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How to Use a Public Restroom and Not Get Sick

ADA Sign Depot

April 19, 2019

The Right Way to Use a Public Bathroom (to Avoid Getting Sick)

The odds of becoming ill from using a public bathroom are slim. But there are a few things you can do to minimize your risk even more. Here’s what to keep in mind.

By Melinda Wenner Moyer New York Times April 17, 2019

ADA Sign Depot brushed aluminum restroom signageThere are a handful of things in this world I’m extremely thankful for, yet also quite grossed out by. Public bathrooms are one of them. (Also: colonoscopies.) My disgust peaks around this time of year, when everyone around me seems to be coughing or sneezing or both — sometimes in the next stall.

What, if anything, can we do to minimize our exposure to germs when we have to relieve ourselves in public? I called a handful of experts — it’s fun to ask total strangers about toilet bacteria, believe me — and dug up some pretty nasty research to find out. You’re welcome.

Choose your stall wisely.

In a 1995 study, a researcher at the University of California, San Diego, monitored how much toilet paper was used in each of four stalls in a men’s room at a state beach. Over 10 weeks, he found that 60 percent of the paper was used in the two middle stalls, which suggests that these were the most commonly chosen. Assuming that all stalls are cleaned at the same frequency, the cleanest stalls should, then, be the ones on the ends. That said, if one stall looks visibly cleaner than the rest, that’s most likely your best bet, even if it’s not at the end.

Don’t fret about the toilet seat.

“To my knowledge, no one has ever acquired an S.T.D. on the toilet seat, unless they were having sex on the toilet seat,” Abigail Salyers, former president of the American Society of Microbiology, told WebMD. Put another way, for you to catch something nasty from a seat, the germs on it have to travel into your genital or urinary tract or get into your body via an open cut or sore on your rear end — none of which are particularly likely. (This assumes you don’t touch the seat with your hands. Try not to. Also: Don’t touch your face in a public bathroom, because any germs on your hands could then get into your nose or mouth.)

If you’re grossed out nonetheless, consider cleaning the toilet seat with an alcohol-based wipe before you sit down, suggested Dr. David Jay Weber, an epidemiologist and physician at the Gillings School of Global Public Health at the University of North Carolina, Chapel Hill. You can also line the seat with toilet paper, but try not to touch the seat in the process — and keep in mind that the paper you line the seat with may also have germs on it, because the last time the toilet was flushed, it probably aerosolized germs from the toilet into the air, which may have settled on the paper you’re using.

What about squatting? Research suggests that most women prefer squatting over a toilet seat to avoid germ and urine exposure. But some doctors worry that this position can make it hard to fully relax the pelvic floor, which could pose risks. Some research suggests, for instance, that women who squat take longer to urinate and don’t release all of their urine, which could increase the risk for urinary tract infections. But in healthy individuals, these risks are most likely small, said Dr. Doreen Chung, a urologist at NewYork-Presbyterian/Columbia University Irving Medical Center. And it’s far better to squat than to eschew the restroom entirely, she said. “There are patients who hold in their urine who are then unable to relax their pelvic floor musculature to urinate,” she said. But if you do squat, be kind and clean up after yourself if need be. (Ladies, you know what I’m talking about.)

Most public toilets don’t have lids, but if yours does, close the lid before flushing to minimize the number of germs released into the air. Either way, exit the stall as quickly as possible after flushing, Dr. Weber said.

Wash — and dry — your hands, and don’t touch anything after you do.

It’s very important to wash your hands after using a public bathroom — they will inevitably get germy because of what you’ve touched. A 2011 study, for instance, found fecal bacteria on public bathroom flush handles as well as skin-related bacteria, including staphylococci and streptococci, on bathroom doors, stall doors, faucet handles and soap dispensers. Yet many people either don’t wash their hands or don’t do it the right way. “There are areas people miss, like the back of the tops of the fingers,” said Dr. Matthew Zahn, chairman of the Infectious Diseases Society of America’s public health committee. Dr. Weber suggested washing for at least 15 seconds with water at a comfortable temperature so that you aren’t inclined to rush.

Think twice, though, before using your just-washed hands to turn off the faucet. “That’s probably the dirtiest place in the bathroom,” said Dr. Judy Stone, a Maryland-based infectious disease physician — after all, everyone turns on the faucet with dirty hands. Instead, consider drying your hands with a paper towel and then using that towel to turn off the faucet. (If it’s an automatic faucet, congratulations: You just won the lottery. If there are no paper towels, use toilet paper or an alcohol wipe if you have one.)

As for hand dryers versus paper towels: When it comes to hygiene, towels win. That’s because if you or other bathroom users have lingering hand germs, they’ll get blown all over the bathroom by dryers. In a 2012 review of 12 studies, researchers in Australia and China concluded that compared with dryers, paper towels “cause less contamination of the washroom environment.” Also, if you, like me, have been tempted not to dry your hands at all, or to only partly dry them, please reconsider. A 1997 study found that bacteria, when touched, adhere to wet hands much more readily than to dry hands, and also that wet hands deposit bacteria onto other surfaces quite easily.

There’s one final and often-forgotten bathroom step that has implications for your health: exiting. Even if your hands are clean when you walk toward the bathroom door, they won’t be after you’ve pushed the door open with your hands or grasped a door handle. If possible, open the door with your shoulder, elbow or hip. If the door has to be pulled open, Dr. Stone suggested using the paper towel you used for hand drying, then discarding the towel outside.

But honestly, don’t worry.

Fellow germaphobes, a final note of reassurance: It’s quite unlikely that public bathrooms will make you sick, and it’s better to go when you need to than to hold it until you get home. Yes, bathrooms often smell and sometimes look unsavory, and it’s true that they harbor germs. But so do so many other places we frequent, including offices, schools, homes and stores. And unlike so many of these other germy locales, public bathrooms come equipped with soap and water, which do a marvelous job of removing microbes from your hands. Germs won’t make you sick if you leave them in the bathroom instead of taking them with you.

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