By Richard Trubo
Perhaps Ally McBeal can ease her off-the-charts stress levels by escaping to the office restroom. But for most of us, public toilets are actually a bit scary.
If you squirm at the thought of creepy germs lurking on toilet seats and faucet handles, you probably spend as little time as possible in the restrooms of your office building, not to mention those in restaurants, hotels and (God forbid!) gas stations. And during those nerve-wracking moments when you dare to venture into the confines of the bathroom, you may find yourself pushing open the stall door with your elbows, crouching precariously above the toilet seat rather than letting your skin touch it, and flushing with your shoe.
But while there's plenty of bathroom paranoia to go around, anxiety might be a little overdone. Yes, there can be plenty of bugs lying in wait in public restrooms, including both familiar and unfamiliar suspects like streptococcus, staphylococcus, E. coli and shigella bacteria, hepatitis A virus, the common cold virus, and various sexually transmitted organisms. But if your immune system is healthy, and if you adopt simple hygienic measures like handwashing, you should be able to deliver a knockout punch to most of what you encounter and perhaps put your "germ-phobia" to rest.
No doubt about it, there could be a witch's brew of germs wherever you turn in public restrooms. Many people consider toilet seats to be public enemy No. 1 -- the playground for organisms responsible for STDs like chlamydia or gonorrhea. But before you panic, the toilet seat is not a common vehicle for transmitting infections to humans. Many disease-causing organisms can survive for only a short time on the surface of the seat, and for an infection to occur, the germs would have to be transferred from the toilet seat to your urethral or genital tract, or through a cut or sore on the buttocks or thighs, which is possible but very unlikely.
"To my knowledge, no one has ever acquired an STD on the toilet seat -- unless they were having sex on the toilet seat!" says Abigail Salyers, PhD, president of the American Society for Microbiology (ASM).
Common cold germs, like most viruses, die rapidly, and thus may be less of a threat than you think. "Even if you come into contact with particular viruses or bacteria, you'd have to contract them in amounts large enough to make you sick," says Judy Daly, PhD, professor of pathology at the University of Utah in Salt Lake City.
Germs in feces can be propelled into the air when the toilet is flushed. For that reason, Philip Tierno, MD, director of clinical microbiology and diagnostic immunology at New York University Medical Center and Mt. Sinai Medical Center, advises leaving the stall immediately after flushing to keep the microscopic, airborne mist from choosing you as a landing site. "The greatest aerosol dispersal occurs not during the initial moments of the flush, but rather once most of the water has already left the bowl," he says.
Other hot zones in public bathrooms include sinks, faucet handles, and towel dispensers. Picture someone emerging from a bathroom stall, and turning on the faucet with dirty hands, and you'll know why faucet handles are a potentially troublesome surface. Studies at the University of Arizona in Tucson found that sinks are the greatest reservoir of germ colonies in restrooms, thanks in part to accumulations of water that become breeding grounds for tiny organisms.
"Your own immune system is your first line of defense against contracting diseases in public restrooms," says Daly. But hand washing is a very important adjunct. Yet a survey that was part of ASM's Clean Hands Campaign revealed this dirty little secret: Though 95% of men and women claim that they wash after using a public toilet, observations made by researchers discovered that only 67% actually do.
"Many people are unconcerned about microorganisms because you can rush out of an airport bathroom without washing your hands, and lightning won't strike you," says Salyers. "So these people may think that handwashing is not all that important."
Even if you wash your hands, you may not do it properly, says Tierno, author of The Secret Life of Germs. "Some individuals move their hands quickly under a flow of water for only a second or so, and they don't use soap. That's not going to do much good."
Tierno advises rubbing soapy water all over the hands and fingers for 20 to 30 seconds, including under the fingernails. As you create friction by rubbing the hands together, you'll loosen the disease-causing particles on the hands. After rinsing thoroughly, repeat the process, he says.
Even if you're a frequent visitor to public restrooms, you can coexist peacefully and even healthfully with the germs around you. In addition to handwashing, try these strategies:
- Rather than flushing the toilet with your bare hand, use your shoe. Everyone else is probably doing it.
- After washing your hands, use a paper towel to shut off the faucet and to open the door on your way out, in order to keep from becoming contaminated, says Tierno.
- Whenever possible, use a restroom stall with toilet paper that is almost completely covered in a metal or plastic holder, which will guard against splattering water and germs.
- Use hot-air hand dryers with care. In order to feel the hot air, you might have to get very close to the vents. Don't let your hands touch the surface of the vents, however, or you'll risk contamination.
Originally published June 10, 2002.
Reviewed by Charlotte E. Grayson, MD.
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