There was an interesting article in the Times about this this week. Here it is, (copied and pasted as it would be behind a paywall):
To wash your hands or not to wash your hands? Imagine you are in a public loo. Alone. No one is watching. Do you go straight to the sink and wash your hands or, fearful of touching more surfaces than you absolutely have to, sneak out?
Well a recent survey by the Royal Pharmaceutical Society suggests that one in five of us heads straight for the door, and this is probably a conservative estimate based on previous surveys that suggest the proportion who don’t wash their hands is often much higher. In their defence, they know what they touched just before turning the tap, but they can’t be so sure about the hundreds of other users that day. Indeed, the more you think about it, the more rational it seems to be selfish and skip the hand-washing, but are public conveniences really a breeding ground for nasty bacteria and viruses?
A survey suggests that one in five of us avoids washing hands at a public toiletA survey suggests that one in five of us avoids washing hands at a public toilet
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As a young lad I vividly remember visiting the loos on a French campsite with my father, who had a bit of a thing about other people’s bacteria. He was the sort of chap who would open the door with his knee, hover over the loo seat (if present in France) and flush with his elbow. “Never wash your hands in a public loo,” he told me. “Wait until you get back to the caravan.”
And it wasn’t just my father who made me wary of public conveniences. In my twenties I had a pee — along with about 200 other men — during half-time at Twickenham. Standing next to me at the urinal was a microbiologist friend of mine who looked stunned when I headed for the sink afterwards. “Never wash your hands in a public loo,” he said, echoing my father’s advice. But was he right?
In a word, no. A 2011 study of 12 public conveniences found that the pattern of bacteria and viruses they harbour are surprisingly similar to those found in our bathrooms at home. The difference, of course, is that they are other people’s bacteria and viruses, and the busier the facility the greater is the likelihood of one of them being something nasty.
A 2014 study by a team in Chicago did turn up a few unpleasant pathogens, including herpes and genital wart viruses and a bacterium that causes impetigo, but the vast majority of microbes found on swabbing various surfaces were harmless species that live on our skin.
There have been documented cases of people picking up nasty infections from public conveniences — including a girl who caught gonorrhoea from a loo seat (BMJ 2003) — but these are vanishingly rare. In truth, the cold, barren environment of most public conveniences is extremely hostile to bacteria and viruses and many die within minutes of landing on surfaces such as taps, flushes and loo seats.
As a doctor I am more scrupulous with my hand hygiene than most and probably wash my hands about 50 times a day. Despite my upbringing, that also includes trips to public loos. But I am careful. My particular bête noire is the manual tap because you have to touch it again after you have washed your hands, which seems to defeat the whole object.
Modern facilities with automatic taps make me feel more comfortable, but how should you dry your hands? We know that hand-drying is important in reducing transmission of bacteria and viruses but, given the choice, should you go for the paper towel, the hand-dryer or the back of your jeans?
It depends who you ask. Studies funded by tissue manufacturers suggest that hand-dryers simply blow all the microbes floating in the air over your hands — and there are plenty, not least from the “plume” of mist produced by flushing. Studies funded by hand-dryer manufacturers such as Dyson show their no-touch products in a much better light. I am not aware of any published studies into the back-of-the-jeans technique. Perhaps it is something I should look into.
How dangerous are public loos?
● The RPS survey also revealed that most people (84 per cent) who wash their hands don’t wash them properly or for long enough (minimum 20 seconds). For full details and tips visit the RPS at bit.ly/2xSdB4s
● The handles on the doors into the loo — the main entrance and cubicle — tend to have the highest bacterial counts, according to published research
● The toilet seat and flush handle come next, but have a disproportionately higher number of gut bacteria as a result of faecal contamination
● Taps, despite my paranoia, are only the fifth most contaminated surface, and they mostly harbour skin bacteria that are just as easily exchanged when shaking hands or touching surfaces ranging from keyboards to grab handles on buses and trains.
● The cubicle closest to the entrance (the one most people walk past) is often the least used and may be the cleanest
● Hang your bags and coat on the back of the door. Don’t put them on the floor
● Automatic no-touch devices reduce the risk of cross-contamination, but if you are really particular you can always take in your own wipes and antibacterial hand rub.
● For more details of what lurks where read this paper: bit.ly/2wsYxY4