Picture this: You’re in a public restroom. You carefully lay down a strip of toilet paper, forming a protective shield between you and all the germs of the world. You’re a centimeter from sitting down... when the paper slips into the bowl.
Blergh, right? Well, there's good and bad news. First, the good: Public toilet seats are actually one of the cleanest places in the entire restroom. The bad news: Everything else can be pretty nasty.
The Germy Truth
So no worries if you make contact. Even if the person before you didn’t wipe it down, there’s no huge risk: Very few germs transmitted that way can make you sick, says Kelly Reynolds, Ph.D, an associate professor of environmental and occupational health also at the University of Arizona. And even if they could, the porous toilet paper would basically do nothing to prevent it. (Comforting.)
The real threat lies beneath, Gerba says. “The germiest spot in restrooms is always the floor.” According to Gerba’s research, when the toilet flushes, it sends a spray of droplets into the air, which then settle onto any surfaces within six feet of the flush. Microbiological hazards of household toilets: droplet production and the fate of residual organisms. Gerba CP, Wallis C, Melnick JL. Applied microbiology, 1975, Nov.;30(2):0003-6919. Viral contamination of aerosol and surfaces through toilet use in health care and other settings. Verani M, Bigazzi R, Carducci A. American journal of infection control, 2014, May.;42(7):1527-3296. Those droplets can be carrying bacteria from any fecal-borne diseases, like E. coli, norovirus, salmonella, or shigella.
All that can be avoided by closing the lid. The only problem: Public restrooms have by and large eliminated lids, Reynolds says. Which means the handle, the toilet paper dispenser, and even the little purse shelf are hotspots for bacteria to linger.
Your Action Plan
With all this horrifying news in mind, what’s the best way to avoid contracting a cold, flu, or fecal-borne disease next time you do your business?
1. Rely on paper towels.
Do what you need to do, then focus on the exit strategy, says Daniel Park, M.D., a pediatric emergency medicine physician at the Medical University of South Carolina. “I use a paper towel to turn on the faucet, I wash my hands with soap and water, I take another paper towel, and then I use that to turn off the faucet and open up the handles of the door.”
Yep, doorknobs and faucet handles are danger zones too, Reynolds says. They’re the first things we touch before washing our hands, and ironically, turning them off contaminates our hands all over again. So while paper towel-handling everything in the vicinity may look a little Michael Jackson-esque, it’s better to be safe than sorry.
2. Beware the flush.
If you see someone walking out of a stall, Reynolds recommends steering clear—the germs from their flush will probably still be in the air. When you're done doing the deed, get fully clothed and ready to go right before you flush. Your germs can't hurt you, but there could be residual germs in the bowl from the person who was there before you.
3. Sit, don't squat.
Reynolds says that even though paper toilet protectors serve no real purpose, she continues to use them. People are just more likely to sit (rather than hover) with a shield in the mix, which keeps actually-not-sterile urine where it should be, improving environmental hygiene and helping keep things clean. Urine is not sterile: use of enhanced urine culture techniques to detect resident bacterial flora in the adult female bladder. Hilt EE, McKinley K, Pearce MM. Journal of clinical microbiology, 2013, Dec.;52(3):1098-660X.
4. Protect your personal items.
Ever put your phone on the floor—just for a second? We have. But never again: As soon as your cell or purse hits that surface, it potentially becomes a carrier for that bacteria and spreads it wherever you put it down next, Gerba says.
As for your purse or bag, avoid placing it on the floor or the shelf, which accumulate the most germs, Reynolds says. Instead, hang it on the hook on the back of the door, which is better than having them in contact with the floor.
5. Wash your hands.
Of course, standard hygiene rules all, so make sure you're washing your hands for the recommended 20 seconds, Park says (one round of "Happy Birthday"). And if you're using your phone on the toilet—don't forget to disinfect.
All in all, public restrooms aren't going to be the death of you. While the ick factor is definitely present, if you keep your hands clean (and avoid skin-on-fluid contact with an open wound, hopefully a given), you'll be fine. If you're still worried, invest in a pack of antibacterial wipes—for yourself, for your faucets, and most of all, for the bottom of your purse.