While in the past, mains drainage and indoor plumbing were a sign of modernity, today people want “designer” bathrooms, luxury fixtures, power showers, fitted kitchens, and the latest technology. There has been a “restroom revolution” in Asia in particular, with companies such as Toto producing complete prefabricated bathroom units for the Japanese housing market, all the components being made together. Colored polyester resins, modern plastics, and marble and granite composites feature strongly in these modern bathroom modules (Greed 2003). Likewise, modern automatic public toilets are fully integrated, prefabricated systems that often use stainless steel and pathogen-resistant polymer materials. However, user-end toilet innovation must be matched by provider-end infrastructural sewerage system provision. The functionality of domestic toilets is dependent on there being a working sewerage system to take away output. Alternatively, the output from a luxury bathroom, as is the case in some affluent areas in developing countries, might end up in a cesspool under the house for collection by traditional night-soil operatives. Alternatively, as in some parts of the Americas and Australasia, even upmarket private houses are not served by a municipal sewerage and drainage system, and depend upon their own cesspits, generators, and water tanks.
Those who attempted to bring plumbing indoors faced technical as well as attitudinal challenges. Decisions on how wastewater was removed required as much concern as those made to ensure an adequate water supply. But equally vexing was the prevailing miasma theory of disease, which held that illnesses stemmed from "bad air" that was readily identifiable by its offensive odor. This led to a distrust of early indoor plumbing that tended to leak and a deadly fear of the sewer gas that accompanied the leaks. It is no wonder then that many individuals maintained a strong belief that elimination was best taken care of out of doors.