Dear Dr. Eva,

​I love your columns and appreciate the variety of topics you address – always sensitively.

​I know this sounds nutty, but how safe (or not) are public / shared toilets? I remember as a kid my mom would carry those paper toilet seat covers or use toilet paper before sitting down. My sister does the same. But is it really necessary? Especially if there’s nothing visible on it and you know it’s cleaned nightly? I’ve been wondering this for years but have been too embarrassed to ask.

​;) Thanks!!

​Pee-shy

 

Dear Pee-Shy,

​It’s not necessary. There is no health problem that is transmitted by sitting on a toilet seat that is dry and appears clean. It is also pretty farfetched that people would pick up infections from wet or dirty toilet seats, either, unless they had a sore or rash on their own “seat” (thighs and buttocks). The skin is an important part of the immune system. If there are breaks in the skin, it makes us more vulnerable to infection, but the main sources of infection are others’ hands, pets, and dirt – not toilet seats. No one wants to sit in urine, but it’s important to know that urine normally contains no bacteria. Even if a urine infection is present, urine infections are not passed from person to person.

​ Many people have concerns about getting a sexually-transmitted infection from a toilet seat. There is no reported case of this occurring. At the risk of being obvious: the reason sexually-transmitted infections are called sexually-transmitted infections is that they can only be transmitted by sexual intercourse, and not in other ways. On occasion it may be emotionally important for a person to insist that (for example) he or she got Chlamydia from a toilet seat because it might be awkward or even dangerous to admit what really happened. That’s understandable, but it doesn’t make it real.

​People who squat on toilets to avoid contact with the seat frequently get the seat wet with urine, dirty from feces (poop), or from their shoes and are at risk of falling. I don’t recommend it.

​People who use lots of toilet paper to cover the seats of public toilets contribute to the frequent problems of clogged toilets and lack of paper.

​Most infections people get are either airborne (breathed in, like influenza or tuberculosis) or fecal-oral, like diarrhea and hepatitis A. Fecal-oral infections occur when an infected person does not clean hands well after a bowel movement then shakes another person’s hand, touches paper money, or prepares food. Then the second person becomes infected. The place to break that chain of infection does not relate to toilet use. It is about hand-washing.

​Let’s consider some more common and less noticed sources of fecal-oral infections, in the bathroom and elsewhere:

  • Door knobs and handles, especially in the bathroom – the home bathroom as well as public. Think about it: hands, and whatever those hands touch after wiping and before washing, are far more contaminated with bacteria than buttock cheeks. Use of a dry paper towel or doubled toilet paper to touch door handles, faucets, and the door of the bathroom is a smart idea. If that’s not practical, apply hand sanitizer once out of the bathroom.
  • Wash hands after handling money. Money has a greater number and variety of bacteria than a toilet. This is because people touch far more things – and a far greater number of other people – with their hands than with their bottoms. Also, money passes through far more individuals’ hands than the number of people who sit on a toilet between cleanings.
  • Now that swimming weather is here, remember to wear rubber shoes or flip-flops at the pool to keep from getting athletes’ foot fungus!

• A study showed that only 32% of men and 62% of women wash their hands in public bathrooms. It’s a new low! It’s also a recipe for frequent illness. Remember that to wash your hands effectively you need to use soap, wash for least 30 seconds, wash between your fingers, and wash under your nails.

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