinated research programme on Community-led Total Sanitation (CLTS) is a radically different approach to rural sanitation in developing countries and has shown promising successes where traditional rural sanitation programmes have failed. CLTS is an unsubsidized approach to rural sanitation that facilitates communities to recognize the problem of open defecation and take collective action to clean up and become ‘open defecation free’. It uses community-led methods such as participatory mapping and analysing pathways between feces and mouth as a means of galvanizing communities into action. An IDS 'In Focus' Policy Brief suggests that in many countries the Millennium development goal for sanitation is off track and asks how CLTS can be adopted and spread on a large scale in the many countries and regions where open defecation still prevails.^[17]

Regulation

In United States, sanitation is a legislative requirement of occupational safety and health, which is governed by 29 CFR Part 1910.141.^[18]

See also

• Disinfectant
• Environmental epidemiology
• Environmental health
• Epidemiology
• International sanitary conferences
• Lifewater International
• Micro credit for water supply and sanitation
• National Sanitation Foundation
• Public health
• Sewage collection and disposal
• Trap (plumbing)
• Waste management
• Water and sanitation program
• Water crisis
• Water pollution
• Water supply
• Water supply and sanitation in Sub-Saharan Africa
• World Plumbing Council
• World Toilet Organization

References

1. ^ who.int
2. ^ Carlo M. Cipolla, Before the Industrial Revolution: European Society and Economy 1000-1700, W.W. Norton and Company, London (1980) ISBN 0-393-95115-4
3. ^ Burnett White, Natural History of Infectious Diseases
4. ^ Environmental Biotechnology: Advancement in Water And Wastewater Application, edited by Z. Ujang, IWA Proceedings, Malaysia (2003)
5. ^ Typical U.S. water treatment standards
6. ^ Pacific Institute
7. ^ The Joint Monitoring Programme of WHO and UNICEF:definitions
8. ^ WHO
9. ^ Sanitation and drinking water: is the world on track? Circle of Blue, July 31, 2008
10. ^ ^{a b} World Health Organization and UNICEF. Progress on Drinking Water and Sanitation: Special Focus on Sanitation.
11. ^ George Tchobanoglous and Frank Kreith Handbook of Solid Waste Management, McGraw Hill (2002)
12. ^ William D. Robinson, The Solid Waste Handbook: A Practical Guide, John Wiley and sons (1986)
13. ^ Japan External Trade Organization. "Food Sanitation Law in Japan" (PDF). http://www.jetro.go.jp/en/market/regulations/pdf/food-e.pdf. Retrieved 1 March 2008. 
14. ^ Treatment of deadleg plumbing areas
15. ^ "Peri-urban Water and Sanitation Services". Springer. 2010. http://www.springer.com/978-90-481-9424-7. 
16. ^ "Sanitation and Hygiene: knocking on new doors" (PDF). Overseas Development Institute. 2006. http://www.odi.org.uk/resources/details.asp?id=48&title=sanitation-hygiene-knocking-doors. Retrieved 2007. 
17. ^ 'Beyond Subsidies - Triggering a Revolution in Rural Sanitation' Institute of Development Studies (IDS) In Focus Policy Brief 10 July 2009.
18. ^ Code of Federal Regulations. "1910.141 Sanitation" (PDF). http://a257.g.akamaitech.net/7/257/2422/06sept20031800/edocket.access.gpo.gov/cfr_2003/julqtr/pdf/29cfr1910.141.pdf. Retrieved 1 March 2008. 

External links

Look up sanitation in Wiktionary, the free dictionary.

• Urban Wastewater Treatment in France, MEEDDM
• IRC International Water and Sanitation Centre, the Hague, the Netherlands
• [1]
• Sanitation, Hygiene and Wastewater Resource Guide (World Bank)
• Tilley et al.: Compendium of Sanitation Systems and Technologies, Water Supply and Sanitation Collaborative Council / Swiss Federal Institute of Aquatic Science and Technology (EAWAG), 2008
• Central Asia Health Review (CAHR). Poor Sanitation Causes Death among Children under Five in Afghanistan
• The 2006 UNDP Human Development Report: Beyond scarcity: Power, poverty and the global water crisis - Chapter 3: The vast deficit in sanitation accessed on August 22, 2007
• Water Supply and Sanitation, World Bank accessed on August 22, 2007
• Early urban sanitation in ancient India
• Sanitation coverage vs. population growth: an encouraging trend
• Daily cover in landfills
• Hy2U innovative handwashing device and campaign
• Your Health in Your Hands UNICEF Documentary narrated by Khaled Abol Naga
• Poo Productions, music and film organization raising awareness about sanitation issues
• Akvo.org - The open source for water and sanitation, including the Akvopedia, water and sanitation wiki
• Community-Led Total Sanitation (CLTS)
• India's National Level portal on Sanitation
• Google - public data "Improved sanitation facilities, urban (% of urban population with access)"
• Indian cities cannot simply flush Development and Cooperation International Journal

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Dansk (Danish)
n. - hygiejne, sanitetsvæsen, sanitet, teknisk hygiejne

Nederlands (Dutch)
afvalverwerking, rioolwaterzuivering

Français (French)
n. - installations sanitaires

Deutsch (German)
n. - Kanalisation, Hygiene

Ελληνική (Greek)
n. - υγιεινή, εξυγίανση, αποκομιδή αποβλήτων και σκουπιδιών από σπίτια

Italiano (Italian)
igiene, fognature, nettezza urbana

Português (Portuguese)
n. - saneamento (m)

Русский (Russian)
оздоровление, санация, улучшение санитарных условий, санитария, санитарная профилактика, водопровод и канализация, ассенизация

Español (Spanish)
n. - higiene, saneamiento

Svenska (Swedish)
n. - renhållning, sanitär utrustning, sanitära anläggningar, hälsovård

中文（简体）(Chinese (Simplified))
公共卫生, 环境卫生, 下水道设施, 卫生设备, 盥洗设备

中文（繁體）(Chinese (Traditional))
n. - 公共衛生, 環境衛生, 下水道設施, 衛生設備, 盥洗設備

한국어 (Korean)
n. - 공중 위생, 위생 시설, 하수구 설비

日本語 (Japanese)
n. - 公衆衛生, 衛生設備

العربيه (Arabic)
‏(الاسم) جعل ألشيء صحيا‏

עברית (Hebrew)
n. - ‮תברואנות, סניטציה‬

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