World Toilet Day is about taking action to tackle the global sanitation crisis and achieve Sustainable Development Goal 6: water and sanitation for all by 2030.

Washroom, toilet, bathroom

A report from the World Health Organization shows that 40% of the world’s population currently does not have access to reasonable public health facilities, making infectious diseases raging and killing 2 million people every year.

The creation of toilet civilization is a basic livelihood issue, and it is also a window to human civilization.

To create a toilet civilization requires the joint efforts of mankind. The toilet problem is a common problem faced by most developing countries, and some developed countries also have shortcomings. The purpose of designing World Toilet Day is to inspire people to raise awareness, take actions, create a toilet civilization, improve human health and hygiene index, life happiness index, promote the construction of basic sanitation facilities, and advocate a clean, comfortable and hygienic environment for everyone. Since fecal-oral transmission was confirmed as a channel for the spread of the new crown pneumonia epidemic, epidemic prevention in public toilets has become a hot topic in society. Since the beginning of this year, companies in the industry have begun to develop new technologies and products for toilet epidemic prevention, improve new standards for toilet cleaning, and upgrade new models of toilet management. People all over the world work together to improve the world’s environmental sanitation problems and continuously improve the level of toilet civilization.

toilet seat

China’s toilet revolution demonstrates the responsibility for people’s livelihood. Small toilets, great people’s livelihood. The toilet problem is related to the improvement of the tourism environment, the improvement of the quality of life of the broad masses of people, the improvement of national quality and the progress of social civilization. During the “Thirteenth Five-Year Plan” period, the “toilet revolution” is in full swing and deepening in our country, gradually expanding from cities to rural areas. From 2018 to 2020, 64,000 tourist toilets will be built, renovated and expanded nationwide. At present, the penetration rate of sanitary toilets in rural areas across the country has reached more than 65%. Today, public toilets have become landscapes, and the renovation of rural toilets has been fully popularized. The toilet revolution has achieved fruitful results. Dirty, messy, poor, few, and partial toilets have become a thing of the past. “Toilet problem is not a trivial matter.” It is necessary to “strive to make up for this short board that affects the quality of life of the masses.” The Chinese toilet revolution has improved the happiness index of people’s livelihood and improved the level of social civilization. Beautiful toilets are becoming a business card of the development level of the times.

toilet in airport

The toilet expo will add technology wings to toilet civilization. The creation of toilet civilization is not only an issue of environmental sanitation, people’s livelihood and happiness, but also an issue of technological progress. The China Toilet Revolution Innovation Expo (abbreviated as: Toilet Expo) was founded in 2016 and held in Shanghai every November to discuss the direction of sustainable development and help The revolutionary development of the toilet has achieved good results over the years, and its influence has continued to expand. The theme of the 2020 Shanghai Toilet Expo is “toilet revolution” leading the new trend of future public health space development, responding to the call of the national “toilet revolution” covering all fields, involving housing construction, tourism, culture, education, sanitation and other systems, showing new technologies, New materials, new processes and new equipment. The toilet expo is an important carrier to promote toilet civilization to a higher level. This year’s Toilet Expo will fully demonstrate new technologies and products for public toilets in the exhibition section and technical forums. At the same time, a special technical forum on public toilets will be opened. Experts, scholars, and business representatives will be invited to share information on toilet epidemic prevention to the public. The importance and good habits of civilized toileting provide new opportunities for the toilet industry to resume work and production after the epidemic, and make a solid contribution to the continued construction of the anti-epidemic defense line.

On Toilet Day, toilet civilization helps human beings become healthier. The rapid development of urbanization, the continuous growth of urban population, the continuous increase of the people’s happiness demand index, and the continuous improvement of the level of toilet civilization are to strengthen the planning, construction and management of public health spaces and are important measures to improve the urban living environment. From the toilet day to the toilet expo, toilet civilization cannot be ignored. To create toilet civilization, escort a healthy life, the development of a beautiful era, the public environment is bound to become better and better, and the people’s health level is bound to improve.

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However various studies have shown that hygiene compliance rates in these critical industries are not what they should be. According to WHO, even in resource-rich hospital settings, hand hygiene compliance can be well below 40 per cent. Elsewhere, the Food Standards Agency found that a shocking 39 per cent of staff do not wash their hands after visiting the toilet, and a huge 53 per cent do not wash their hands before preparing food. Hand hygiene has a part to play in general washrooms too – less than six per cent of the population wash their hands adequately according to a study by Borchgrevink, C.P. et al.

So why is this the case, and how can better hand hygiene compliance be promoted and put into place?

Hygiene critical areas: healthcare

The first and most obvious area where hand hygiene is critical is healthcare. Healthcare Associated Infections (HCAIs) are a persistent and serious health threat to patients, and inadequate hand hygiene compliance has a significant part to play in this. In the UK alone, a study by the University of Nottingham found that HCAIs caused by hospital superbugs such as C.difficile and MRSA are responsible for at least 5,000 deaths a year; greater than the number associated with road traffic accidents.

There are several reasons for low hand hygiene compliance in healthcare. According to a report by the AHA Health Forum, the issue is twofold: the human factor, and the method of reporting. On an individual level, insufficient education can lead to common misconceptions; that glove use does not necessitate hand washing; demands being placed on medical staff can lead to fewer hand hygiene events than necessary, or simply forgetfulness. Furthermore, when it comes to reporting hand hygiene compliance, data can also be inaccurate. If measured incorrectly, the required actions are less likely to be implemented when it comes to a hand hygiene review.

Tackling hand hygiene compliance can come in many forms. Greater awareness and education is needed, for example, the teaching of the WHO’S 5-Moments for Hand Hygiene. Strategic placement of resources around healthcare facilities can aid this, encouraging and reminding healthcare professionals when to sanitise and clean.

Alcohol-based hand sanitisers have been cited by the WHO as an essential, complementary method to washing with soap to drive hand hygiene compliance within healthcare facilities, as they require less time and are highly effective at killing potentially harmful germs. Well-placed dispenser points, and smaller more portable pump packs can also be effective here.

Monitoring can also assist when evaluating hand hygiene rates. Existing observation methods can be unreliable, but technology-based electric monitoring systems can both remind professionals of hand hygiene events and record these. They have been proven to provide accurate and reliable data on true hand hygiene compliance levels to help identify areas for improvement.

Hygiene critical areas: the food industry

Another critical area for hand hygiene compliance is the food industry, where the cross contamination of food can cause serious illness outbreaks. Thirty per cent of foodborne illness outbreaks can be traced to poor personal hygiene according to a study by Epidemiol, but many of these diseases are preventable through proper hand washing.

A study by Oregon State University found that the top factors affecting hand hygiene compliance were time constraints, inadequate facilities, a lack of accountability and a lack of general support for hand washing practices in the workplace. With the fast pace and turnover of the food industry, factors such as language barriers and unfamiliarity with the working environment can also lead to misunderstandings and a low compliance rate.

Long-term behavioural change needs to be driven in order to improve hand hygiene compliance in the food industry. More awareness and education of the risks and procedures involved is recommended, ensuring that proper training is fulfilled so that employees are aware of how to avoid cross-contamination. However for high compliance, the right products need to be provided at the right times – an on-site assessment can help with this, by identifying critical hand hygiene control points.

As with the healthcare environment, if products are clearly signposted and labelled, this will assist in promoting thorough and compliant hand washing.  Hand washing should also be incorporated with the use of hand sanitisers, which can be used without water, at the point of need, to provide rapid and easily accessible hand hygiene.

Protecting the general population

When it comes to the general washroom, although less hygiene critical in relation to acute illnesses, hand washing is important when it comes to infection prevention across the general population in places such as offices, schools and public spaces. According to the Centre for Economic and Business Research, the UK economy lost €4.9 billion in 2013 due to poor hygiene related sick leave.

The WHO states that 80 per cent of germs are spread through personal contact or by touching contaminated surfaces, and in office environments, for example, if hand hygiene is not promoted it can quickly manifest in absenteeism and loss of productivity.

A recent survey by the Royal Society for Public Health also found that although the importance of hand hygiene is generally well understood by the public, there is some confusion over the relationship between germs and hygiene, and the times and situations where hand washing is most vital.

There are a wide range of factors that contribute to low hand hygiene compliance levels in general washrooms. An understanding of the difference between washroom types is vital, as is awareness amongst users. In offices, for example, it is critical to bring raised awareness of hand hygiene and the potential risks to truly drive compliance. Resources such as posters and signs can help encourage this, as can training and skin care plans.

One of the important factors is quality product provision and its presentation. Products which are easy and enjoyable to use, have a pleasant scent and care for the skin communicate freshness and cleanliness to the user, thus encouraging hand hygiene compliance.

Despite the above, hygiene compliance rates can swiftly become irrelevant if the washroom itself is unhygienic, or the products contaminated. Commonly seen in general washrooms, open soap systems that are bulk filled can actually present a serious hygiene problem. Airborne germs and bacteria can enter the soap reservoir, potentially contaminating the soap – these dispensers are also often inadequately cleaned or refilled.

Procedure states that they should be emptied and cleaned thoroughly on each refill, however this rarely happens, meaning that contaminated soap is simply topped up. According to a study by Chattman, Maxwell and Gerba, a huge 25 per cent of public refillable bulk soap dispensers are contaminated with unsafe levels of bacteria and can actually leave the hands with 25 times more bacteria after washing.

Maximum hygiene

Cartridge soap dispensers which are sealed will bring maximum hygiene, with a measured dose of fresh product dispensed each time. The maintenance of washrooms has a significant impact on hand hygiene, and with a more readily replaceable cartridge, this is made easier and simpler for cleaning professionals. With visibly cleaner and more pleasant soap dispensers, users are far more likely to wash hands thoroughly and carry out a full hand hygiene event.

Not only are soap cartridges more hygienic, when coupled with foam soaps, they are much more cost effective with savings on refill time and water use, as well as reducing product usage and packaging.

Although the risks of inadequate hand hygiene are clear to most users, a clean washroom and availability of product is often the primary concern. Whether in hygiene-critical environments or general washrooms, it is clear that more could be done to really raise awareness of the risk, and make hand hygiene matter to users.

Time constraints, lack of awareness and proper facilities are common factors across all sectors from hospitals to office washrooms. More education, raised awareness and the provision of quality, safe skin care products could have a huge impact on hand hygiene compliance rates, thus reducing the spread of infection and ultimately the risk to life across all industries.

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Any healthcare worker, caregiver or person involved in the direct or indirect care of the patient has to be involved in hand hygiene and must be able to perform it correctly and at the right time.

Disinfect your hands by preferably rubbing them with an alcoholic preparation for routine hand hygiene when the hands do not show visible dirt. It is faster, more effective and respectful with your hands than washing with soap and water. Wash your hands with soap and water when they are visibly dirty or after using the bathroom. If there is a strong suspicion of exposure to possible spore-forming pathogens, including outbreaks of Clostridium difficile, the mode of choice for handwashing is with soap and water.

More information on http://www.who.int/gpsc/pops/en/

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