Drainage systems, an occluded source of sanitation related outbreaks

Blom, Kristina

In excreta disposal there is a high load of microorganisms such as viruses, bacteria, fungi, and protozoa that could cause infections [30, 31] . Based on the study of Korzeniewska and Harnisz, the load of enteric bacteria is probably underestimated due to insufficient detection methods [32] . Furthermore, it has been shown that both air and water are contaminated by bacteria in the sewage at Wastewater Treatment Plants (WWTP) jeopardizing the health of both plant workers and surrounding population [32] . Clearly human excreta must be managed in a safe way to minimize the risk of exposure to microbes of clinical significance. This condition is further realized in regulations and guidance documents by e.g. the Centers for Disease Control and Prevention (CDC), Health Safety Executive (HSE) in UK, and Environmental Protection Agencies (EPA) to assure safe working environment for workers exposed to excreta disposal [33] [34] [35] . Sadly, despite abolition of manual scavenging in India, about 1.2 million scavengers work as sanitary workers and face numerous health hazards among them infections [36] .