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Article: A mixed-methods study on toilet hygiene practices among Chinese in Hong Kong

TitleA mixed-methods study on toilet hygiene practices among Chinese in Hong Kong
Authors
KeywordsChina
Hygiene practices
Infectious diseases
Public toilet
Issue Date2019
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcpublichealth/
Citation
BMC Public Health, 2019, v. 19 n. 1, p. article no. 1654 How to Cite?
AbstractBackground: Public toilets are a common transmission vector of infectious diseases due to environmental contamination. Research on Chinese people’s hygiene practices in public lavatories are lacking. This study examined Chinese people’s hygiene practices in public lavatories in Hong Kong. Methods: We conducted qualitative interviews and a self-administered questionnaire survey with local residents from June 2016 to April 2018. Four focus group discussions and three individual interviews informed the design of the questionnaire. We recruited interviewees and survey respondents via social service centers. The interviews and questionnaire focused on the public’s daily practices and hygiene behaviors in public toilets. Content analysis of qualitative data was conducted. Multivariable logistic regressions were used to examine the association between age and toilet hygiene behaviors. Results: Our qualitative component revealed a range of handwashing practices, from not washing at all, washing without soap, to washing for a longer time than instructions. Other toilet use practices were identified, such as not covering toilet lid before flushing and stepping on toilet seats due to dirtiness, and spitting into toilet bowls or hand basin. Totally, 300 respondents completed the questionnaire. Among them, 212 (70.9%) were female and 246 (86.1%) were aged 65 or below. More than two thirds always washed hands with soap (68.7%) and dried hands with paper towels (68.4%). Up to 16.2% reported stepping on toilet seats and 43.9% never covered the toilet lid before flushing. Over one fourth (26.4%) spit into squat toilets/ toilet bowl. Regression analyses showed that the elderly group were less likely to report stepping on toilet seats (adjusted odds ratio, AOR = 0.17, 95%CI 0.03–0.88), flushing with the toilet lid closed (AOR = 0.40, 0.16–0.96), but more likely to spit into squat toilets/ toilet bowl (AOR = 4.20, 1.50–11.74). Conclusions Hong Kong Chinese’s compliance to hygiene practices in public toilets is suboptimal. Stepping on toilet seat is a unique Chinese practice due to the dirtiness of toilet seats. Spitting practices may increase the risk of airborne infectious diseases and need improvement. Measures are needed to improve toilet hygiene behaviors, including public education campaigns and keeping toilet environment clean.
Persistent Identifierhttp://hdl.handle.net/10722/280967
ISSN
2018 Impact Factor: 2.567
2015 SCImago Journal Rankings: 1.372
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorWu, DD-
dc.contributor.authorLam, TP-
dc.contributor.authorChan, HY-
dc.contributor.authorLam, KF-
dc.contributor.authorZhou, XD-
dc.contributor.authorXu, JY-
dc.contributor.authorSun, KST-
dc.contributor.authorHo, PL-
dc.date.accessioned2020-02-25T07:43:23Z-
dc.date.available2020-02-25T07:43:23Z-
dc.date.issued2019-
dc.identifier.citationBMC Public Health, 2019, v. 19 n. 1, p. article no. 1654-
dc.identifier.issn1471-2458-
dc.identifier.urihttp://hdl.handle.net/10722/280967-
dc.description.abstractBackground: Public toilets are a common transmission vector of infectious diseases due to environmental contamination. Research on Chinese people’s hygiene practices in public lavatories are lacking. This study examined Chinese people’s hygiene practices in public lavatories in Hong Kong. Methods: We conducted qualitative interviews and a self-administered questionnaire survey with local residents from June 2016 to April 2018. Four focus group discussions and three individual interviews informed the design of the questionnaire. We recruited interviewees and survey respondents via social service centers. The interviews and questionnaire focused on the public’s daily practices and hygiene behaviors in public toilets. Content analysis of qualitative data was conducted. Multivariable logistic regressions were used to examine the association between age and toilet hygiene behaviors. Results: Our qualitative component revealed a range of handwashing practices, from not washing at all, washing without soap, to washing for a longer time than instructions. Other toilet use practices were identified, such as not covering toilet lid before flushing and stepping on toilet seats due to dirtiness, and spitting into toilet bowls or hand basin. Totally, 300 respondents completed the questionnaire. Among them, 212 (70.9%) were female and 246 (86.1%) were aged 65 or below. More than two thirds always washed hands with soap (68.7%) and dried hands with paper towels (68.4%). Up to 16.2% reported stepping on toilet seats and 43.9% never covered the toilet lid before flushing. Over one fourth (26.4%) spit into squat toilets/ toilet bowl. Regression analyses showed that the elderly group were less likely to report stepping on toilet seats (adjusted odds ratio, AOR = 0.17, 95%CI 0.03–0.88), flushing with the toilet lid closed (AOR = 0.40, 0.16–0.96), but more likely to spit into squat toilets/ toilet bowl (AOR = 4.20, 1.50–11.74). Conclusions Hong Kong Chinese’s compliance to hygiene practices in public toilets is suboptimal. Stepping on toilet seat is a unique Chinese practice due to the dirtiness of toilet seats. Spitting practices may increase the risk of airborne infectious diseases and need improvement. Measures are needed to improve toilet hygiene behaviors, including public education campaigns and keeping toilet environment clean.-
dc.languageeng-
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcpublichealth/-
dc.relation.ispartofBMC Public Health-
dc.rightsBMC Public Health. Copyright © BioMed Central Ltd.-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectChina-
dc.subjectHygiene practices-
dc.subjectInfectious diseases-
dc.subjectPublic toilet-
dc.titleA mixed-methods study on toilet hygiene practices among Chinese in Hong Kong-
dc.typeArticle-
dc.identifier.emailLam, TP: tplam@hku.hk-
dc.identifier.emailChan, HY: step0826@hku.hk-
dc.identifier.emailLam, KF: hrntlkf@hkucc.hku.hk-
dc.identifier.emailSun, KST: kssun2@hku.hk-
dc.identifier.emailHo, PL: plho@hku.hk-
dc.identifier.authorityLam, TP=rp00386-
dc.identifier.authorityLam, KF=rp00718-
dc.identifier.authorityHo, PL=rp00406-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/s12889-019-8014-4-
dc.identifier.pmid31823757-
dc.identifier.pmcidPMC6902477-
dc.identifier.scopuseid_2-s2.0-85076376552-
dc.identifier.hkuros309234-
dc.identifier.volume19-
dc.identifier.issue1-
dc.identifier.spagearticle no. 1654-
dc.identifier.epagearticle no. 1654-
dc.publisher.placeUnited Kingdom-

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