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Covering my a** – June 28, 2006

Dear Lucy: I was wondering if there are communicable diseases one can get from using a public toilet and if toilet seat covers actually reduce the chances of those diseases being transmitted. I'm all for being healthy and sanitary, but I'm also an environmentalist and don't see any point in wasting the paper if it's not doing any good. —Caught With My Pants Down

Dear Caught: What a great question! Lucy must confess some fondness for the idea of a barrier between her own derriere and all the derrieres that have previously occupied the same public toilet seat. But, like you, she's wondered what measure of protection a thin sheet of paper might actually afford and from what dangers she is being protected.

For answers, Lucy turned to MIT Medical internist and infectious disease specialist Howard Heller, M.D. Not surprisingly, Heller confirms our suspicions that as long as the seat is visibly clean, toilet seat covers provide little more than a reduction in the "ick factor" associated with using a public toilet. "It's very difficult to get sick from a toilet seat," Heller says adamantly. "This is especially true for sexually transmitted diseases (STDs)," he adds. (Hmmm… apparently, there's a reason they're referred to as sexually transmitted.) However, Heller notes, "a little extra caution might be warranted if one is traveling in an area where enteric infections like cholera are more common."

But for most diseases, Heller continues, "toilet seat transmission" would require the unlikely coincidence of two factors: 1) the presence of a sufficient number of germs to cause illness, and 2) a way for those germs on the seat to get into your urethra, genital tract, or blood stream. Interestingly enough, the first condition may be even more unlikely than the second. Microbiologists studying bacterial concentrations in offices found, in every case, that toilet seats were, by far, the cleanest surfaces of any sampled—a whopping 50 times cleaner than phone receivers, which were the filthiest. (High germ counts were also found on office desktops, the computer keyboard, and the mouse.)

But don't think public restrooms are without hazards. Just think about the number of unwashed hands that touch bathroom door handles, sinks, faucets, and towel dispensers in public restrooms. Now that's a source of germs worth worrying about. So, wash your hands correctly (see hhttp://www.uhn.ca/Home/Bug_stops_here/docs/handwashing.pdf for a video demonstration of correct hand-washing technique) and, to avoid recontamination of clean hands, use a paper towel to turn off the water tap and open the exit door. Lucy's "bottom" line? You may safely forgo the toilet seat cover, but put some paper between your hands and other bathroom surfaces. — Lucy

Information contained in Ask Lucy is intended solely for general educational purposes and is not intended as professional medical advice related to individual situations. Always obtain the advice of a qualified healthcare professional if you need medical diagnosis, advice, or treatment. Never disregard medical advice you have received, nor delay getting such advice, because of something you read in this column.

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