Little has been studied about the potential risks and hazards arising from the use and operation of container-based sanitation (CBS) systems. Building on existing risk assessment frameworks, this case study aimed to identify exposure risks from faecal pathogens and relevant control measures in a CBS service chain. The case study employed a mixed-methods approach that included environmental sampling, key informant interviews, and direct observation. This inclusion of a behavioural dimension reflects a socio-cultural approach to risk analysis that is less evident in overtly quantitative approaches to risk assessment that are typical of the health risk field. Data from this case study was collected in Naivasha, Kenya in July 2016. The hazard intensity and role of specific transmission routes was validated by environmental sampling, which found a high level of faecal contamination on toilet surfaces and a consequent high risk of hand-to-mouth infection for users and operators. The hazard analysis identified nine critical control points where exposure risks may be either prevented or reduced via the implementation of relevant control measures. We discovered that the production of exposure risks was related to multiple, inter-related causal mechanisms and risk factors, findings we expect will guide approaches to exposure risk management in the future.

Abad, F.X., Villena, C., Guix, S., Caballero, S., Pinto, R.M. and Bosch, A. (2001) ‘Potential role of fomites in the vesicular transmission of human astroviruses’, Applied and Environmental Microbiology 67(9): 3904–7 <http://dx.doi.org/10.1128/AEM.67.9.3904-3907>.

Ajzen, I. (1985) ‘From intentions to actions: a theory of planned behavior’, in J. Kuhl and J. Beckmann (eds), Action Control: From Cognition to Behaviour, Berlin: Springer-Verlag.

Antwi-Agyei, P., Peasey, A., Biran, A., Bruce, J. and Ensink, J. (2016) ‘Risk perceptions of wastewater use for urban agriculture in Accra, Ghana’, PloS One 11(3): e0150603.

Bain, R., Cronk, R., Hossain, R., Bonjour, S., Onda, K., Wright, J., Yang, H. (2014) ‘Global assessment of exposure to faecal contamination through drinking water based on a systematic review’, Tropical Medicine & International Health: TM & IH 19(8): 917–27.

Baker, K.K., O’Reilly, C.E., Levine, M.M., Kotloff, K.L., Nataro, J.P., Ayers, T.L., Farag, T.H. (2016) ‘Sanitation and hygiene-specific risk factors for moderate-to-severe diarrhea in young children in the Global Enteric Multicenter Study, 2007–2011: case-control study’, PLoS Medicine 13(5): 2007–11 <http://dx.doi.org/10.1371/journal.pmed.1002010>.

Barker, J. and Bloomfield, S.F. (2000) ‘Survival of Salmonella in bathrooms and toilets in domestic homes following salmonellosis’, Journal of Applied Microbiology 89(1): 137–44 <http://dx.doi.org/10.1046/j.1365-2672.2000.01091.x>.

Berner, C., Woods, E. and Foote, A. (2015) ‘Waste transformation, not waste treatment: understanding the value of poop in Sanivation’s waste processing model for cities’, in Faecal Sludge Management (FSM) 4 Conference Proceedings – Case Study Abstracts, pp. 3–5.

Bischel, H.N., Özel Duygan, B.D., Strande, L., McArdell, C.S., Udert, K.M. and Kohn, T. (2015) ‘Pathogens and pharmaceuticals in source-separated urine in eThekwini, South Africa’, Water Research 85: 57–65 <http://dx.doi.org/10.1016/j.watres.2015.08.022>.

Bleck, D. and Wettberg, W. (2012) ‘Waste collection in developing countries: tackling occupational safety and health hazards at their source’, Waste Management 32(11): 2009–17 <http://dx.doi.org/10.1016/j.wasman.2012.03.025>.

Broomfield, M., Davies, J., Furmston, P., Levy, L., Pollard, S.J.T. and Smith, R. (2010) Exposure Assessment of Landfill Sites Volume 1: Main Report, London, UK: Environment Agency.

Brown, J., Cumming, O., Bartram, J., Cairncross, S., Ensink, J., Holcomb, D. and Knee, J. (2015) ‘A controlled, before-and-after trial of an urban sanitation intervention to reduce enteric infections in children: research protocol for the Maputo Sanitation (MapSan) study, Mozambique’, BMJ Open 5(6): e008215.

Buckley, C.A., Foxon, K.M., Hawksworth, D.J., Archer, C., Pillay, S., Appleton, C., Smith, M. and Rodda, N. (2008) Research into UD/VIDP (Urine Diversion Ventilated Improved Double Pit) Toilets: Prevalence and Die-off of Ascaris Ova in Urine Diversion Waste, South Africa: Water Research Commission.

Burgess, T. (2016) Overflowing Cities: The State of the World’s Toilets 2016, London: WaterAid.

Buttner, M.P. and Stetzenbach, L.D. (1993) Monitoring airborne fungal spores in an experimental indoor environment to evaluate sampling methods and the effects of human activity on air sampling’, Applied and Environmental Microbiology 59(1): 219–26.

Cairncross, S., Hunt, C., Boisson, S., Bostoen, K., Curtis, V., Fung, I.C.H. and Schmidt, W.P. (2010) ‘Water, sanitation and hygiene for the prevention of diarrhoea’, International Journal of Epidemiology 39(Suppl. 1): 193–205 <http://dx.doi.org/10.1093/ije/dyq035>.

Campos, L.C., Ross, P., Nasir, Z.A., Taylor, H. and Parkinson, J. (2015) ‘Development and application of a methodology to assess sanitary risks in Maputo, Mozambique’, Environment and Urbanization 27(2): 371–88 <http://dx.doi.org/10.1177/0956247815595784>.

Carrington, E.-G. (2001) Evaluation of Sludge Treatments for Pathogen Reduction [pdf], Luxembourg: European Commission <http://ec.europa.eu/environment/archives/waste/sludge/pdf/sludge_eval.pdf> [accessed 27 September 2018].

Contzen, N. and Mosler, H.J. (2015) Methodological Fact Sheet 1: The Risks, Attitudes, Norms, Abilities, and Self-regulation (RANAS) Approach to Systematic Behavior Change, Dübendorf, Switzerland: Eawag, Swiss Federal Institute of Aquatic Science and Technology.

Curtis, V., Cairncross, S. and Yonli, R. (2000) ‘Domestic hygiene and diarrhoea’, Tropical Medicine and International Health 5(1): 22–32 <http://dx.doi.org/10.1046/j.1365-3156.2000.00512.x>.

Curtis, V., de Barra, M. and Aunger, R. (2011) ‘Disgust as an adaptive system for disease avoidance behaviour’, Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences 366(1563): 389–401 <http://dx.doi.org/10.1098/rstb.2010.0117>.

Darout, I.A., Astrom, A.N. and Skaug, N. (2005) ‘Knowledge and behaviour related to oral health among secondary school students in Khartoum Province, Sudan’, International Dental Journal 55(4): 224–30.

Devamani, C., Norman, G. and Schmidt, W.-P. (2014) ‘A simple microbiological tool to evaluate the effect of environmental health interventions on hand contamination’, International Journal of Environmental Research and Public Health 11(11): 11846–59.

Devine, J. and Devine, J. (2009) Introducing SaniFOAM: A Framework to Analyze Sanitation Behaviors to Design Effective Sanitation Programs [pdf], Water and Sanitation Program Working Paper <http://documents.worldbank.org/curated/en/272351468334778050/pdf/722050WSP0Box30PUBLIC00GSP0sanifoam.pdf> [accessed 26 September 2018].

Drechsel, P., Amoah, P., Löfman, O., Heistad, A., Fodge, M., Jenssen, P. and Stenström, T.A. (2008) ‘Quantitative microbial risk assessment of wastewater and faecal sludge reuse in Ghana’, in J. Hazel (ed.), Proceedings of the 33rd WEDC International Conference on Access to Sanitation and Safe Water: Global Partnerships and Local Actions, Accra, Ghana, 7–11 April 2008, pp. 90–7, Leicestershire, UK: Water, Engineering and Development Centre (WEDC).

du Preez, M., Conroy, R.M., Ligondo, S., Hennessy, J., Elmore-Meegan, M., Soita, A. and McGuigan, K.G. (2011) ‘Randomized intervention study of solar disinfection of drinking water in the prevention of dysentery in Kenyan children aged under 5 years’, Environmental Science & Technology 45: 9315–23 <http://dx.doi.org/10.1021/es2018835>.

Edmunds, K.L., Abd Elrahman, S., Bell, D.J., Brainard, J., Dervisevic, S., Fedha, T.P. and Few, R. (2016) ‘Recommendations for dealing with waste contaminated with Ebola virus: a hazard analysis of critical control points approach’, Bulletin of the World Health Organization (94): 424–32 <http://dx.doi.org/10.2471/BLT.15.163931>.

Emch, M. (1999) ‘Diarrheal disease risk in Matlab, Bangladesh’, Social Science and Medicine 49(4): 519–30 <http://dx.doi.org/10.1016/S0277-9536(99)00146-X>.

Enger, K.S., Nelson, K.L., Rose, J.B. and Eisenberg, J.N.S. (2013) ‘The joint effects of efficacy and compliance: a study of household water treatment effectiveness against childhood diarrhea’, Water Research 47(3): 1181–90 <http://dx.doi.org/10.1016/j.watres.2012.11.034>.

Exley, J.L.R., Liseka, B., Cumming, O. and Ensink, J.H.J. (2015) ‘The sanitation ladder, what constitutes an improved form of sanitation?’ Environmental Science and Technology 49(2): 1086–94 <http://dx.doi.org/10.1021/es503945x>.

Feacham, R., Bradley, D.H., Garelick, H. and Mara, D.D. (eds) (1983) Sanitation and Disease: Health Aspects of Excreta and Wastewater Management, Washington, DC: World Bank.

Forsythe, S.J. (2010) The Microbiology of Safe Food, 2nd edn, London: Blackwell Publishing Ltd.

Graf, J., Meierhofer, R., Wegelin, M. and Mosler, H.J. (2008) ‘Water disinfection and hygiene behaviour in an urban slum in Kenya: impact on childhood diarrhoea and influence of beliefs’, International Journal of Environmental Health Research 18(5): 335–55.

Haagsma, J., Tariq, L., Heederik, D.J. and Havelaar, A.H. (2012) ‘Infectious disease risks associated with occupational exposure: a systematic review of the literature’, Occupational and Environmental Medicine 69(2): 140–6 <http://dx.doi.org/10.1136/oemed-2011-100068>.

Haas, C. (2014) ‘QMRAwiki dose response’ [online], <http://qmrawiki.canr.msu.edu/index.php/Dose_Response> [accessed 26 September 2018].

Höglund, C. (2001) Evaluation of Microbial Health Risks Associated with the Reuse of Source-Separated Human Urine, doctoral thesis, Royal Institute of Technology (KTH) Department of Biotechnology, Applied Microbiology Swedish Institute for Infectious Disease Control (SMI) Department of Water and Environmental Microbiology, Stockholm.

Humphrey, J.H. (2009) ‘Child undernutrition, tropical enteropathy, toilets, and handwashing’, The Lancet 374(9694): 1032–5 <http://dx.doi.org/10.1016/S0140-6736(09)60950-8>.

Hurst, N.W. (1998) Risk Assessment The Human Dimensions, United Kingdom: Royal Society of Chemistry Publishing.

Julian, T.R. (2016) ‘Environmental transmission of diarrheal pathogens in low and middle income countries’, Environmental Science: Processes & Impacts 18: 944–55 <http://dx.doi.org/10.1039/C6EM00222F>.

Julian, T.R., Leckie, J.O. and Boehm, A.B. (2010) ‘Virus transfer between fingerpads and fomites’, Journal of Applied Microbiology 109(6): 1868–74 <http://dx.doi.org/10.1111/j.1365-2672.2010.04814.x>.

Katukiza, A.Y., Ronteltap, M., van der Steen, P., Foppen, J.W.A. and Lens, P.N.L. (2014) ‘Quantification of microbial risks to human health caused by waterborne viruses and bacteria in an urban slum’, Journal of Applied Microbiology 116(2): 447–63 <http://dx.doi.org/10.1111/jam.12368>.

Leveson, N.G. (2011) Engineering a Safer World: Systems Thinking Applied to Safety [pdf] <http://sunnyday.mit.edu/safer-world.pdf> [accessed 27 September 2018].

Leveson, N. (2012) ‘Safety-guided design’, in Engineering a Safer World: Systems Thinking Applied to Safety, Cambridge, MA: Massachusetts Institute of Technology (MIT) Press.

Lingaas, E. and Fagernes, M. (2009) ‘Development of a method to measure bacterial transfer from hands’, Journal of Hospital Infection 72(1): 43–9 <http://dx.doi.org/10.1016/j.jhin.2009.01.022>.

Makaya, J.M., Kaplon, J., Fremy, C., Barro, N., Aho, S., Pothier, P., Belliot, G. and Traore, A.S. (2015) ‘Norovirus and rotavirus survival in urine collected from a public ecological sanitation system in Ouagadougou, Burkina Faso’, Food and Environmental Virology 7(1): 41–8.

Maponga, B.A., Chirundu, D., Gombe, N.T., Tshimanga, M., Shambira, G. and Takundwa, L. (2013) ‘Risk factors for contracting watery diarrhoea in Kadoma City, Zimbabwe, 2011: a case control study’, BMC Infectious Diseases 13: 567.

Mara, D.D. and Oragui, J. (1985) ‘Bacteriological methods for distinguishing between human and animal faecal pollution of water: results of fieldwork in Nigeria and Zimbabwe’, Bulletin of the World Health Organization 63(4): 773–83.

Maricou, H., Verstraete, W. and Mesuere, K. (1998) ‘Hygienic aspects of biowaste composting: airborne microbial concentrations as a function of feedstock, operation and season’, Waste Management & Research 16(4): 304–11 <http://dx.doi.org/10.1177/0734242X9801600402>.

Mattioli, M.C.M., Pickering, A.J., Gilsdorf, R.J., Davis, J. and Boehm, A.B. (2013) ‘Hands and water as vectors of diarrheal pathogens in Bagamoyo, Tanzania’, Environmental Science & Technology 47(1): 355–63 <http://dx.doi.org/10.1021/es303878d>.

Mattioli, M.C.M., Davis, J. and Boehm, A.B. (2015) ‘Hand-to-mouth contacts result in greater ingestion of feces than dietary water consumption in Tanzania: a quantitative fecal exposure assessment model’, Environmental Science & Technology 49(3): 1912–20 <http://dx.doi.org/10.1021/es505555f>.

Mayer, J. (1986) ‘Ecological associative analysis’, in M. Pacione (ed.), Medical Geography: Progress and Prospect, p. 64, London: Croom Helm.

McMahon, S., Caruso, B.A., Obure, A., Okumu, F. and Rheingans, R.D. (2011) ‘Anal cleansing practices and faecal contamination: a preliminary investigation of behaviours and conditions in schools in rural Nyanza Province, Kenya’, Tropical Medicine and International Health 16(12): 1536–40 <http://dx.doi.org/10.1111/j.1365-3156.2011.02879.x>.

Medland, L., Cotton, A.P. and Scott, R.E. (2015) Understanding and Addressing Vulnerability in the Sanitation Service Chain, SPLASH Urban Sanitation Research Programme Briefing Note 3, Loughborough, UK: Water, Engineering and Development Centre (WEDC).

Michie, S., West, R., Campbell, R., Brown, J. and Gainforth, H. (2014) ABC of Behavior Change Theories, 1st edn, London: Silverback Publishing.

Mnkeni, P.N.S., Kutu, F.R., Muchaonyerwa, P. and Austin, L.M. (2008) ‘Evaluation of human urine as a source of nutrients for selected vegetables and maize under tunnel house conditions in the Eastern Cape, South Africa’, Waste Management & Research: The Journal of the International Solid Wastes and Public Cleansing Association, ISWA 26(2): 132–9.

Moore, G. and Griffith, C. (2007) ‘Problems associated with traditional hygiene swabbing: the need for in-house standardization’, Journal of Applied Microbiology 103(4): 1090–103 <http://dx.doi.org/10.1111/j.1365-2672.2007.03330.x>.

Mosler, H. (2012a) ‘A systematic approach to behavior change interventions for the water and sanitation sector in developing countries: a conceptual model, a review, and a guideline’, International Journal of Environmental Health Research 22: 431–49.

Mosler, H. (2012b) ‘How to achieve evidence-based behavioural change’, Sandec News: 14–5.

Moya, J., Bearer, C.F. and Etzel, R. (2004) ‘Various life stages’, Pediatrics 113(4): 996–1006 <http://dx.doi.org/10.1542/peds.113.4.S1.996>.

Mwase, I., Mutoro, A., Owino, V., Garcia, A-L. and Wright, C.M. (2016) ‘Poor infant feeding practices and high prevalence of malnutrition in urban slum child care centres in Nairobi: a pilot study’, Journal of Tropical Pediatrics 62(1): 46–54.

Ngure, F.M., Reid, B.M., Humphrey, J.H., Mbuya, M.N., Pelto, G. and Stoltzfus, R.J. (2014) ‘Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links’, Annals of the New York Academy of Sciences 1308(1): 118–28 <http://dx.doi.org/10.1111/nyas.12330>.

Nyoka, R., Foote, A.D., Woods, E., Lokey, H., O’Reilly, C.E., Magumba, F., Okello, P., Mintz, E.D., Marano, N. and Morris, J.F. (2017) ‘Sanitation practices and perceptions in Kakuma refugee camp, Kenya: comparing the status quo with a novel service-based approach’, PLoS ONE 12(7): 1–16 <http://dx.doi.org/10.1371/journal.pone.0180864>.

O’Keefe, M., Luthi, C., Tumwebaze, I.K. and Tobias, R. (2015) ‘Opportunities and limits to market-driven sanitation services: evidence from urban informal settlements in East Africa’, Environment and Urbanization 27(2): 421–40 <https://doi.org/10.1177%2F0956247815581758>.

Peasey, A. (2000) ‘Health aspects of dry sanitation with waste reuse’, Knowledge Creation Diffusion Utilization 324: 48.

PHE (2013) Detection and Enumeration of Bacteria in Swabs and Other Environmental Samples, Microbiology Services Food Water and Environmental Microbiology Standard Method [online], London: Public Health England, Microbiology Services Food, Water & Environmental Microbiology Methods Working Group <www.hpa.org.uk/ProductsServices/MicrobiologyPathology/SpecialistMicrobiologyServices/FoodWaterEnvironmentalMicrobiologyServices/NationalReferenceLab oratoryForFoodMicrobiology/> [accessed 27 September 2018].

Pickering, A.J., Julian, T.R., Marks, S.J., Mattioli, M.C., Boehm, A.B., Schwab, K.J. and Davis, J. (2012) ‘Fecal contamination and diarrheal pathogens on surfaces and in soils among Tanzanian households with and without improved sanitation’, Environmental Science & Technology 46(11): 5736–43 <http://dx.doi.org/10.1021/es300022c>.

Prüss-üstün, A., Kay, D., Fewtrell, L. and Bartram, J. (2004) ‘Unsafe water, sanitation and hygiene’, in M. Ezzati, A.D. Lopez, A. Rodgers, and C.L.J. Murray (eds), Comparative Quantification of Health Risks Global and Regional Burden of Disease Attributable to Selected Major Risk Factors Volume 1, pp. 1321–52, Geneva: WHO.

Rheingans, R., Anderson, J.D., Luyendijk, R. and Cumming, O. (2014) ‘Measuring disparities in sanitation access: does the measure matter?’ Tropical Medicine & International Health: TM & IH 19(1): 2–13.

Robb, K., Null, C., Teunis, P., Yakubu, H., Armah, G. and Moe, C.L. (2017) ‘Assessment of fecal exposure pathways in low-income urban neighborhoods in Accra, Ghana: rationale, design, methods, and key findings of the Sanipath study’, American Journal of Tropical Medicine and Hygiene 97(4): 1020–32 <http://dx.doi.org/10.4269/ajtmh.16-0508>.

Rochelle-Newall, E., Huong Nguyen, T.M., Quynh Le, T.P., Sengtaheuanghoung, O. and Ribolzi, O. (2015) ‘A short review of fecal indicator bacteria in tropical aquatic ecosystems: knowledge gaps and future directions’, Frontiers in Microbiology 6: 308.

Rongo, L.M.B., Barten, F., Msamanga, G.I., Heederik, D. and Dolmans, W.M.V. (2004) ‘Occupational exposure and health problems in small-scale industry workers in Dar es Salaam, Tanzania: a situation analysis’, Occupational Medicine (Oxford, England) 54(1): 42–6.

Rusin, P., Maxwell, S. and Gerba, C. (2002) ‘Comparative surface-to-hand and fingertip-to-mouth transfer efficiency of gram-positive bacteria, gram-negative bacteria, and phage’, Journal of Applied Microbiology 93(4): 585–92 <http://dx.doi.org/10.1046/j.1365-2672.2002.01734.x>.

Russel, K., Tilmans, S. Kramer, S., Sklar, R., Tillias, D. and Davis, J. (2015) ‘User perceptions of and willingness to pay for household container-based sanitation services: experience from Cap Haitien, Haiti’, Environment and Urbanization 27(2): 525–40 <http://dx.doi.org/10.1177/0956247815596522>.

Scammel, M.K. (2010) ‘Qualitative environmental health research: an analysis of the literature: 1991–2008’, Environmental Health Perspectives 118(8): 1146–54.

Scheithauer, S., Häfner, H., Seef, R., Seef, S., Hilgers, R.D. and Lemmen, S. (2016) ‘Disinfection of gloves: feasible, but pay attention to the disinfectant/glove combination’, Journal of Hospital Infection 94(3): 268–72 <http://dx.doi.org/10.1016/j.jhin.2016.08.007>.

Scott, E., Bloomfield, S.F. and Barlow, C.G. (1982) ‘An investigation of microbial contamination in the domestic environment’, Journal of Hygiene (Cambridge) 89: 279–93.

Stenström, T.A., Seidu, R., Nelson, E. and Christian, Z. (2011) Microbial Exposure and Health Assessments in Sanitation Technologies and Systems [pdf], Stockholm, Sweden: EcoSanRes Programme, Stockholm Environment Institute <www.ecosanres.org/pdf_files/Microbial_Exposure_&_Health_Assessments_in_Sanitation_Technologies_&_Systems.pdf> [accessed 26 September 2018].

Thomas, E., Andrés, L.A., Borja-Vega, C. and Sturzenegger, G. (2018) Innovations in WASH Impact Measures: Water and Sanitation Measurement Technologies and Practices to Inform the Sustainable Development Goals, Washington, DC: World Bank.

Tilmans, S., Russel, K., Sklar, R., Page, L., Kramer, S. and Davis, J. (2016) ‘Container-based sanitation: assessing costs and effectiveness of excreta management in Cap Haitien, Haiti’, Environment and Urbanization 27(6), 89–104 <http://dx.doi.org/10.1177/0956247815572746>.

Tschopp, A., Bernard, A., Thommen, A.M., Jeggli, S., Dumont, X., Oppliger, A. and Hotz, P. (2011) ‘Exposure to bioaerosols, respiratory health and lung-specific proteins: a prospective study in garbage and wastewater workers’, Occupational and Environmental Medicine 68(11): 856–9 <http://dx.doi.org/10.1136/oem.2010.060178>.

Turner, S., Lines, S., Chen, Y., Hussey, L. and Agius, R. (2005) ‘Work-related infectious disease reported to the Occupational Disease Intelligence Network and The Health and Occupation Reporting network in the UK (2000–2003)’, Occupational Medicine 55(4): 275–81 <http://dx.doi.org/10.1093/occmed/kqi109>.

Walser, S.M., Gerstner, D.G., Brenner, B., Bünger, J., Eikmann, T., Janssen, B., Kolb, S., Kolk, A., Nowak, D., Raulf, M., Sagunski, H., Sedlmaier, N., Suchenwirth, R., Wiesmüller, G., Wollin, K.M., Tesseraux, I. and Herr, C.E.W. (2015) ‘Evaluation of exposure-response relationships for health effects of microbial bioaerosols: a systematic review’, International Journal of Hygiene and Environmental Health 218(7): 577–89 <http://dx.doi.org/10.1016/j.ijheh.2015.07.004>.

Wang, Y., Moe, C.L., Null, C., Raj, S.J., Baker, K.K., Robb, K.A. and Yakubu, H. (2017) ‘Multipathway quantitative assessment of exposure to fecal contamination for young children in low-income urban environments in Accra, Ghana: the Sanipath analytical approach’, American Journal of Tropical Medicine and Hygiene 97(4): 1009–19 <http://dx.doi.org/10.4269/ajtmh.16-0408>.

Westrell, T. (2004) Microbial Risk Assessment and its Implications for Risk Management in Urban Water Systems, doctoral thesis, Linköping University, The Tema Institute, Department of Water and Environmental Studies, Linköping: Linköping University Electronic Press.

WHO (2003) Annex 7 Application of Hazard Analysis and Critical Control Point (HACCP) Methodology to Pharmaceuticals, WHO Technical Report Series, No. 908, 2003 Annex, pp. 99–112, Geneva: WHO.

WHO (2016) Sanitation Safety Planning, Geneva: WHO.

WHO (2017) Progress on Drinking Water, Sanitation and Hygiene, Geneva: WHO.

Worrell, C.M., Wiegand, R.E., Davis, S.M., Odero, K.O., Blackstock, A., Cuéllar, V.M., Njenga, S.M., Montgomery, J.M., Roy, S.L. and Fox, L.M. (2016) ‘A cross-sectional study of water, sanitation, and hygiene-related risk factors for soil-transmitted helminth infection in urban school- and preschool-aged children in Kibera, Nairobi’, Plos One 11(3): e0150744 <http://dx.doi.org/10.1371/journal.pone.0150744>.

WSUP/EY (2017) The World Can’t Wait for Sewers [pdf], Water & Sanitation for the Urban Poor and Ernst and Young <www.ey.com/Publication/vwLUAssets/ey-the-world-cant-wait-for-sewers/$FILE/ey-the-world-cant-wait-for-sewers.pdf> [accessed 27 September 2018].

Abad, F.X., Villena, C., Guix, S., Caballero, S., Pinto, R.M. and Bosch, A. (2001) ‘Potential role of fomites in the vesicular transmission of human astroviruses’, Applied and Environmental Microbiology 67(9): 3904–7 <http://dx.doi.org/10.1128/AEM.67.9.3904-3907>.

Ajzen, I. (1985) ‘From intentions to actions: a theory of planned behavior’, in J. Kuhl and J. Beckmann (eds), Action Control: From Cognition to Behaviour, Berlin: Springer-Verlag.

Antwi-Agyei, P., Peasey, A., Biran, A., Bruce, J. and Ensink, J. (2016) ‘Risk perceptions of wastewater use for urban agriculture in Accra, Ghana’, PloS One 11(3): e0150603.

Bain, R., Cronk, R., Hossain, R., Bonjour, S., Onda, K., Wright, J., Yang, H. (2014) ‘Global assessment of exposure to faecal contamination through drinking water based on a systematic review’, Tropical Medicine & International Health: TM & IH 19(8): 917–27.

Baker, K.K., O’Reilly, C.E., Levine, M.M., Kotloff, K.L., Nataro, J.P., Ayers, T.L., Farag, T.H. (2016) ‘Sanitation and hygiene-specific risk factors for moderate-to-severe diarrhea in young children in the Global Enteric Multicenter Study, 2007–2011: case-control study’, PLoS Medicine 13(5): 2007–11 <http://dx.doi.org/10.1371/journal.pmed.1002010>.

Barker, J. and Bloomfield, S.F. (2000) ‘Survival of Salmonella in bathrooms and toilets in domestic homes following salmonellosis’, Journal of Applied Microbiology 89(1): 137–44 <http://dx.doi.org/10.1046/j.1365-2672.2000.01091.x>.

Berner, C., Woods, E. and Foote, A. (2015) ‘Waste transformation, not waste treatment: understanding the value of poop in Sanivation’s waste processing model for cities’, in Faecal Sludge Management (FSM) 4 Conference Proceedings – Case Study Abstracts, pp. 3–5.

Bischel, H.N., Özel Duygan, B.D., Strande, L., McArdell, C.S., Udert, K.M. and Kohn, T. (2015) ‘Pathogens and pharmaceuticals in source-separated urine in eThekwini, South Africa’, Water Research 85: 57–65 <http://dx.doi.org/10.1016/j.watres.2015.08.022>.

Bleck, D. and Wettberg, W. (2012) ‘Waste collection in developing countries: tackling occupational safety and health hazards at their source’, Waste Management 32(11): 2009–17 <http://dx.doi.org/10.1016/j.wasman.2012.03.025>.

Broomfield, M., Davies, J., Furmston, P., Levy, L., Pollard, S.J.T. and Smith, R. (2010) Exposure Assessment of Landfill Sites Volume 1: Main Report, London, UK: Environment Agency.

Brown, J., Cumming, O., Bartram, J., Cairncross, S., Ensink, J., Holcomb, D. and Knee, J. (2015) ‘A controlled, before-and-after trial of an urban sanitation intervention to reduce enteric infections in children: research protocol for the Maputo Sanitation (MapSan) study, Mozambique’, BMJ Open 5(6): e008215.

Buckley, C.A., Foxon, K.M., Hawksworth, D.J., Archer, C., Pillay, S., Appleton, C., Smith, M. and Rodda, N. (2008) Research into UD/VIDP (Urine Diversion Ventilated Improved Double Pit) Toilets: Prevalence and Die-off of Ascaris Ova in Urine Diversion Waste, South Africa: Water Research Commission.

Burgess, T. (2016) Overflowing Cities: The State of the World’s Toilets 2016, London: WaterAid.

Buttner, M.P. and Stetzenbach, L.D. (1993) Monitoring airborne fungal spores in an experimental indoor environment to evaluate sampling methods and the effects of human activity on air sampling’, Applied and Environmental Microbiology 59(1): 219–26.

Cairncross, S., Hunt, C., Boisson, S., Bostoen, K., Curtis, V., Fung, I.C.H. and Schmidt, W.P. (2010) ‘Water, sanitation and hygiene for the prevention of diarrhoea’, International Journal of Epidemiology 39(Suppl. 1): 193–205 <http://dx.doi.org/10.1093/ije/dyq035>.

Campos, L.C., Ross, P., Nasir, Z.A., Taylor, H. and Parkinson, J. (2015) ‘Development and application of a methodology to assess sanitary risks in Maputo, Mozambique’, Environment and Urbanization 27(2): 371–88 <http://dx.doi.org/10.1177/0956247815595784>.

Carrington, E.-G. (2001) Evaluation of Sludge Treatments for Pathogen Reduction [pdf], Luxembourg: European Commission <http://ec.europa.eu/environment/archives/waste/sludge/pdf/sludge_eval.pdf> [accessed 27 September 2018].

Contzen, N. and Mosler, H.J. (2015) Methodological Fact Sheet 1: The Risks, Attitudes, Norms, Abilities, and Self-regulation (RANAS) Approach to Systematic Behavior Change, Dübendorf, Switzerland: Eawag, Swiss Federal Institute of Aquatic Science and Technology.

Curtis, V., Cairncross, S. and Yonli, R. (2000) ‘Domestic hygiene and diarrhoea’, Tropical Medicine and International Health 5(1): 22–32 <http://dx.doi.org/10.1046/j.1365-3156.2000.00512.x>.

Curtis, V., de Barra, M. and Aunger, R. (2011) ‘Disgust as an adaptive system for disease avoidance behaviour’, Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences 366(1563): 389–401 <http://dx.doi.org/10.1098/rstb.2010.0117>.

Darout, I.A., Astrom, A.N. and Skaug, N. (2005) ‘Knowledge and behaviour related to oral health among secondary school students in Khartoum Province, Sudan’, International Dental Journal 55(4): 224–30.

Devamani, C., Norman, G. and Schmidt, W.-P. (2014) ‘A simple microbiological tool to evaluate the effect of environmental health interventions on hand contamination’, International Journal of Environmental Research and Public Health 11(11): 11846–59.

Devine, J. and Devine, J. (2009) Introducing SaniFOAM: A Framework to Analyze Sanitation Behaviors to Design Effective Sanitation Programs [pdf], Water and Sanitation Program Working Paper <http://documents.worldbank.org/curated/en/272351468334778050/pdf/722050WSP0Box30PUBLIC00GSP0sanifoam.pdf> [accessed 26 September 2018].

Drechsel, P., Amoah, P., Löfman, O., Heistad, A., Fodge, M., Jenssen, P. and Stenström, T.A. (2008) ‘Quantitative microbial risk assessment of wastewater and faecal sludge reuse in Ghana’, in J. Hazel (ed.), Proceedings of the 33rd WEDC International Conference on Access to Sanitation and Safe Water: Global Partnerships and Local Actions, Accra, Ghana, 7–11 April 2008, pp. 90–7, Leicestershire, UK: Water, Engineering and Development Centre (WEDC).

du Preez, M., Conroy, R.M., Ligondo, S., Hennessy, J., Elmore-Meegan, M., Soita, A. and McGuigan, K.G. (2011) ‘Randomized intervention study of solar disinfection of drinking water in the prevention of dysentery in Kenyan children aged under 5 years’, Environmental Science & Technology 45: 9315–23 <http://dx.doi.org/10.1021/es2018835>.

Edmunds, K.L., Abd Elrahman, S., Bell, D.J., Brainard, J., Dervisevic, S., Fedha, T.P. and Few, R. (2016) ‘Recommendations for dealing with waste contaminated with Ebola virus: a hazard analysis of critical control points approach’, Bulletin of the World Health Organization (94): 424–32 <http://dx.doi.org/10.2471/BLT.15.163931>.

Emch, M. (1999) ‘Diarrheal disease risk in Matlab, Bangladesh’, Social Science and Medicine 49(4): 519–30 <http://dx.doi.org/10.1016/S0277-9536(99)00146-X>.

Enger, K.S., Nelson, K.L., Rose, J.B. and Eisenberg, J.N.S. (2013) ‘The joint effects of efficacy and compliance: a study of household water treatment effectiveness against childhood diarrhea’, Water Research 47(3): 1181–90 <http://dx.doi.org/10.1016/j.watres.2012.11.034>.

Exley, J.L.R., Liseka, B., Cumming, O. and Ensink, J.H.J. (2015) ‘The sanitation ladder, what constitutes an improved form of sanitation?’ Environmental Science and Technology 49(2): 1086–94 <http://dx.doi.org/10.1021/es503945x>.

Feacham, R., Bradley, D.H., Garelick, H. and Mara, D.D. (eds) (1983) Sanitation and Disease: Health Aspects of Excreta and Wastewater Management, Washington, DC: World Bank.

Forsythe, S.J. (2010) The Microbiology of Safe Food, 2nd edn, London: Blackwell Publishing Ltd.

Graf, J., Meierhofer, R., Wegelin, M. and Mosler, H.J. (2008) ‘Water disinfection and hygiene behaviour in an urban slum in Kenya: impact on childhood diarrhoea and influence of beliefs’, International Journal of Environmental Health Research 18(5): 335–55.

Haagsma, J., Tariq, L., Heederik, D.J. and Havelaar, A.H. (2012) ‘Infectious disease risks associated with occupational exposure: a systematic review of the literature’, Occupational and Environmental Medicine 69(2): 140–6 <http://dx.doi.org/10.1136/oemed-2011-100068>.

Haas, C. (2014) ‘QMRAwiki dose response’ [online], <http://qmrawiki.canr.msu.edu/index.php/Dose_Response> [accessed 26 September 2018].

Höglund, C. (2001) Evaluation of Microbial Health Risks Associated with the Reuse of Source-Separated Human Urine, doctoral thesis, Royal Institute of Technology (KTH) Department of Biotechnology, Applied Microbiology Swedish Institute for Infectious Disease Control (SMI) Department of Water and Environmental Microbiology, Stockholm.

Humphrey, J.H. (2009) ‘Child undernutrition, tropical enteropathy, toilets, and handwashing’, The Lancet 374(9694): 1032–5 <http://dx.doi.org/10.1016/S0140-6736(09)60950-8>.

Hurst, N.W. (1998) Risk Assessment The Human Dimensions, United Kingdom: Royal Society of Chemistry Publishing.

Julian, T.R. (2016) ‘Environmental transmission of diarrheal pathogens in low and middle income countries’, Environmental Science: Processes & Impacts 18: 944–55 <http://dx.doi.org/10.1039/C6EM00222F>.

Julian, T.R., Leckie, J.O. and Boehm, A.B. (2010) ‘Virus transfer between fingerpads and fomites’, Journal of Applied Microbiology 109(6): 1868–74 <http://dx.doi.org/10.1111/j.1365-2672.2010.04814.x>.

Katukiza, A.Y., Ronteltap, M., van der Steen, P., Foppen, J.W.A. and Lens, P.N.L. (2014) ‘Quantification of microbial risks to human health caused by waterborne viruses and bacteria in an urban slum’, Journal of Applied Microbiology 116(2): 447–63 <http://dx.doi.org/10.1111/jam.12368>.

Leveson, N.G. (2011) Engineering a Safer World: Systems Thinking Applied to Safety [pdf] <http://sunnyday.mit.edu/safer-world.pdf> [accessed 27 September 2018].

Leveson, N. (2012) ‘Safety-guided design’, in Engineering a Safer World: Systems Thinking Applied to Safety, Cambridge, MA: Massachusetts Institute of Technology (MIT) Press.

Lingaas, E. and Fagernes, M. (2009) ‘Development of a method to measure bacterial transfer from hands’, Journal of Hospital Infection 72(1): 43–9 <http://dx.doi.org/10.1016/j.jhin.2009.01.022>.

Makaya, J.M., Kaplon, J., Fremy, C., Barro, N., Aho, S., Pothier, P., Belliot, G. and Traore, A.S. (2015) ‘Norovirus and rotavirus survival in urine collected from a public ecological sanitation system in Ouagadougou, Burkina Faso’, Food and Environmental Virology 7(1): 41–8.

Maponga, B.A., Chirundu, D., Gombe, N.T., Tshimanga, M., Shambira, G. and Takundwa, L. (2013) ‘Risk factors for contracting watery diarrhoea in Kadoma City, Zimbabwe, 2011: a case control study’, BMC Infectious Diseases 13: 567.

Mara, D.D. and Oragui, J. (1985) ‘Bacteriological methods for distinguishing between human and animal faecal pollution of water: results of fieldwork in Nigeria and Zimbabwe’, Bulletin of the World Health Organization 63(4): 773–83.

Maricou, H., Verstraete, W. and Mesuere, K. (1998) ‘Hygienic aspects of biowaste composting: airborne microbial concentrations as a function of feedstock, operation and season’, Waste Management & Research 16(4): 304–11 <http://dx.doi.org/10.1177/0734242X9801600402>.

Mattioli, M.C.M., Pickering, A.J., Gilsdorf, R.J., Davis, J. and Boehm, A.B. (2013) ‘Hands and water as vectors of diarrheal pathogens in Bagamoyo, Tanzania’, Environmental Science & Technology 47(1): 355–63 <http://dx.doi.org/10.1021/es303878d>.

Mattioli, M.C.M., Davis, J. and Boehm, A.B. (2015) ‘Hand-to-mouth contacts result in greater ingestion of feces than dietary water consumption in Tanzania: a quantitative fecal exposure assessment model’, Environmental Science & Technology 49(3): 1912–20 <http://dx.doi.org/10.1021/es505555f>.

Mayer, J. (1986) ‘Ecological associative analysis’, in M. Pacione (ed.), Medical Geography: Progress and Prospect, p. 64, London: Croom Helm.

McMahon, S., Caruso, B.A., Obure, A., Okumu, F. and Rheingans, R.D. (2011) ‘Anal cleansing practices and faecal contamination: a preliminary investigation of behaviours and conditions in schools in rural Nyanza Province, Kenya’, Tropical Medicine and International Health 16(12): 1536–40 <http://dx.doi.org/10.1111/j.1365-3156.2011.02879.x>.

Medland, L., Cotton, A.P. and Scott, R.E. (2015) Understanding and Addressing Vulnerability in the Sanitation Service Chain, SPLASH Urban Sanitation Research Programme Briefing Note 3, Loughborough, UK: Water, Engineering and Development Centre (WEDC).

Michie, S., West, R., Campbell, R., Brown, J. and Gainforth, H. (2014) ABC of Behavior Change Theories, 1st edn, London: Silverback Publishing.

Mnkeni, P.N.S., Kutu, F.R., Muchaonyerwa, P. and Austin, L.M. (2008) ‘Evaluation of human urine as a source of nutrients for selected vegetables and maize under tunnel house conditions in the Eastern Cape, South Africa’, Waste Management & Research: The Journal of the International Solid Wastes and Public Cleansing Association, ISWA 26(2): 132–9.

Moore, G. and Griffith, C. (2007) ‘Problems associated with traditional hygiene swabbing: the need for in-house standardization’, Journal of Applied Microbiology 103(4): 1090–103 <http://dx.doi.org/10.1111/j.1365-2672.2007.03330.x>.

Mosler, H. (2012a) ‘A systematic approach to behavior change interventions for the water and sanitation sector in developing countries: a conceptual model, a review, and a guideline’, International Journal of Environmental Health Research 22: 431–49.

Mosler, H. (2012b) ‘How to achieve evidence-based behavioural change’, Sandec News: 14–5.

Moya, J., Bearer, C.F. and Etzel, R. (2004) ‘Various life stages’, Pediatrics 113(4): 996–1006 <http://dx.doi.org/10.1542/peds.113.4.S1.996>.

Mwase, I., Mutoro, A., Owino, V., Garcia, A-L. and Wright, C.M. (2016) ‘Poor infant feeding practices and high prevalence of malnutrition in urban slum child care centres in Nairobi: a pilot study’, Journal of Tropical Pediatrics 62(1): 46–54.

Ngure, F.M., Reid, B.M., Humphrey, J.H., Mbuya, M.N., Pelto, G. and Stoltzfus, R.J. (2014) ‘Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links’, Annals of the New York Academy of Sciences 1308(1): 118–28 <http://dx.doi.org/10.1111/nyas.12330>.

Nyoka, R., Foote, A.D., Woods, E., Lokey, H., O’Reilly, C.E., Magumba, F., Okello, P., Mintz, E.D., Marano, N. and Morris, J.F. (2017) ‘Sanitation practices and perceptions in Kakuma refugee camp, Kenya: comparing the status quo with a novel service-based approach’, PLoS ONE 12(7): 1–16 <http://dx.doi.org/10.1371/journal.pone.0180864>.

O’Keefe, M., Luthi, C., Tumwebaze, I.K. and Tobias, R. (2015) ‘Opportunities and limits to market-driven sanitation services: evidence from urban informal settlements in East Africa’, Environment and Urbanization 27(2): 421–40 <https://doi.org/10.1177%2F0956247815581758>.

Peasey, A. (2000) ‘Health aspects of dry sanitation with waste reuse’, Knowledge Creation Diffusion Utilization 324: 48.

PHE (2013) Detection and Enumeration of Bacteria in Swabs and Other Environmental Samples, Microbiology Services Food Water and Environmental Microbiology Standard Method [online], London: Public Health England, Microbiology Services Food, Water & Environmental Microbiology Methods Working Group <www.hpa.org.uk/ProductsServices/MicrobiologyPathology/SpecialistMicrobiologyServices/FoodWaterEnvironmentalMicrobiologyServices/NationalReferenceLab oratoryForFoodMicrobiology/> [accessed 27 September 2018].

Pickering, A.J., Julian, T.R., Marks, S.J., Mattioli, M.C., Boehm, A.B., Schwab, K.J. and Davis, J. (2012) ‘Fecal contamination and diarrheal pathogens on surfaces and in soils among Tanzanian households with and without improved sanitation’, Environmental Science & Technology 46(11): 5736–43 <http://dx.doi.org/10.1021/es300022c>.

Prüss-üstün, A., Kay, D., Fewtrell, L. and Bartram, J. (2004) ‘Unsafe water, sanitation and hygiene’, in M. Ezzati, A.D. Lopez, A. Rodgers, and C.L.J. Murray (eds), Comparative Quantification of Health Risks Global and Regional Burden of Disease Attributable to Selected Major Risk Factors Volume 1, pp. 1321–52, Geneva: WHO.

Rheingans, R., Anderson, J.D., Luyendijk, R. and Cumming, O. (2014) ‘Measuring disparities in sanitation access: does the measure matter?’ Tropical Medicine & International Health: TM & IH 19(1): 2–13.

Robb, K., Null, C., Teunis, P., Yakubu, H., Armah, G. and Moe, C.L. (2017) ‘Assessment of fecal exposure pathways in low-income urban neighborhoods in Accra, Ghana: rationale, design, methods, and key findings of the Sanipath study’, American Journal of Tropical Medicine and Hygiene 97(4): 1020–32 <http://dx.doi.org/10.4269/ajtmh.16-0508>.

Rochelle-Newall, E., Huong Nguyen, T.M., Quynh Le, T.P., Sengtaheuanghoung, O. and Ribolzi, O. (2015) ‘A short review of fecal indicator bacteria in tropical aquatic ecosystems: knowledge gaps and future directions’, Frontiers in Microbiology 6: 308.

Rongo, L.M.B., Barten, F., Msamanga, G.I., Heederik, D. and Dolmans, W.M.V. (2004) ‘Occupational exposure and health problems in small-scale industry workers in Dar es Salaam, Tanzania: a situation analysis’, Occupational Medicine (Oxford, England) 54(1): 42–6.

Rusin, P., Maxwell, S. and Gerba, C. (2002) ‘Comparative surface-to-hand and fingertip-to-mouth transfer efficiency of gram-positive bacteria, gram-negative bacteria, and phage’, Journal of Applied Microbiology 93(4): 585–92 <http://dx.doi.org/10.1046/j.1365-2672.2002.01734.x>.

Russel, K., Tilmans, S. Kramer, S., Sklar, R., Tillias, D. and Davis, J. (2015) ‘User perceptions of and willingness to pay for household container-based sanitation services: experience from Cap Haitien, Haiti’, Environment and Urbanization 27(2): 525–40 <http://dx.doi.org/10.1177/0956247815596522>.

Scammel, M.K. (2010) ‘Qualitative environmental health research: an analysis of the literature: 1991–2008’, Environmental Health Perspectives 118(8): 1146–54.

Scheithauer, S., Häfner, H., Seef, R., Seef, S., Hilgers, R.D. and Lemmen, S. (2016) ‘Disinfection of gloves: feasible, but pay attention to the disinfectant/glove combination’, Journal of Hospital Infection 94(3): 268–72 <http://dx.doi.org/10.1016/j.jhin.2016.08.007>.

Scott, E., Bloomfield, S.F. and Barlow, C.G. (1982) ‘An investigation of microbial contamination in the domestic environment’, Journal of Hygiene (Cambridge) 89: 279–93.

Stenström, T.A., Seidu, R., Nelson, E. and Christian, Z. (2011) Microbial Exposure and Health Assessments in Sanitation Technologies and Systems [pdf], Stockholm, Sweden: EcoSanRes Programme, Stockholm Environment Institute <www.ecosanres.org/pdf_files/Microbial_Exposure_&_Health_Assessments_in_Sanitation_Technologies_&_Systems.pdf> [accessed 26 September 2018].

Thomas, E., Andrés, L.A., Borja-Vega, C. and Sturzenegger, G. (2018) Innovations in WASH Impact Measures: Water and Sanitation Measurement Technologies and Practices to Inform the Sustainable Development Goals, Washington, DC: World Bank.

Tilmans, S., Russel, K., Sklar, R., Page, L., Kramer, S. and Davis, J. (2016) ‘Container-based sanitation: assessing costs and effectiveness of excreta management in Cap Haitien, Haiti’, Environment and Urbanization 27(6), 89–104 <http://dx.doi.org/10.1177/0956247815572746>.

Tschopp, A., Bernard, A., Thommen, A.M., Jeggli, S., Dumont, X., Oppliger, A. and Hotz, P. (2011) ‘Exposure to bioaerosols, respiratory health and lung-specific proteins: a prospective study in garbage and wastewater workers’, Occupational and Environmental Medicine 68(11): 856–9 <http://dx.doi.org/10.1136/oem.2010.060178>.

Turner, S., Lines, S., Chen, Y., Hussey, L. and Agius, R. (2005) ‘Work-related infectious disease reported to the Occupational Disease Intelligence Network and The Health and Occupation Reporting network in the UK (2000–2003)’, Occupational Medicine 55(4): 275–81 <http://dx.doi.org/10.1093/occmed/kqi109>.

Walser, S.M., Gerstner, D.G., Brenner, B., Bünger, J., Eikmann, T., Janssen, B., Kolb, S., Kolk, A., Nowak, D., Raulf, M., Sagunski, H., Sedlmaier, N., Suchenwirth, R., Wiesmüller, G., Wollin, K.M., Tesseraux, I. and Herr, C.E.W. (2015) ‘Evaluation of exposure-response relationships for health effects of microbial bioaerosols: a systematic review’, International Journal of Hygiene and Environmental Health 218(7): 577–89 <http://dx.doi.org/10.1016/j.ijheh.2015.07.004>.

Wang, Y., Moe, C.L., Null, C., Raj, S.J., Baker, K.K., Robb, K.A. and Yakubu, H. (2017) ‘Multipathway quantitative assessment of exposure to fecal contamination for young children in low-income urban environments in Accra, Ghana: the Sanipath analytical approach’, American Journal of Tropical Medicine and Hygiene 97(4): 1009–19 <http://dx.doi.org/10.4269/ajtmh.16-0408>.

Westrell, T. (2004) Microbial Risk Assessment and its Implications for Risk Management in Urban Water Systems, doctoral thesis, Linköping University, The Tema Institute, Department of Water and Environmental Studies, Linköping: Linköping University Electronic Press.

WHO (2003) Annex 7 Application of Hazard Analysis and Critical Control Point (HACCP) Methodology to Pharmaceuticals, WHO Technical Report Series, No. 908, 2003 Annex, pp. 99–112, Geneva: WHO.

WHO (2016) Sanitation Safety Planning, Geneva: WHO.

WHO (2017) Progress on Drinking Water, Sanitation and Hygiene, Geneva: WHO.

Worrell, C.M., Wiegand, R.E., Davis, S.M., Odero, K.O., Blackstock, A., Cuéllar, V.M., Njenga, S.M., Montgomery, J.M., Roy, S.L. and Fox, L.M. (2016) ‘A cross-sectional study of water, sanitation, and hygiene-related risk factors for soil-transmitted helminth infection in urban school- and preschool-aged children in Kibera, Nairobi’, Plos One 11(3): e0150744 <http://dx.doi.org/10.1371/journal.pone.0150744>.

WSUP/EY (2017) The World Can’t Wait for Sewers [pdf], Water & Sanitation for the Urban Poor and Ernst and Young <www.ey.com/Publication/vwLUAssets/ey-the-world-cant-wait-for-sewers/$FILE/ey-the-world-cant-wait-for-sewers.pdf> [accessed 27 September 2018].

Abad, F.X., Villena, C., Guix, S., Caballero, S., Pinto, R.M. and Bosch, A. (2001) ‘Potential role of fomites in the vesicular transmission of human astroviruses’, Applied and Environmental Microbiology 67(9): 3904–7 <http://dx.doi.org/10.1128/AEM.67.9.3904-3907>.

Ajzen, I. (1985) ‘From intentions to actions: a theory of planned behavior’, in J. Kuhl and J. Beckmann (eds), Action Control: From Cognition to Behaviour, Berlin: Springer-Verlag.

Antwi-Agyei, P., Peasey, A., Biran, A., Bruce, J. and Ensink, J. (2016) ‘Risk perceptions of wastewater use for urban agriculture in Accra, Ghana’, PloS One 11(3): e0150603.

Bain, R., Cronk, R., Hossain, R., Bonjour, S., Onda, K., Wright, J., Yang, H. (2014) ‘Global assessment of exposure to faecal contamination through drinking water based on a systematic review’, Tropical Medicine & International Health: TM & IH 19(8): 917–27.

Baker, K.K., O’Reilly, C.E., Levine, M.M., Kotloff, K.L., Nataro, J.P., Ayers, T.L., Farag, T.H. (2016) ‘Sanitation and hygiene-specific risk factors for moderate-to-severe diarrhea in young children in the Global Enteric Multicenter Study, 2007–2011: case-control study’, PLoS Medicine 13(5): 2007–11 <http://dx.doi.org/10.1371/journal.pmed.1002010>.

Barker, J. and Bloomfield, S.F. (2000) ‘Survival of Salmonella in bathrooms and toilets in domestic homes following salmonellosis’, Journal of Applied Microbiology 89(1): 137–44 <http://dx.doi.org/10.1046/j.1365-2672.2000.01091.x>.

Berner, C., Woods, E. and Foote, A. (2015) ‘Waste transformation, not waste treatment: understanding the value of poop in Sanivation’s waste processing model for cities’, in Faecal Sludge Management (FSM) 4 Conference Proceedings – Case Study Abstracts, pp. 3–5.

Bischel, H.N., Özel Duygan, B.D., Strande, L., McArdell, C.S., Udert, K.M. and Kohn, T. (2015) ‘Pathogens and pharmaceuticals in source-separated urine in eThekwini, South Africa’, Water Research 85: 57–65 <http://dx.doi.org/10.1016/j.watres.2015.08.022>.

Bleck, D. and Wettberg, W. (2012) ‘Waste collection in developing countries: tackling occupational safety and health hazards at their source’, Waste Management 32(11): 2009–17 <http://dx.doi.org/10.1016/j.wasman.2012.03.025>.

Broomfield, M., Davies, J., Furmston, P., Levy, L., Pollard, S.J.T. and Smith, R. (2010) Exposure Assessment of Landfill Sites Volume 1: Main Report, London, UK: Environment Agency.

Brown, J., Cumming, O., Bartram, J., Cairncross, S., Ensink, J., Holcomb, D. and Knee, J. (2015) ‘A controlled, before-and-after trial of an urban sanitation intervention to reduce enteric infections in children: research protocol for the Maputo Sanitation (MapSan) study, Mozambique’, BMJ Open 5(6): e008215.

Buckley, C.A., Foxon, K.M., Hawksworth, D.J., Archer, C., Pillay, S., Appleton, C., Smith, M. and Rodda, N. (2008) Research into UD/VIDP (Urine Diversion Ventilated Improved Double Pit) Toilets: Prevalence and Die-off of Ascaris Ova in Urine Diversion Waste, South Africa: Water Research Commission.

Burgess, T. (2016) Overflowing Cities: The State of the World’s Toilets 2016, London: WaterAid.

Buttner, M.P. and Stetzenbach, L.D. (1993) Monitoring airborne fungal spores in an experimental indoor environment to evaluate sampling methods and the effects of human activity on air sampling’, Applied and Environmental Microbiology 59(1): 219–26.

Cairncross, S., Hunt, C., Boisson, S., Bostoen, K., Curtis, V., Fung, I.C.H. and Schmidt, W.P. (2010) ‘Water, sanitation and hygiene for the prevention of diarrhoea’, International Journal of Epidemiology 39(Suppl. 1): 193–205 <http://dx.doi.org/10.1093/ije/dyq035>.

Campos, L.C., Ross, P., Nasir, Z.A., Taylor, H. and Parkinson, J. (2015) ‘Development and application of a methodology to assess sanitary risks in Maputo, Mozambique’, Environment and Urbanization 27(2): 371–88 <http://dx.doi.org/10.1177/0956247815595784>.

Carrington, E.-G. (2001) Evaluation of Sludge Treatments for Pathogen Reduction [pdf], Luxembourg: European Commission <http://ec.europa.eu/environment/archives/waste/sludge/pdf/sludge_eval.pdf> [accessed 27 September 2018].

Contzen, N. and Mosler, H.J. (2015) Methodological Fact Sheet 1: The Risks, Attitudes, Norms, Abilities, and Self-regulation (RANAS) Approach to Systematic Behavior Change, Dübendorf, Switzerland: Eawag, Swiss Federal Institute of Aquatic Science and Technology.

Curtis, V., Cairncross, S. and Yonli, R. (2000) ‘Domestic hygiene and diarrhoea’, Tropical Medicine and International Health 5(1): 22–32 <http://dx.doi.org/10.1046/j.1365-3156.2000.00512.x>.

Curtis, V., de Barra, M. and Aunger, R. (2011) ‘Disgust as an adaptive system for disease avoidance behaviour’, Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences 366(1563): 389–401 <http://dx.doi.org/10.1098/rstb.2010.0117>.

Darout, I.A., Astrom, A.N. and Skaug, N. (2005) ‘Knowledge and behaviour related to oral health among secondary school students in Khartoum Province, Sudan’, International Dental Journal 55(4): 224–30.

Devamani, C., Norman, G. and Schmidt, W.-P. (2014) ‘A simple microbiological tool to evaluate the effect of environmental health interventions on hand contamination’, International Journal of Environmental Research and Public Health 11(11): 11846–59.

Devine, J. and Devine, J. (2009) Introducing SaniFOAM: A Framework to Analyze Sanitation Behaviors to Design Effective Sanitation Programs [pdf], Water and Sanitation Program Working Paper <http://documents.worldbank.org/curated/en/272351468334778050/pdf/722050WSP0Box30PUBLIC00GSP0sanifoam.pdf> [accessed 26 September 2018].

Drechsel, P., Amoah, P., Löfman, O., Heistad, A., Fodge, M., Jenssen, P. and Stenström, T.A. (2008) ‘Quantitative microbial risk assessment of wastewater and faecal sludge reuse in Ghana’, in J. Hazel (ed.), Proceedings of the 33rd WEDC International Conference on Access to Sanitation and Safe Water: Global Partnerships and Local Actions, Accra, Ghana, 7–11 April 2008, pp. 90–7, Leicestershire, UK: Water, Engineering and Development Centre (WEDC).

du Preez, M., Conroy, R.M., Ligondo, S., Hennessy, J., Elmore-Meegan, M., Soita, A. and McGuigan, K.G. (2011) ‘Randomized intervention study of solar disinfection of drinking water in the prevention of dysentery in Kenyan children aged under 5 years’, Environmental Science & Technology 45: 9315–23 <http://dx.doi.org/10.1021/es2018835>.

Edmunds, K.L., Abd Elrahman, S., Bell, D.J., Brainard, J., Dervisevic, S., Fedha, T.P. and Few, R. (2016) ‘Recommendations for dealing with waste contaminated with Ebola virus: a hazard analysis of critical control points approach’, Bulletin of the World Health Organization (94): 424–32 <http://dx.doi.org/10.2471/BLT.15.163931>.

Emch, M. (1999) ‘Diarrheal disease risk in Matlab, Bangladesh’, Social Science and Medicine 49(4): 519–30 <http://dx.doi.org/10.1016/S0277-9536(99)00146-X>.

Enger, K.S., Nelson, K.L., Rose, J.B. and Eisenberg, J.N.S. (2013) ‘The joint effects of efficacy and compliance: a study of household water treatment effectiveness against childhood diarrhea’, Water Research 47(3): 1181–90 <http://dx.doi.org/10.1016/j.watres.2012.11.034>.

Exley, J.L.R., Liseka, B., Cumming, O. and Ensink, J.H.J. (2015) ‘The sanitation ladder, what constitutes an improved form of sanitation?’ Environmental Science and Technology 49(2): 1086–94 <http://dx.doi.org/10.1021/es503945x>.

Feacham, R., Bradley, D.H., Garelick, H. and Mara, D.D. (eds) (1983) Sanitation and Disease: Health Aspects of Excreta and Wastewater Management, Washington, DC: World Bank.

Forsythe, S.J. (2010) The Microbiology of Safe Food, 2nd edn, London: Blackwell Publishing Ltd.

Graf, J., Meierhofer, R., Wegelin, M. and Mosler, H.J. (2008) ‘Water disinfection and hygiene behaviour in an urban slum in Kenya: impact on childhood diarrhoea and influence of beliefs’, International Journal of Environmental Health Research 18(5): 335–55.

Haagsma, J., Tariq, L., Heederik, D.J. and Havelaar, A.H. (2012) ‘Infectious disease risks associated with occupational exposure: a systematic review of the literature’, Occupational and Environmental Medicine 69(2): 140–6 <http://dx.doi.org/10.1136/oemed-2011-100068>.

Haas, C. (2014) ‘QMRAwiki dose response’ [online], <http://qmrawiki.canr.msu.edu/index.php/Dose_Response> [accessed 26 September 2018].

Höglund, C. (2001) Evaluation of Microbial Health Risks Associated with the Reuse of Source-Separated Human Urine, doctoral thesis, Royal Institute of Technology (KTH) Department of Biotechnology, Applied Microbiology Swedish Institute for Infectious Disease Control (SMI) Department of Water and Environmental Microbiology, Stockholm.

Humphrey, J.H. (2009) ‘Child undernutrition, tropical enteropathy, toilets, and handwashing’, The Lancet 374(9694): 1032–5 <http://dx.doi.org/10.1016/S0140-6736(09)60950-8>.

Hurst, N.W. (1998) Risk Assessment The Human Dimensions, United Kingdom: Royal Society of Chemistry Publishing.

Julian, T.R. (2016) ‘Environmental transmission of diarrheal pathogens in low and middle income countries’, Environmental Science: Processes & Impacts 18: 944–55 <http://dx.doi.org/10.1039/C6EM00222F>.

Julian, T.R., Leckie, J.O. and Boehm, A.B. (2010) ‘Virus transfer between fingerpads and fomites’, Journal of Applied Microbiology 109(6): 1868–74 <http://dx.doi.org/10.1111/j.1365-2672.2010.04814.x>.

Katukiza, A.Y., Ronteltap, M., van der Steen, P., Foppen, J.W.A. and Lens, P.N.L. (2014) ‘Quantification of microbial risks to human health caused by waterborne viruses and bacteria in an urban slum’, Journal of Applied Microbiology 116(2): 447–63 <http://dx.doi.org/10.1111/jam.12368>.

Leveson, N.G. (2011) Engineering a Safer World: Systems Thinking Applied to Safety [pdf] <http://sunnyday.mit.edu/safer-world.pdf> [accessed 27 September 2018].

Leveson, N. (2012) ‘Safety-guided design’, in Engineering a Safer World: Systems Thinking Applied to Safety, Cambridge, MA: Massachusetts Institute of Technology (MIT) Press.

Lingaas, E. and Fagernes, M. (2009) ‘Development of a method to measure bacterial transfer from hands’, Journal of Hospital Infection 72(1): 43–9 <http://dx.doi.org/10.1016/j.jhin.2009.01.022>.

Makaya, J.M., Kaplon, J., Fremy, C., Barro, N., Aho, S., Pothier, P., Belliot, G. and Traore, A.S. (2015) ‘Norovirus and rotavirus survival in urine collected from a public ecological sanitation system in Ouagadougou, Burkina Faso’, Food and Environmental Virology 7(1): 41–8.

Maponga, B.A., Chirundu, D., Gombe, N.T., Tshimanga, M., Shambira, G. and Takundwa, L. (2013) ‘Risk factors for contracting watery diarrhoea in Kadoma City, Zimbabwe, 2011: a case control study’, BMC Infectious Diseases 13: 567.

Mara, D.D. and Oragui, J. (1985) ‘Bacteriological methods for distinguishing between human and animal faecal pollution of water: results of fieldwork in Nigeria and Zimbabwe’, Bulletin of the World Health Organization 63(4): 773–83.

Maricou, H., Verstraete, W. and Mesuere, K. (1998) ‘Hygienic aspects of biowaste composting: airborne microbial concentrations as a function of feedstock, operation and season’, Waste Management & Research 16(4): 304–11 <http://dx.doi.org/10.1177/0734242X9801600402>.

Mattioli, M.C.M., Pickering, A.J., Gilsdorf, R.J., Davis, J. and Boehm, A.B. (2013) ‘Hands and water as vectors of diarrheal pathogens in Bagamoyo, Tanzania’, Environmental Science & Technology 47(1): 355–63 <http://dx.doi.org/10.1021/es303878d>.

Mattioli, M.C.M., Davis, J. and Boehm, A.B. (2015) ‘Hand-to-mouth contacts result in greater ingestion of feces than dietary water consumption in Tanzania: a quantitative fecal exposure assessment model’, Environmental Science & Technology 49(3): 1912–20 <http://dx.doi.org/10.1021/es505555f>.

Mayer, J. (1986) ‘Ecological associative analysis’, in M. Pacione (ed.), Medical Geography: Progress and Prospect, p. 64, London: Croom Helm.

McMahon, S., Caruso, B.A., Obure, A., Okumu, F. and Rheingans, R.D. (2011) ‘Anal cleansing practices and faecal contamination: a preliminary investigation of behaviours and conditions in schools in rural Nyanza Province, Kenya’, Tropical Medicine and International Health 16(12): 1536–40 <http://dx.doi.org/10.1111/j.1365-3156.2011.02879.x>.

Medland, L., Cotton, A.P. and Scott, R.E. (2015) Understanding and Addressing Vulnerability in the Sanitation Service Chain, SPLASH Urban Sanitation Research Programme Briefing Note 3, Loughborough, UK: Water, Engineering and Development Centre (WEDC).

Michie, S., West, R., Campbell, R., Brown, J. and Gainforth, H. (2014) ABC of Behavior Change Theories, 1st edn, London: Silverback Publishing.

Mnkeni, P.N.S., Kutu, F.R., Muchaonyerwa, P. and Austin, L.M. (2008) ‘Evaluation of human urine as a source of nutrients for selected vegetables and maize under tunnel house conditions in the Eastern Cape, South Africa’, Waste Management & Research: The Journal of the International Solid Wastes and Public Cleansing Association, ISWA 26(2): 132–9.

Moore, G. and Griffith, C. (2007) ‘Problems associated with traditional hygiene swabbing: the need for in-house standardization’, Journal of Applied Microbiology 103(4): 1090–103 <http://dx.doi.org/10.1111/j.1365-2672.2007.03330.x>.

Mosler, H. (2012a) ‘A systematic approach to behavior change interventions for the water and sanitation sector in developing countries: a conceptual model, a review, and a guideline’, International Journal of Environmental Health Research 22: 431–49.

Mosler, H. (2012b) ‘How to achieve evidence-based behavioural change’, Sandec News: 14–5.

Moya, J., Bearer, C.F. and Etzel, R. (2004) ‘Various life stages’, Pediatrics 113(4): 996–1006 <http://dx.doi.org/10.1542/peds.113.4.S1.996>.

Mwase, I., Mutoro, A., Owino, V., Garcia, A-L. and Wright, C.M. (2016) ‘Poor infant feeding practices and high prevalence of malnutrition in urban slum child care centres in Nairobi: a pilot study’, Journal of Tropical Pediatrics 62(1): 46–54.

Ngure, F.M., Reid, B.M., Humphrey, J.H., Mbuya, M.N., Pelto, G. and Stoltzfus, R.J. (2014) ‘Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links’, Annals of the New York Academy of Sciences 1308(1): 118–28 <http://dx.doi.org/10.1111/nyas.12330>.

Nyoka, R., Foote, A.D., Woods, E., Lokey, H., O’Reilly, C.E., Magumba, F., Okello, P., Mintz, E.D., Marano, N. and Morris, J.F. (2017) ‘Sanitation practices and perceptions in Kakuma refugee camp, Kenya: comparing the status quo with a novel service-based approach’, PLoS ONE 12(7): 1–16 <http://dx.doi.org/10.1371/journal.pone.0180864>.

O’Keefe, M., Luthi, C., Tumwebaze, I.K. and Tobias, R. (2015) ‘Opportunities and limits to market-driven sanitation services: evidence from urban informal settlements in East Africa’, Environment and Urbanization 27(2): 421–40 <https://doi.org/10.1177%2F0956247815581758>.

Peasey, A. (2000) ‘Health aspects of dry sanitation with waste reuse’, Knowledge Creation Diffusion Utilization 324: 48.

PHE (2013) Detection and Enumeration of Bacteria in Swabs and Other Environmental Samples, Microbiology Services Food Water and Environmental Microbiology Standard Method [online], London: Public Health England, Microbiology Services Food, Water & Environmental Microbiology Methods Working Group <www.hpa.org.uk/ProductsServices/MicrobiologyPathology/SpecialistMicrobiologyServices/FoodWaterEnvironmentalMicrobiologyServices/NationalReferenceLab oratoryForFoodMicrobiology/> [accessed 27 September 2018].

Pickering, A.J., Julian, T.R., Marks, S.J., Mattioli, M.C., Boehm, A.B., Schwab, K.J. and Davis, J. (2012) ‘Fecal contamination and diarrheal pathogens on surfaces and in soils among Tanzanian households with and without improved sanitation’, Environmental Science & Technology 46(11): 5736–43 <http://dx.doi.org/10.1021/es300022c>.

Prüss-üstün, A., Kay, D., Fewtrell, L. and Bartram, J. (2004) ‘Unsafe water, sanitation and hygiene’, in M. Ezzati, A.D. Lopez, A. Rodgers, and C.L.J. Murray (eds), Comparative Quantification of Health Risks Global and Regional Burden of Disease Attributable to Selected Major Risk Factors Volume 1, pp. 1321–52, Geneva: WHO.

Rheingans, R., Anderson, J.D., Luyendijk, R. and Cumming, O. (2014) ‘Measuring disparities in sanitation access: does the measure matter?’ Tropical Medicine & International Health: TM & IH 19(1): 2–13.

Robb, K., Null, C., Teunis, P., Yakubu, H., Armah, G. and Moe, C.L. (2017) ‘Assessment of fecal exposure pathways in low-income urban neighborhoods in Accra, Ghana: rationale, design, methods, and key findings of the Sanipath study’, American Journal of Tropical Medicine and Hygiene 97(4): 1020–32 <http://dx.doi.org/10.4269/ajtmh.16-0508>.

Rochelle-Newall, E., Huong Nguyen, T.M., Quynh Le, T.P., Sengtaheuanghoung, O. and Ribolzi, O. (2015) ‘A short review of fecal indicator bacteria in tropical aquatic ecosystems: knowledge gaps and future directions’, Frontiers in Microbiology 6: 308.

Rongo, L.M.B., Barten, F., Msamanga, G.I., Heederik, D. and Dolmans, W.M.V. (2004) ‘Occupational exposure and health problems in small-scale industry workers in Dar es Salaam, Tanzania: a situation analysis’, Occupational Medicine (Oxford, England) 54(1): 42–6.

Rusin, P., Maxwell, S. and Gerba, C. (2002) ‘Comparative surface-to-hand and fingertip-to-mouth transfer efficiency of gram-positive bacteria, gram-negative bacteria, and phage’, Journal of Applied Microbiology 93(4): 585–92 <http://dx.doi.org/10.1046/j.1365-2672.2002.01734.x>.

Russel, K., Tilmans, S. Kramer, S., Sklar, R., Tillias, D. and Davis, J. (2015) ‘User perceptions of and willingness to pay for household container-based sanitation services: experience from Cap Haitien, Haiti’, Environment and Urbanization 27(2): 525–40 <http://dx.doi.org/10.1177/0956247815596522>.

Scammel, M.K. (2010) ‘Qualitative environmental health research: an analysis of the literature: 1991–2008’, Environmental Health Perspectives 118(8): 1146–54.

Scheithauer, S., Häfner, H., Seef, R., Seef, S., Hilgers, R.D. and Lemmen, S. (2016) ‘Disinfection of gloves: feasible, but pay attention to the disinfectant/glove combination’, Journal of Hospital Infection 94(3): 268–72 <http://dx.doi.org/10.1016/j.jhin.2016.08.007>.

Scott, E., Bloomfield, S.F. and Barlow, C.G. (1982) ‘An investigation of microbial contamination in the domestic environment’, Journal of Hygiene (Cambridge) 89: 279–93.

Stenström, T.A., Seidu, R., Nelson, E. and Christian, Z. (2011) Microbial Exposure and Health Assessments in Sanitation Technologies and Systems [pdf], Stockholm, Sweden: EcoSanRes Programme, Stockholm Environment Institute <www.ecosanres.org/pdf_files/Microbial_Exposure_&_Health_Assessments_in_Sanitation_Technologies_&_Systems.pdf> [accessed 26 September 2018].

Thomas, E., Andrés, L.A., Borja-Vega, C. and Sturzenegger, G. (2018) Innovations in WASH Impact Measures: Water and Sanitation Measurement Technologies and Practices to Inform the Sustainable Development Goals, Washington, DC: World Bank.

Tilmans, S., Russel, K., Sklar, R., Page, L., Kramer, S. and Davis, J. (2016) ‘Container-based sanitation: assessing costs and effectiveness of excreta management in Cap Haitien, Haiti’, Environment and Urbanization 27(6), 89–104 <http://dx.doi.org/10.1177/0956247815572746>.

Tschopp, A., Bernard, A., Thommen, A.M., Jeggli, S., Dumont, X., Oppliger, A. and Hotz, P. (2011) ‘Exposure to bioaerosols, respiratory health and lung-specific proteins: a prospective study in garbage and wastewater workers’, Occupational and Environmental Medicine 68(11): 856–9 <http://dx.doi.org/10.1136/oem.2010.060178>.

Turner, S., Lines, S., Chen, Y., Hussey, L. and Agius, R. (2005) ‘Work-related infectious disease reported to the Occupational Disease Intelligence Network and The Health and Occupation Reporting network in the UK (2000–2003)’, Occupational Medicine 55(4): 275–81 <http://dx.doi.org/10.1093/occmed/kqi109>.

Walser, S.M., Gerstner, D.G., Brenner, B., Bünger, J., Eikmann, T., Janssen, B., Kolb, S., Kolk, A., Nowak, D., Raulf, M., Sagunski, H., Sedlmaier, N., Suchenwirth, R., Wiesmüller, G., Wollin, K.M., Tesseraux, I. and Herr, C.E.W. (2015) ‘Evaluation of exposure-response relationships for health effects of microbial bioaerosols: a systematic review’, International Journal of Hygiene and Environmental Health 218(7): 577–89 <http://dx.doi.org/10.1016/j.ijheh.2015.07.004>.

Wang, Y., Moe, C.L., Null, C., Raj, S.J., Baker, K.K., Robb, K.A. and Yakubu, H. (2017) ‘Multipathway quantitative assessment of exposure to fecal contamination for young children in low-income urban environments in Accra, Ghana: the Sanipath analytical approach’, American Journal of Tropical Medicine and Hygiene 97(4): 1009–19 <http://dx.doi.org/10.4269/ajtmh.16-0408>.

Westrell, T. (2004) Microbial Risk Assessment and its Implications for Risk Management in Urban Water Systems, doctoral thesis, Linköping University, The Tema Institute, Department of Water and Environmental Studies, Linköping: Linköping University Electronic Press.

WHO (2003) Annex 7 Application of Hazard Analysis and Critical Control Point (HACCP) Methodology to Pharmaceuticals, WHO Technical Report Series, No. 908, 2003 Annex, pp. 99–112, Geneva: WHO.

WHO (2016) Sanitation Safety Planning, Geneva: WHO.

WHO (2017) Progress on Drinking Water, Sanitation and Hygiene, Geneva: WHO.

Worrell, C.M., Wiegand, R.E., Davis, S.M., Odero, K.O., Blackstock, A., Cuéllar, V.M., Njenga, S.M., Montgomery, J.M., Roy, S.L. and Fox, L.M. (2016) ‘A cross-sectional study of water, sanitation, and hygiene-related risk factors for soil-transmitted helminth infection in urban school- and preschool-aged children in Kibera, Nairobi’, Plos One 11(3): e0150744 <http://dx.doi.org/10.1371/journal.pone.0150744>.

WSUP/EY (2017) The World Can’t Wait for Sewers [pdf], Water & Sanitation for the Urban Poor and Ernst and Young <www.ey.com/Publication/vwLUAssets/ey-the-world-cant-wait-for-sewers/$FILE/ey-the-world-cant-wait-for-sewers.pdf> [accessed 27 September 2018].

Abad, F.X., Villena, C., Guix, S., Caballero, S., Pinto, R.M. and Bosch, A. (2001) ‘Potential role of fomites in the vesicular transmission of human astroviruses’, Applied and Environmental Microbiology 67(9): 3904–7 <http://dx.doi.org/10.1128/AEM.67.9.3904-3907>.

Ajzen, I. (1985) ‘From intentions to actions: a theory of planned behavior’, in J. Kuhl and J. Beckmann (eds), Action Control: From Cognition to Behaviour, Berlin: Springer-Verlag.

Antwi-Agyei, P., Peasey, A., Biran, A., Bruce, J. and Ensink, J. (2016) ‘Risk perceptions of wastewater use for urban agriculture in Accra, Ghana’, PloS One 11(3): e0150603.

Bain, R., Cronk, R., Hossain, R., Bonjour, S., Onda, K., Wright, J., Yang, H. (2014) ‘Global assessment of exposure to faecal contamination through drinking water based on a systematic review’, Tropical Medicine & International Health: TM & IH 19(8): 917–27.

Baker, K.K., O’Reilly, C.E., Levine, M.M., Kotloff, K.L., Nataro, J.P., Ayers, T.L., Farag, T.H. (2016) ‘Sanitation and hygiene-specific risk factors for moderate-to-severe diarrhea in young children in the Global Enteric Multicenter Study, 2007–2011: case-control study’, PLoS Medicine 13(5): 2007–11 <http://dx.doi.org/10.1371/journal.pmed.1002010>.

Barker, J. and Bloomfield, S.F. (2000) ‘Survival of Salmonella in bathrooms and toilets in domestic homes following salmonellosis’, Journal of Applied Microbiology 89(1): 137–44 <http://dx.doi.org/10.1046/j.1365-2672.2000.01091.x>.

Berner, C., Woods, E. and Foote, A. (2015) ‘Waste transformation, not waste treatment: understanding the value of poop in Sanivation’s waste processing model for cities’, in Faecal Sludge Management (FSM) 4 Conference Proceedings – Case Study Abstracts, pp. 3–5.

Bischel, H.N., Özel Duygan, B.D., Strande, L., McArdell, C.S., Udert, K.M. and Kohn, T. (2015) ‘Pathogens and pharmaceuticals in source-separated urine in eThekwini, South Africa’, Water Research 85: 57–65 <http://dx.doi.org/10.1016/j.watres.2015.08.022>.

Bleck, D. and Wettberg, W. (2012) ‘Waste collection in developing countries: tackling occupational safety and health hazards at their source’, Waste Management 32(11): 2009–17 <http://dx.doi.org/10.1016/j.wasman.2012.03.025>.

Broomfield, M., Davies, J., Furmston, P., Levy, L., Pollard, S.J.T. and Smith, R. (2010) Exposure Assessment of Landfill Sites Volume 1: Main Report, London, UK: Environment Agency.

Brown, J., Cumming, O., Bartram, J., Cairncross, S., Ensink, J., Holcomb, D. and Knee, J. (2015) ‘A controlled, before-and-after trial of an urban sanitation intervention to reduce enteric infections in children: research protocol for the Maputo Sanitation (MapSan) study, Mozambique’, BMJ Open 5(6): e008215.

Buckley, C.A., Foxon, K.M., Hawksworth, D.J., Archer, C., Pillay, S., Appleton, C., Smith, M. and Rodda, N. (2008) Research into UD/VIDP (Urine Diversion Ventilated Improved Double Pit) Toilets: Prevalence and Die-off of Ascaris Ova in Urine Diversion Waste, South Africa: Water Research Commission.

Burgess, T. (2016) Overflowing Cities: The State of the World’s Toilets 2016, London: WaterAid.

Buttner, M.P. and Stetzenbach, L.D. (1993) Monitoring airborne fungal spores in an experimental indoor environment to evaluate sampling methods and the effects of human activity on air sampling’, Applied and Environmental Microbiology 59(1): 219–26.

Cairncross, S., Hunt, C., Boisson, S., Bostoen, K., Curtis, V., Fung, I.C.H. and Schmidt, W.P. (2010) ‘Water, sanitation and hygiene for the prevention of diarrhoea’, International Journal of Epidemiology 39(Suppl. 1): 193–205 <http://dx.doi.org/10.1093/ije/dyq035>.

Campos, L.C., Ross, P., Nasir, Z.A., Taylor, H. and Parkinson, J. (2015) ‘Development and application of a methodology to assess sanitary risks in Maputo, Mozambique’, Environment and Urbanization 27(2): 371–88 <http://dx.doi.org/10.1177/0956247815595784>.

Carrington, E.-G. (2001) Evaluation of Sludge Treatments for Pathogen Reduction [pdf], Luxembourg: European Commission <http://ec.europa.eu/environment/archives/waste/sludge/pdf/sludge_eval.pdf> [accessed 27 September 2018].

Contzen, N. and Mosler, H.J. (2015) Methodological Fact Sheet 1: The Risks, Attitudes, Norms, Abilities, and Self-regulation (RANAS) Approach to Systematic Behavior Change, Dübendorf, Switzerland: Eawag, Swiss Federal Institute of Aquatic Science and Technology.

Curtis, V., Cairncross, S. and Yonli, R. (2000) ‘Domestic hygiene and diarrhoea’, Tropical Medicine and International Health 5(1): 22–32 <http://dx.doi.org/10.1046/j.1365-3156.2000.00512.x>.

Curtis, V., de Barra, M. and Aunger, R. (2011) ‘Disgust as an adaptive system for disease avoidance behaviour’, Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences 366(1563): 389–401 <http://dx.doi.org/10.1098/rstb.2010.0117>.

Darout, I.A., Astrom, A.N. and Skaug, N. (2005) ‘Knowledge and behaviour related to oral health among secondary school students in Khartoum Province, Sudan’, International Dental Journal 55(4): 224–30.

Devamani, C., Norman, G. and Schmidt, W.-P. (2014) ‘A simple microbiological tool to evaluate the effect of environmental health interventions on hand contamination’, International Journal of Environmental Research and Public Health 11(11): 11846–59.

Devine, J. and Devine, J. (2009) Introducing SaniFOAM: A Framework to Analyze Sanitation Behaviors to Design Effective Sanitation Programs [pdf], Water and Sanitation Program Working Paper <http://documents.worldbank.org/curated/en/272351468334778050/pdf/722050WSP0Box30PUBLIC00GSP0sanifoam.pdf> [accessed 26 September 2018].

Drechsel, P., Amoah, P., Löfman, O., Heistad, A., Fodge, M., Jenssen, P. and Stenström, T.A. (2008) ‘Quantitative microbial risk assessment of wastewater and faecal sludge reuse in Ghana’, in J. Hazel (ed.), Proceedings of the 33rd WEDC International Conference on Access to Sanitation and Safe Water: Global Partnerships and Local Actions, Accra, Ghana, 7–11 April 2008, pp. 90–7, Leicestershire, UK: Water, Engineering and Development Centre (WEDC).

du Preez, M., Conroy, R.M., Ligondo, S., Hennessy, J., Elmore-Meegan, M., Soita, A. and McGuigan, K.G. (2011) ‘Randomized intervention study of solar disinfection of drinking water in the prevention of dysentery in Kenyan children aged under 5 years’, Environmental Science & Technology 45: 9315–23 <http://dx.doi.org/10.1021/es2018835>.

Edmunds, K.L., Abd Elrahman, S., Bell, D.J., Brainard, J., Dervisevic, S., Fedha, T.P. and Few, R. (2016) ‘Recommendations for dealing with waste contaminated with Ebola virus: a hazard analysis of critical control points approach’, Bulletin of the World Health Organization (94): 424–32 <http://dx.doi.org/10.2471/BLT.15.163931>.

Emch, M. (1999) ‘Diarrheal disease risk in Matlab, Bangladesh’, Social Science and Medicine 49(4): 519–30 <http://dx.doi.org/10.1016/S0277-9536(99)00146-X>.

Enger, K.S., Nelson, K.L., Rose, J.B. and Eisenberg, J.N.S. (2013) ‘The joint effects of efficacy and compliance: a study of household water treatment effectiveness against childhood diarrhea’, Water Research 47(3): 1181–90 <http://dx.doi.org/10.1016/j.watres.2012.11.034>.

Exley, J.L.R., Liseka, B., Cumming, O. and Ensink, J.H.J. (2015) ‘The sanitation ladder, what constitutes an improved form of sanitation?’ Environmental Science and Technology 49(2): 1086–94 <http://dx.doi.org/10.1021/es503945x>.

Feacham, R., Bradley, D.H., Garelick, H. and Mara, D.D. (eds) (1983) Sanitation and Disease: Health Aspects of Excreta and Wastewater Management, Washington, DC: World Bank.

Forsythe, S.J. (2010) The Microbiology of Safe Food, 2nd edn, London: Blackwell Publishing Ltd.

Graf, J., Meierhofer, R., Wegelin, M. and Mosler, H.J. (2008) ‘Water disinfection and hygiene behaviour in an urban slum in Kenya: impact on childhood diarrhoea and influence of beliefs’, International Journal of Environmental Health Research 18(5): 335–55.

Haagsma, J., Tariq, L., Heederik, D.J. and Havelaar, A.H. (2012) ‘Infectious disease risks associated with occupational exposure: a systematic review of the literature’, Occupational and Environmental Medicine 69(2): 140–6 <http://dx.doi.org/10.1136/oemed-2011-100068>.

Haas, C. (2014) ‘QMRAwiki dose response’ [online], <http://qmrawiki.canr.msu.edu/index.php/Dose_Response> [accessed 26 September 2018].

Höglund, C. (2001) Evaluation of Microbial Health Risks Associated with the Reuse of Source-Separated Human Urine, doctoral thesis, Royal Institute of Technology (KTH) Department of Biotechnology, Applied Microbiology Swedish Institute for Infectious Disease Control (SMI) Department of Water and Environmental Microbiology, Stockholm.

Humphrey, J.H. (2009) ‘Child undernutrition, tropical enteropathy, toilets, and handwashing’, The Lancet 374(9694): 1032–5 <http://dx.doi.org/10.1016/S0140-6736(09)60950-8>.

Hurst, N.W. (1998) Risk Assessment The Human Dimensions, United Kingdom: Royal Society of Chemistry Publishing.

Julian, T.R. (2016) ‘Environmental transmission of diarrheal pathogens in low and middle income countries’, Environmental Science: Processes & Impacts 18: 944–55 <http://dx.doi.org/10.1039/C6EM00222F>.

Julian, T.R., Leckie, J.O. and Boehm, A.B. (2010) ‘Virus transfer between fingerpads and fomites’, Journal of Applied Microbiology 109(6): 1868–74 <http://dx.doi.org/10.1111/j.1365-2672.2010.04814.x>.

Katukiza, A.Y., Ronteltap, M., van der Steen, P., Foppen, J.W.A. and Lens, P.N.L. (2014) ‘Quantification of microbial risks to human health caused by waterborne viruses and bacteria in an urban slum’, Journal of Applied Microbiology 116(2): 447–63 <http://dx.doi.org/10.1111/jam.12368>.

Leveson, N.G. (2011) Engineering a Safer World: Systems Thinking Applied to Safety [pdf] <http://sunnyday.mit.edu/safer-world.pdf> [accessed 27 September 2018].

Leveson, N. (2012) ‘Safety-guided design’, in Engineering a Safer World: Systems Thinking Applied to Safety, Cambridge, MA: Massachusetts Institute of Technology (MIT) Press.

Lingaas, E. and Fagernes, M. (2009) ‘Development of a method to measure bacterial transfer from hands’, Journal of Hospital Infection 72(1): 43–9 <http://dx.doi.org/10.1016/j.jhin.2009.01.022>.

Makaya, J.M., Kaplon, J., Fremy, C., Barro, N., Aho, S., Pothier, P., Belliot, G. and Traore, A.S. (2015) ‘Norovirus and rotavirus survival in urine collected from a public ecological sanitation system in Ouagadougou, Burkina Faso’, Food and Environmental Virology 7(1): 41–8.

Maponga, B.A., Chirundu, D., Gombe, N.T., Tshimanga, M., Shambira, G. and Takundwa, L. (2013) ‘Risk factors for contracting watery diarrhoea in Kadoma City, Zimbabwe, 2011: a case control study’, BMC Infectious Diseases 13: 567.

Mara, D.D. and Oragui, J. (1985) ‘Bacteriological methods for distinguishing between human and animal faecal pollution of water: results of fieldwork in Nigeria and Zimbabwe’, Bulletin of the World Health Organization 63(4): 773–83.

Maricou, H., Verstraete, W. and Mesuere, K. (1998) ‘Hygienic aspects of biowaste composting: airborne microbial concentrations as a function of feedstock, operation and season’, Waste Management & Research 16(4): 304–11 <http://dx.doi.org/10.1177/0734242X9801600402>.

Mattioli, M.C.M., Pickering, A.J., Gilsdorf, R.J., Davis, J. and Boehm, A.B. (2013) ‘Hands and water as vectors of diarrheal pathogens in Bagamoyo, Tanzania’, Environmental Science & Technology 47(1): 355–63 <http://dx.doi.org/10.1021/es303878d>.

Mattioli, M.C.M., Davis, J. and Boehm, A.B. (2015) ‘Hand-to-mouth contacts result in greater ingestion of feces than dietary water consumption in Tanzania: a quantitative fecal exposure assessment model’, Environmental Science & Technology 49(3): 1912–20 <http://dx.doi.org/10.1021/es505555f>.

Mayer, J. (1986) ‘Ecological associative analysis’, in M. Pacione (ed.), Medical Geography: Progress and Prospect, p. 64, London: Croom Helm.

McMahon, S., Caruso, B.A., Obure, A., Okumu, F. and Rheingans, R.D. (2011) ‘Anal cleansing practices and faecal contamination: a preliminary investigation of behaviours and conditions in schools in rural Nyanza Province, Kenya’, Tropical Medicine and International Health 16(12): 1536–40 <http://dx.doi.org/10.1111/j.1365-3156.2011.02879.x>.

Medland, L., Cotton, A.P. and Scott, R.E. (2015) Understanding and Addressing Vulnerability in the Sanitation Service Chain, SPLASH Urban Sanitation Research Programme Briefing Note 3, Loughborough, UK: Water, Engineering and Development Centre (WEDC).

Michie, S., West, R., Campbell, R., Brown, J. and Gainforth, H. (2014) ABC of Behavior Change Theories, 1st edn, London: Silverback Publishing.

Mnkeni, P.N.S., Kutu, F.R., Muchaonyerwa, P. and Austin, L.M. (2008) ‘Evaluation of human urine as a source of nutrients for selected vegetables and maize under tunnel house conditions in the Eastern Cape, South Africa’, Waste Management & Research: The Journal of the International Solid Wastes and Public Cleansing Association, ISWA 26(2): 132–9.

Moore, G. and Griffith, C. (2007) ‘Problems associated with traditional hygiene swabbing: the need for in-house standardization’, Journal of Applied Microbiology 103(4): 1090–103 <http://dx.doi.org/10.1111/j.1365-2672.2007.03330.x>.

Mosler, H. (2012a) ‘A systematic approach to behavior change interventions for the water and sanitation sector in developing countries: a conceptual model, a review, and a guideline’, International Journal of Environmental Health Research 22: 431–49.

Mosler, H. (2012b) ‘How to achieve evidence-based behavioural change’, Sandec News: 14–5.

Moya, J., Bearer, C.F. and Etzel, R. (2004) ‘Various life stages’, Pediatrics 113(4): 996–1006 <http://dx.doi.org/10.1542/peds.113.4.S1.996>.

Mwase, I., Mutoro, A., Owino, V., Garcia, A-L. and Wright, C.M. (2016) ‘Poor infant feeding practices and high prevalence of malnutrition in urban slum child care centres in Nairobi: a pilot study’, Journal of Tropical Pediatrics 62(1): 46–54.

Ngure, F.M., Reid, B.M., Humphrey, J.H., Mbuya, M.N., Pelto, G. and Stoltzfus, R.J. (2014) ‘Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links’, Annals of the New York Academy of Sciences 1308(1): 118–28 <http://dx.doi.org/10.1111/nyas.12330>.

Nyoka, R., Foote, A.D., Woods, E., Lokey, H., O’Reilly, C.E., Magumba, F., Okello, P., Mintz, E.D., Marano, N. and Morris, J.F. (2017) ‘Sanitation practices and perceptions in Kakuma refugee camp, Kenya: comparing the status quo with a novel service-based approach’, PLoS ONE 12(7): 1–16 <http://dx.doi.org/10.1371/journal.pone.0180864>.

O’Keefe, M., Luthi, C., Tumwebaze, I.K. and Tobias, R. (2015) ‘Opportunities and limits to market-driven sanitation services: evidence from urban informal settlements in East Africa’, Environment and Urbanization 27(2): 421–40 <https://doi.org/10.1177%2F0956247815581758>.

Peasey, A. (2000) ‘Health aspects of dry sanitation with waste reuse’, Knowledge Creation Diffusion Utilization 324: 48.

PHE (2013) Detection and Enumeration of Bacteria in Swabs and Other Environmental Samples, Microbiology Services Food Water and Environmental Microbiology Standard Method [online], London: Public Health England, Microbiology Services Food, Water & Environmental Microbiology Methods Working Group <www.hpa.org.uk/ProductsServices/MicrobiologyPathology/SpecialistMicrobiologyServices/FoodWaterEnvironmentalMicrobiologyServices/NationalReferenceLab oratoryForFoodMicrobiology/> [accessed 27 September 2018].

Pickering, A.J., Julian, T.R., Marks, S.J., Mattioli, M.C., Boehm, A.B., Schwab, K.J. and Davis, J. (2012) ‘Fecal contamination and diarrheal pathogens on surfaces and in soils among Tanzanian households with and without improved sanitation’, Environmental Science & Technology 46(11): 5736–43 <http://dx.doi.org/10.1021/es300022c>.

Prüss-üstün, A., Kay, D., Fewtrell, L. and Bartram, J. (2004) ‘Unsafe water, sanitation and hygiene’, in M. Ezzati, A.D. Lopez, A. Rodgers, and C.L.J. Murray (eds), Comparative Quantification of Health Risks Global and Regional Burden of Disease Attributable to Selected Major Risk Factors Volume 1, pp. 1321–52, Geneva: WHO.

Rheingans, R., Anderson, J.D., Luyendijk, R. and Cumming, O. (2014) ‘Measuring disparities in sanitation access: does the measure matter?’ Tropical Medicine & International Health: TM & IH 19(1): 2–13.

Robb, K., Null, C., Teunis, P., Yakubu, H., Armah, G. and Moe, C.L. (2017) ‘Assessment of fecal exposure pathways in low-income urban neighborhoods in Accra, Ghana: rationale, design, methods, and key findings of the Sanipath study’, American Journal of Tropical Medicine and Hygiene 97(4): 1020–32 <http://dx.doi.org/10.4269/ajtmh.16-0508>.

Rochelle-Newall, E., Huong Nguyen, T.M., Quynh Le, T.P., Sengtaheuanghoung, O. and Ribolzi, O. (2015) ‘A short review of fecal indicator bacteria in tropical aquatic ecosystems: knowledge gaps and future directions’, Frontiers in Microbiology 6: 308.

Rongo, L.M.B., Barten, F., Msamanga, G.I., Heederik, D. and Dolmans, W.M.V. (2004) ‘Occupational exposure and health problems in small-scale industry workers in Dar es Salaam, Tanzania: a situation analysis’, Occupational Medicine (Oxford, England) 54(1): 42–6.

Rusin, P., Maxwell, S. and Gerba, C. (2002) ‘Comparative surface-to-hand and fingertip-to-mouth transfer efficiency of gram-positive bacteria, gram-negative bacteria, and phage’, Journal of Applied Microbiology 93(4): 585–92 <http://dx.doi.org/10.1046/j.1365-2672.2002.01734.x>.

Russel, K., Tilmans, S. Kramer, S., Sklar, R., Tillias, D. and Davis, J. (2015) ‘User perceptions of and willingness to pay for household container-based sanitation services: experience from Cap Haitien, Haiti’, Environment and Urbanization 27(2): 525–40 <http://dx.doi.org/10.1177/0956247815596522>.

Scammel, M.K. (2010) ‘Qualitative environmental health research: an analysis of the literature: 1991–2008’, Environmental Health Perspectives 118(8): 1146–54.

Scheithauer, S., Häfner, H., Seef, R., Seef, S., Hilgers, R.D. and Lemmen, S. (2016) ‘Disinfection of gloves: feasible, but pay attention to the disinfectant/glove combination’, Journal of Hospital Infection 94(3): 268–72 <http://dx.doi.org/10.1016/j.jhin.2016.08.007>.

Scott, E., Bloomfield, S.F. and Barlow, C.G. (1982) ‘An investigation of microbial contamination in the domestic environment’, Journal of Hygiene (Cambridge) 89: 279–93.

Stenström, T.A., Seidu, R., Nelson, E. and Christian, Z. (2011) Microbial Exposure and Health Assessments in Sanitation Technologies and Systems [pdf], Stockholm, Sweden: EcoSanRes Programme, Stockholm Environment Institute <www.ecosanres.org/pdf_files/Microbial_Exposure_&_Health_Assessments_in_Sanitation_Technologies_&_Systems.pdf> [accessed 26 September 2018].

Thomas, E., Andrés, L.A., Borja-Vega, C. and Sturzenegger, G. (2018) Innovations in WASH Impact Measures: Water and Sanitation Measurement Technologies and Practices to Inform the Sustainable Development Goals, Washington, DC: World Bank.

Tilmans, S., Russel, K., Sklar, R., Page, L., Kramer, S. and Davis, J. (2016) ‘Container-based sanitation: assessing costs and effectiveness of excreta management in Cap Haitien, Haiti’, Environment and Urbanization 27(6), 89–104 <http://dx.doi.org/10.1177/0956247815572746>.

Tschopp, A., Bernard, A., Thommen, A.M., Jeggli, S., Dumont, X., Oppliger, A. and Hotz, P. (2011) ‘Exposure to bioaerosols, respiratory health and lung-specific proteins: a prospective study in garbage and wastewater workers’, Occupational and Environmental Medicine 68(11): 856–9 <http://dx.doi.org/10.1136/oem.2010.060178>.

Turner, S., Lines, S., Chen, Y., Hussey, L. and Agius, R. (2005) ‘Work-related infectious disease reported to the Occupational Disease Intelligence Network and The Health and Occupation Reporting network in the UK (2000–2003)’, Occupational Medicine 55(4): 275–81 <http://dx.doi.org/10.1093/occmed/kqi109>.

Walser, S.M., Gerstner, D.G., Brenner, B., Bünger, J., Eikmann, T., Janssen, B., Kolb, S., Kolk, A., Nowak, D., Raulf, M., Sagunski, H., Sedlmaier, N., Suchenwirth, R., Wiesmüller, G., Wollin, K.M., Tesseraux, I. and Herr, C.E.W. (2015) ‘Evaluation of exposure-response relationships for health effects of microbial bioaerosols: a systematic review’, International Journal of Hygiene and Environmental Health 218(7): 577–89 <http://dx.doi.org/10.1016/j.ijheh.2015.07.004>.

Wang, Y., Moe, C.L., Null, C., Raj, S.J., Baker, K.K., Robb, K.A. and Yakubu, H. (2017) ‘Multipathway quantitative assessment of exposure to fecal contamination for young children in low-income urban environments in Accra, Ghana: the Sanipath analytical approach’, American Journal of Tropical Medicine and Hygiene 97(4): 1009–19 <http://dx.doi.org/10.4269/ajtmh.16-0408>.

Westrell, T. (2004) Microbial Risk Assessment and its Implications for Risk Management in Urban Water Systems, doctoral thesis, Linköping University, The Tema Institute, Department of Water and Environmental Studies, Linköping: Linköping University Electronic Press.

WHO (2003) Annex 7 Application of Hazard Analysis and Critical Control Point (HACCP) Methodology to Pharmaceuticals, WHO Technical Report Series, No. 908, 2003 Annex, pp. 99–112, Geneva: WHO.

WHO (2016) Sanitation Safety Planning, Geneva: WHO.

WHO (2017) Progress on Drinking Water, Sanitation and Hygiene, Geneva: WHO.

Worrell, C.M., Wiegand, R.E., Davis, S.M., Odero, K.O., Blackstock, A., Cuéllar, V.M., Njenga, S.M., Montgomery, J.M., Roy, S.L. and Fox, L.M. (2016) ‘A cross-sectional study of water, sanitation, and hygiene-related risk factors for soil-transmitted helminth infection in urban school- and preschool-aged children in Kibera, Nairobi’, Plos One 11(3): e0150744 <http://dx.doi.org/10.1371/journal.pone.0150744>.

WSUP/EY (2017) The World Can’t Wait for Sewers [pdf], Water & Sanitation for the Urban Poor and Ernst and Young <www.ey.com/Publication/vwLUAssets/ey-the-world-cant-wait-for-sewers/$FILE/ey-the-world-cant-wait-for-sewers.pdf> [accessed 27 September 2018].