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  1. Simha P, Barton MA, Perez-Mercado LF, McConville JR, Lalander C, Magri ME, et al.
    Sci Total Environ, 2021 Apr 15;765:144438.
    PMID: 33418332 DOI: 10.1016/j.scitotenv.2020.144438
    Source-separating sanitation systems offer the possibility of recycling nutrients present in wastewater as crop fertilisers. Thereby, they can reduce agriculture's impacts on global sources, sinks, and cycles for nitrogen and phosphorous, as well as their associated environmental costs. However, it has been broadly assumed that people would be reluctant to perform the new sanitation behaviours that are necessary for implementing such systems in practice. Yet, few studies have tried to systematically gather evidence in support of this assumption. To address this gap, we surveyed 3763 people at 20 universities in 16 countries using a standardised questionnaire. We identified and systematically assessed cross-cultural and country-level explanatory factors that were strongly associated with people's willingness to consume food grown using human urine as fertiliser. Overall, 68% of the respondents favoured recycling human urine, 59% stated a willingness to eat urine-fertilised food, and only 11% believed that urine posed health risks that could not be mitigated by treatment. Most people did not expect to pay less for urine-fertilised food, but only 15% were willing to pay a price premium. Consumer perceptions were found to differ greatly by country and the strongest predictive factors for acceptance overall were cognitive factors (perceptions of risks and benefits) and social norms. Increasing awareness and building trust among consumers about the effectiveness of new sanitation systems via cognitive and normative messaging can help increase acceptance. Based on our findings, we believe that in many countries, acceptance by food consumers will not be the major social barrier to closing the loop on human urine. That a potential market exists for urine-fertilised food, however, needs to be communicated to other stakeholders in the sanitation service chain.
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