Evaluating the sustainability of sanitation systems is essential in achieving the sixth sustainable development goal. However, there are only limited number of available evaluation indexes, which are utilized to macroscopically determine a community’s sanitation coverage. Consequently, an index is required, which can evaluate different sanitation options for a specific community. In this paper, the sanitation sustainability index (SSI) is suggested as an indicator for evaluating the sustainability of sanitation systems. The SSI has sub-indexes that consider the technical, social, and economic aspects of the sanitation system, and all the variables are dimensionless and heavily dependent on the current state of the community where the sanitation system is going to be implemented. The applicability of the SSI was demonstrated by evaluating the implementation of two onsite sanitation systems, including one septic tank system and one resource-oriented sanitation (ROS) system in South Korea. A sensitivity analysis defined the variables that have significant impact, and the statistical distribution of the SSI for both systems was forecasted. The results showed that for South Korea, which has a profound history of utilizing human waste as fertilizer, utilizing the resource-oriented sanitation system is more sustainable, although it has a lower social sub-index score compared to the septic tank system.

Exposure to environmental tobacco smoke (ETS) is the reason for approximately 1% of global mortality. ETS exposure can happen either as inhalation of direct cigarette smoke (second-hand smoke) or its associated residue particles (third-hand smoke), especially when living with a smoker in the same family. This study investigated the association between the urinary cotinine levels, as biomarkers of exposure to tobacco smoke, of smokers and those exposed to second-hand and third-hand smoke while living in the same family, through a Korean nationwide survey. Direct assessment of ETS exposure and its lifetime effect on human health is practically difficult. Therefore, this study evaluated the internal estimated daily intake (I-EDI) of nicotine and equivalent smoked cigarette per day (CPD). The carcinogenic and non-carcinogenic inhalation risks of ETS exposure were assessed by considering the calculated equivalent CPD and composition of cigarette smoke of high-selling cigarette brands in South Korea. The results show that there is a statistically significant positive correlation between the cotinine levels of smokers and those of the non-smokers living in the same family. The risk assessment results yielded that hazard index (HI) and total excess lifetime cancer risk (ECR) for both second-hand and third-hand smoke exposure can exceed 1 and 1 × 10⁻⁶, respectively, especially in women and children. In the composition of the cigarette smoke, 1,3-butadiene and acrolein substances had the highest contribution to HI and ECR. Consequently, the provision of appropriate plans for smoking cessation as a strategy for the prevention of ETS exposure to women and children is deemed necessary.