News

You open the door of the gas station washroom, scanning and sniffing for biohazards. It seems safe. No overflowing urinals or toilets. No sewer stench and your shoes don't stick to the floor.

But research suggests that the riskiest part of your pit stop may come after you flush. Hot water taps usually have far more fecal bacteria on them than toilet seats do, University of Arizona microbiologist Charles Gerba says.

"I'm good at using my elbow," he says.

Scientists, Dr. Gerba in particular, have made a number of discoveries about public washrooms that could turn even the most laissez-faire traveller into a germaphobe.

Consider that when you flush with the lid up, fecal bacteria are propelled into the air, landing on the tank, the floor, the seat and the toilet paper, unless it is protected by a dispenser. Hot-air dryers can also propel bacteria around the room.

When you turn the water on at the sink, it disturbs the microbes that dwell in a slimy matrix in the drain, says Gideon Wolfaardt, professor at Ryerson University. "Those cells get airborne," he says.

The surfaces with the most germs include the urinal handle, the lid of the sanitary napkin receptacle and the knob or handle of the door on the way out.

Visiting even the cleanest of public washrooms offers a chance of picking up an infection. But there are also plenty of germs in kitchens, schools and daycares, buses and subways, as well as at work, especially if you eat your lunch at your desk. Shopping carts are covered in microbes. So is the average shower curtain. There are potentially harmful bacteria almost everywhere microbiologists such as Dr. Gerba have looked.

Exposure to germs is part of life. How dangerous are public washrooms, really? How likely are you to catch something dreadful?

No one can say for sure, because it is difficult to link infections to bathroom visits. But the worst-case scenario is not reassuring. Feces can carry infectious agents for 20 diseases, and in North America you could be exposed to the microorganisms that cause hepatitis A, Norwalk, bacterial dysentery, meningitis and various forms of diarrhea, says Dr. Gerba, whose work is funded by companies that make disinfectants.

This is a conservative list. Websites for companies that sell devices designed to make washrooms safer — like no-touch taps or self-cleaning bathrooms — warn you might also pick up microbes that cause diphtheria or typhoid.

Infectious-diseases experts say there is almost no chance of getting a sexually transmitted disease simply by using public toilets, although scientists have found that the herpes virus can survive for up to 72 hours on inanimate objects, and Trichomonas vaginalis, a parasite that is spread through sexual activity, can also survive on moist objects. Still, you can pretty much rule out getting an STD, even if you sit down on the toilet seat.

"You get diarrhea, not gonorrhea," Dr. Gerba says.

But if you have a scratch or opening in your skin, he warns you could pick up staphylococcus and develop a puss-filled abscess.

Then there are the health problems you can get by putting off a bathroom break too long, says Jack Sim, founder of the World Toilet Organization.

Holding it can lead to incontinence, kidney stones and urinary-tract infections, says Mr. Sim, who heads a global body based in Singapore calling for accessible and clean toilets, both in the developed and developing world. The problem is deadlier in the Third World, where an estimated 2.6 billion people have no access to toilets.

Sticky or stinky public toilets may seem like a luxury in comparison, but people in rich countries such as Canada shouldn't put up with them, says Mr. Sim, whose organization holds an international toilet summit every year.

"People are suffering from dirty toilets, but they are reluctant to vocalize it," the former businessman says. "They have come to expect that toilets are naturally smelly, dirty and wet."

Men have an advantage when faced with a filthy washroom, because they can more easily urinate outside. There are a number of funnel-like devices on the market that allow women to do it standing up without taking off their clothes, including one called the She Pee.

Evolution may explain the appeal of the She Pee, and why public washrooms hold a particular horror for many people.

Valerie Curtis of the London School of Hygiene and Tropical Medicine has investigated the link between disgust and good hygiene. Her theory is that disgust is a protective emotion that evolved because it helped keep humans away from bodily waste and other germ-laden material, such as corpses.

Excrement tops the list of things citizens in many cultures find revolting.

"The person who is happily dabbling their fingers in poo and happily eating it is not going to have many offspring. The gene is going to die out," she says.

The protective nature of disgust helps explain surveys that show 30 per cent of people dread using a public washroom. But it doesn't explain why so many people don't wash their hands after doing so.

Studies suggest that between 20 and 50 per cent skip washing their hands after using the toilet.

Yet wWashing your hands with soap and water for roughly 30 seconds is the best way to make sure you don't get sick from the germs in restrooms or other public places, experts say. Some recommend using a paper towel to turn off the tap and to open the door on your way out.

That's what Leslie Sharkey does. She is a public health nurse in New Brunswick, and once she has washed and dried her hands she tries to avoid any surfaces that someone else has touched.

"If the washroom has no paper towel, I do not dry my hands. I use my forearm to turn off the taps and use a sleeve or shirt tail to open the door," she says.

Both Dr. Gerba and Dr. Wolfaardt say they often wash their hands with an alcohol-based disinfectant after using public washrooms.

Dr. Wolfaardt doesn't recommend anti-bacterial soaps. A recent study found they don't work better than regular soap and water.

He says that 99 per cent of bacteria we encounter are not dangerous, and many protect us. We have microbes on our skin, for example, that prevent opportunistic disease-causing bacteria from taking up residence. Anti-bacterial soap kills the bad guys as well as the good guys, Dr. Wolfaardt says.

Bacteria that survive an encounter with this kind of soap pass on genes that confer resistance.

"You increase the background level of resistance in the bad guys and the good guys," Dr. Wolfaardt says.

But iIt is a good idea to trust your instincts when you enter a public washroom, Dr. Gerba says. His studies have found washrooms that look or smell disgusting usually are more contaminated with fecal bacteria.

"Your nose and your eyes are your best guide," he says. "If you don't like it, don't use it."