The Doctor Game Make a Stink for Better Public Washrooms

By Common Sense Health – W. Gifford-Jones MD and Diana Gifford When asked how to become a famous comedian, Steve Martin replied, “Be so good they can’t ignore you.” It’s true, bad performers can usually be ignored. But there’s no ignoring bad public washrooms. Public washrooms have a reputation for abysmal filth, as evidenced by dirty toilets, overflowing trash, empty or broken soap dispensers, sloppy countertops, and door handles not to be touched. An American survey found that 21 percent of respondents used a public washroom at least six times a week, sometimes over 15 times! The reason was not always obvious. Youth tend to visit washrooms to use their phones, change their clothes, or “get away”. In fact, 21 percent of youth acknowledge the use of public washrooms to take a mental health break, to avoid someone, and on occasion to cry. Older people, in addition to using the facilities, also visit public washrooms to check their appearance. Whatever the reason to visit, how important is it to take precautions? The good news is that some of the germs found in public washrooms are no different than the germs found in many other places, including the bathroom at home. Take Staphylococcus aureus for example. It will be found in dirty public washrooms. But it is also commonly carried around by 20-30 percent of people on their skin or in the respiratory system. It is an opportunistic pathogen, meaning it starts to cause trouble not when commonly encountered in the washroom but when the immune system is weakened or when the natural balance of bacteria in the gut is altered. Authorities disagree on how long certain other nasty germs survive or how readily they cause infection. But many bathroom studies have shown remarkable staying power – up to 8 days for E. coli. According to the Centers for Disease Control and Prevention, the flu can survive on some surfaces for 48 hours. Washing hands after using public facilities is a no brainer. Yet a study published in Antimicrobial Resistance & Infection Control found that handwashing and hand-drying equipment in public washrooms are facilitating infections due to contaminated sink handles and paper towel dispensers. Plus people don’t wash their hands with soapy water for 20 seconds or more. Even with the best of efforts, some researchers have noted that “adequate hand hygiene may not always be achievable when using public washrooms.” That’s because the door handle used to leave the washroom is covered in germs. Opting out of using a public bathroom and resorting to “holding behaviour” is not advisable. “Always go to the bathroom when you have a chance,” goes the sage advice of King George V. Royalty have their own reasons. But among common folk, holding urine in the bladder can invite bacteria in the urine to multiply and cause the development of urinary track infections. When you’ve got to go, you’ve got to go. But there’s worse news to report. A study published in 2020 in Physics of Fluids described a phenomenon known as "toilet turbulence." It’s an alarming and repulsive discovery to learn that flushing a toilet can send small droplets of water and aerosols containing fecal germs three feet into the air above the seat! One public health message advises users to turn away from the toilet when flushing. Good lord! There’s a reason for a toilet seat lid. Put it down before you flush. Making a stink about public washrooms that are poorly designed and infrequently cleaned is probably the best course of action. Afterall, what restaurant or community venue wants to be associated with disgusting washrooms? Sign-up at www.docgiff.com to receive our weekly e-newsletter. For comments, contact-us@docgiff.com. Follow us Instagram @docgiff and @diana_gifford_jones