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Toilet Seats Are a Touchy Topic

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We had no idea Americans have such a fear and loathing of toilet seats. We discovered that when we received a letter from a reader of our newspaper column. She wanted to know a quick way to sterilize the seat in public restrooms. She complained that back pain had made it more difficult to crouch over grungy seats in movie theaters, gas stations and fast food restaurants.

We tried to be reassuring, pointing out that people don't catch horrible diseases from sitting on the toilet. A search of the medical literature turned up no cases and dermatologists we consulted knew of no instances of venereal diseases transmitted in such a casual manner.

Although sterilizing a toilet seat in a public rest room is virtually impossible, we offered her two suggestions. One was to carry alcohol wipes to clean the seat. Another option was a dilute bleach solution that would probably kill most organisms. This might be rather inconvenient to carry around, however.

Then the mail started pouring in and it became clear that our answer was inadequate. Disposable paper seat covers were the most popular solution by far. One writer told us, "Like the people who have American Express cards, I don't leave home without it."

Many of our readers pack disposable seat covers whenever they travel. According to one, "I travel by car a great deal and am often forced to visit rest stops. In California the bathrooms are notoriously filthy and quite often have no seat covers or even toilet paper. I always carry both in my car and put some in my purse before using the facilities. It's a very simple and relatively inexpensive solution to the problem."

Clearly, people prefer not to let their skin come into contact with seats where others have rested their naked derrieres. Without benefit of a paper seat protector, many people tend to crouch or hover rather than to perch. Urologists tell us that this is not a good practice. They have found that women who stand over the seat instead of sitting have a slower release of urine and more residual urine left after emptying the bladder. This could increase the risk of a urinary tract infection. They had found that many of the women they were treating for incontinence did not sit.

Then there is the issue of sprinkling. When someone crouches over the toilet there is a strong likelihood the seat will get wet. Many people do not have the courtesy to dry off the seat afterwards. Hence this famous ditty:

"If you sprinkle when you tinkle, please be neat and wipe the seat." Another variation: "If you sprinkle when you tinkle, be a sweetie and wipe the seatie."

Sadly, though, a lot of folks do not follow this advice.

One listener to our radio show reminded us that this issue is extremely culture-bound. He pointed out that in much of the world people crouch low out of necessity, as the "throne" is unknown. He added that hemorrhoids are far less common in such cultures, but we have no studies on the urological consequences.

Our hunt through the medical literature did turn up one disquieting fact. Public restroom surfaces are commonly contaminated with invisible bacteria, usually those carried in the intestine. Microbiologists recovered these not only from toilet seats, but also from flush and tap handles and doorknobs, which is quite a bit more disconcerting since you have to touch them to get out of the restroom.

We heard from one visitor:

"I have NEVER understood why people get so distressed about germs that might land on the back of their thighs. Seriously... are you going to serve a meal there later or something? Just sit down and get it over with. The REST of us do not like sitting in YOUR pee on the seat after you've done that whole "hover" thing.

"If you're in a disgusting bathroom and you just can't live with the fact that you might have a germ or two on your thighs, then why aren't you carrying wet wipes in your purse so you can wash your backside when you're done? That would seem more logical to me.

"But then again, I've never understood the whole worry about a dirty toilet seat. It's dirty even if it looks clean; fecal microbes get into the air and land on everything when the toilet gets flushed. It's common. There was even a Mythbusters episode about it. Did you know the floors and counters in your KITCHEN have more germs and more potential to do you harm than what is on a toilet seat?" M.O.

Should we advise people to use alcohol wipes on the tap handles? Should you use a clean paper towel to open the door after washing your hands? We don't have the answers to these questions, but we also don't have documented epidemics of diarrhea from public restroom contamination.

Naomi offered this comment:

"Getting wet from sitting on a wet seat is an inconvenience and nothing more. If your skin gets wet, dry it. No other part of you is apt to get wet.

"The reminder about faucet handles, door handles, soap dispensers, etc. is much more important - and you're NOT in a hurry on the way out.
 LEAVE with clean hands, that's what counts."

We were set straight on one issue in this letter from a reader:

"Your dermatologists are wrong when they say you can't get anything from a toilet seat. During World War II I worked in the office of the camp where my husband was stationed. We shared a rest room with the Motor Pool--some of the biggest roughest, toughest females I've ever seen. All the females in our office got those 'little creepy crawly' things. It was very embarrassing to go to the clinic and be examined for treatment. Needless to say, after that experience I do not ever sit on a public toilet. I am 82 and it is not an easy task!"

Share your own bathroom experiences and solutions below in the comment section. 

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After a mastectomy, I had severe pain in my skin. I tried wearing soft clothing, rinsing clothes twice after laundering. Finally an oncology nurse told me I was allergic to the polyester lace in my mastectomy bra. I also had little bumps in the chest area.

I started wearing all-cotton underwear, sweaters, and blouses. The pains subsided. I've hunted all-cotton bras and chemises with no luck. Now I go braless and wear 100% cotton tank tops under my clothes. But I still don't have the weight in the chest area that a mastectomy bra affords for balance, and my chest looks caved-in. Can anyone recommend an on-line company that sells 100% underwear with no synthetic fiber, even in the decoration? Only the least polyester or acrylic causes sharp pains.

I simply grab a paper towel from the same restroom, wet it a bit add a dash of hand soap and wipe the seat clean. Then I take a small piece of toilet paper and cover the front of the toilet seat in case I need to seat down so I would not touch it. I always carry a small pack of kleenex for my nose so in a hurry I have backup paper for the toilet. I am not trying to kill germs, simply trying to rest in a clean seat. You can also take a small bottle of sanitizing gel with you in case soap is missing.

No need to do anything else really, you will not get rid of the bacteria there and shouldn't worry about it. It is simply disgusting to seat that is wet or dirty.

With regard to the following: "Should we advise people to use alcohol wipes on the tap handles? Should you use a clean paper towel to open the door after washing your hands? We ... don't have documented epidemics of diarrhea from public restroom contamination." It would probably be impractical for most people to use alcohol wipes on tap handles. However, I use a paper towel both to turn handles on and off AND to open the door when exiting.

I am surprised that you discount diarrhea as something that can be picked up from public restrooms (or even from private ones), as clostridium difficile (known as c. diff), an acute, treatment-resistant colitis that is becoming much more rampant not just in hospitals and nursing homes but also in the wider community, as well as norovirus (a.k.a. stomach flu), are often transmitted by contact with contaminated handles and surfaces. (Neither is killed by alcohol-based hand gels, which have virtually replaced soap and water.)

So if someone using the bathroom before you has failed to wash hands with soap and water thoroughly (studies have found that most people fall into this category) and is harboring one of these infections (or even a garden-variety respiratory infection), and if they then touch a faucet or door handle, then you come along and touch it, too, and subsequently touch your mouth/nose/eyes or eat some food, you are exposed. If you happen to be taking antibiotics and/or have recently done so, you are now a "sitting duck" for c. difficile, as antibiotic use has now been identified as a common trigger of c diff.

Is it an "epidemic"? It has been called that by some infectious disease experts, but even if it didn't officially reach that standard, one episode of c. diff is enough to upend your life for years to come (people who get it often have recurrence). And even "just" norovirus can land you in the hospital, needing rehydration.

Although I always covered public toilet seats, imagine my dismay when my husband and I got "crabs" (correct name is?) the first day we embarked on a long trip with friends in their motor home. This alerted me to not make assumptions about the hygienic procedures of others, away or in their homes, so "Trust but verify"!

If there are no paper toilet seat covers available I simply "line" the seat with strips of toilet paper. Everything gets flushed when I'm done. Easy peasy! I've lived and traveled all over the world (and have had to use some holes on the floor) but I've never had a problem. I also now carry a spray hand sanitizer that I use instead if washing my hands if the sink area is gross.

I too got 'creepy crawly things' from a bath. And I am sickened every time I see someone else's pee on the seat. Or a toilet unflushed.
How about a public restroom where there are no paper towels? Can't avoid touching handles and knobs there.

I really appreciate places that provide paper seat covers.
Saw Dr. Know on tv with a black light showing how far toilet contents spread thru the air and all over all surfaces from flushing. ICH!!!!!!!! LOWER THE LID BEFORE FLUSHING! Remember, your toothbrush is nearby.

For those concerned about sitting on a clean toilet seat in public rest rooms, I have found a way that is easy and hygenic. Fill a small pocket-size spray bottle (such as those used to clean eye glasses) and fill it with a cleaning solution. I use the liquid cleaner, called Fantastic. Grab a few paper towels when entering the bathroom or carry them with you. Then clean and wipe the seat, drying the solution off thoroughly. This is quick and easy but very thorough. I hope it helps someone else.

when I was a child, pre war, in London each cubicle had a dispensing machine, where for a penny one could buy a thick paper collar that fitted the seat of the loo.

I (a male) always wipe down the seat before having to sit down and flush the toilet. If it is one of the infra-red flushing types, there is button somewhere on the mechanism to push. And I always wash up afterwards and use a paper towel to exit the facility. As a side note; I usually wash my hands PRIOR to using the restroom; learned that from an industrial hygiene instructor in USAF Safety School.

I think most of the discussion is quite humorous, but the sentence "All the females in our office got those 'little creepy crawly' things." caught my attention. I assume the writer referred to pubic lice. It's my understanding that pubic lice are spread by human contact, not by contact with toilet seats or other inanimate objects. That might be a good topic for discussion, whether I'm correct or incorrect. I also think that concern about toilet seats is related to our societal belief that elimination is dirty or somehow shameful.

I do challenge that a kitchen floor has any more microbes than a bathroom but I cannot defend my challenge, so it's useless. Though actually it does get dirtier quicker, but I am talking soil, sand, etc from shoes. The room may stay more moist therefore bacteria can flourish? But back to issue: I would assume that jock itch can be spread from toilet seats! and I am sure any other kind of pubic parasite can be spread the same way. And I would NOT want to use the same toilet as someone with a VD, whether or not "they' say it can't be spread that way. And think about a child who must slide up to the toilet seat as opposed to an adult who can just carefully geographically sit on the seat.

What sort of "creepy crawling things" did the women experience??

Instead of toilet seat covers I just tear two strips of toilet paper and lay on each side on the seat. Then I don't wash my hands or touch anything and immediately use anti-bacterial hand gel the moment I'm completely out of the bathroom.

I hate public toilets, but sometimes must use one. I put the seat up, assume the position and go. Put the seat back down (no pee on seat). Flush with my foot or a wad of toilet paper. Wash hands, turn off tap without touching with clean hands, dry hands with paper towels I carry in my purse. Open door using paper towel on the handle. Extreme, no. Just cautious. I'm not a germophobe. I've had dogs all my life, and cleaned up occasional accidents in the house, and I use poopy pickups outdoors. Then wash my hand very well.

I raised 3 children and ALWAYS carried tin foil in my purse for use in a restroom. I would use a piece approx. 18 in. wide (I used the heavy type) folded multiple times till it fit in purse or whatever I was using. I would open foil, place over seat and fold around edges and make a slit in center and fold under. Myself and all 3 small children could sit on toilet without fear of so called germs. I still use this hint after almost 40 yrs. I always have foil folded in purse when I go out. I am surprised that more don't use this trick. When we were finished it was easy to pick up foil, crush in hand and put in trash.

I don’t freak out when I use a public restroom. But I do take some actions to minimize contact.

1. To minimize touching the toilet seat when I have to pee, but the seat is down (no, I don’t pee anyway ... and figure to heck with the next user). I lift the seat with the side of my shoe sole.

2. If I have to sit for my bodily function, but the seat is up, I use the above procedure to lower the seat.

3. To minimize touching the toilet flush handle, I, once again, use my shoe. I simply lift my leg and hit the flush handle with my shoe ... wal’la, WHOOSH! And I’m no spring chicken. I’m 81. But I admit I’ve been doing stretching exercises since my early 30’s.

4. I always wash my hands. I wash them for 30 seconds, on the advice of a doctor who said it takes that long to actually kill any germs on your hands.

5. Now it time to leave the public restroom. I use a paper towel to grab the door handle, open the door, and toss the towel back into the wastebasket.

All this might not mean I’ve dodged every possible germ or other “nasty," but I feel it gives me a fighting chance, and at the minimum a psychological peace of mind. I hope these ideas may prove helpful to others. B.L.

That black light segment convinced me to put our toothbrushes in the linen closet next to the sink, out of the way of those airborne germs.

I have hip and knee problems and cannot squat over a toilet seat easily. I try to bring a travel size pack of Lysol wipes in my purse, using these to "sanitize" the seat, and drying it before sitting. If I forget, I wet some paper towels and wipe and dry the seat, hoping this will at least reduce the microbial load. It adds extra time in the stall that would not be necessary if prior users would not leave the seat wet with urine or soiled with feces or blood (yes, this happens!) And by the way, an acquaintance, a female physician, in training at a municipal hospital at the time, contracted scabies from a toilet seat.

It would be interesting for a list of things you COULD get from a contaminated toilet seat: jock itch, scabies, crabs, lice, … what else? Maybe not syphylis, or such, who knows, But what COULD you get from an unclean toilet seat?

How about a dirty picture contest to see how dirty some toilets are? I could have submitted a few!

We too have traveled to many countries and always in the glove box of the car we have disposable toilet seat covers but we also make our own colloidal silver which is marvelous. We keep it in a spray bottle the size of a glass lens cleaner and fits easily into my handbag, Also, I don't touch doors on the way out and make sure I use something to cover it when opening. There really are some grubs "out there" but also the Councils are not always the most diligent in their cleaning either. Another gross thing to put up with is when the floors are hosed out and you have long pants on that for a woman must be rolled down and the cuffs get wet - Yuk!

We were living overseas in an Asian country when my daughter was 10 to 12. All the girls in her school had recurrent bouts of boils on their back thighs from the outside toilets So one CAN get problems from toilet seats!!

I too am totally disgusted with those women who insists on hovering and sprinkling on the toilet seat and not cleaning the seat afterwards.

When I have to go I do not have time to clean a seat! For those who insist on standing please lift the toilet seat and then do your hover thing and then the seat I sit on will be somewhat clean.

I have to use public restrooms often. Women who hover sprinkle on the floor and my slacks get dipped in their pee, if the bathroom door opens inward I usually am backed up against the toilet to get out because the stalls are so small. I like doors that open out and that is another whole issue. VA

If you must fashion your own seat cover until more flushable seat covers are available. They are coming back in style and you can purchase them if you want to carry them along. I carry a small spray bottle of water that comes with my Biffy bidet that I have on my toilet at home. The Biffy can be outfitted with a heated water warmer if you like and is absolutely priceless for cleaning yourself after bathrooming. It keeps your hands well away from your own germs and the fresh water feels incredibly good. There is probably more exposure to germs on the door handle to the public toilet. And calm down or don't use public toilets.

I also wish doors open outward, you almost have to touch the toilet to leave when the door opens inward. When my daughters were small I would stand them backward on the seat so they would not have to sit on it.


I also would like doors to open outward, I am 85 and it is very hard to exit with doors that open in. When my daughters were very small I would stand them on the seat facing backwards so they would not have to sit on the seat.


In muslim countries in SE Asia, restaurants have sinks OUTSIDE the bathroom as well as inside. You can wash your hands from the bathroom, but to eat there's the public sink outside. Thankful for that bit of ritual cleaning!

Speaking of restroom doors opening inward or outward. Walmart's doors open inward, and you HAVE TO STRADDLE the stool in order to get the door open. There just is no other way.. And if you have white slacks on, woe to you; if you don't, or even do! Doors should open out. There is often a 1 or 2 inch leeway for you to stand in. TO STAND IN!

You know, I don't worry so much about STD (am I saying that right?) and germs. I worry about lice, jock itch, demodex, fungus and yeast infections.

I am amazed at all the 'things' folks do to clean a toilet seat. I am not about to carry a btl of santizer and find towels to wipe seat. As I said I use the foil and it is amazing. Nothing gets thru this as it would with the paper covers.

You folks make way to much work for yourselves. Most sinks are motion activated and I make sure I have paper coming out of towel rack before I wash or while I am washing so I don't have to touch anything then I use the towel I dried my hands on to open door, or just kick it open. So much easier than your spraying, wiping etc. I just don't want to sit on any seat no matter what I did to it.

Sherry

Carry a bottle of anti bacterial hand gel in your purse, squeeze a bit on to some toilet paper, and use it to wipe down and disinfect the toilet seat.

Sorry to hear you are having such problems, Gloria. I would recommend you purchase natural cotton fabric and have a bra sewn. Check out local seamstresses or with relatives that can sew if you are not able. Then you will have a comfortable custom bra.

Reply to Gloria G -( comment #1) The Vermont Country Store carries many types of 100% cotton clothing. Their catalogue is a trip down memory lane. All cotton bras like the Maidenform ones in the 50's, 100% cotton panties, p.j.s, socks. and many other items like chemises and petticoats. No doubt there is also an on-line shopping site.

The very thought of all those paper towels being used just to close doors or shut off water taps makes me ill. I have never done any of those things, ever! And I simply never get sick. If I use a paper towel at home, I rinse it out, hang it up to dry and re-use it until it's tattered! Then I recycle it. OH, the poor poor trees, giving their lives so people could just turn off a tap with their remains and then toss it in the garbage.

If I sit in someone's pee, I just wipe off my thighs when I'm done, badda-boom; it's all good. And I NEVER flush the toilet at home till it's been used at least 4-5 times. If I'm out and about, I'll avoid putting TP in the toilet so people hopefully won't notice it's not flushed (I have very light pee) and thus another gallon+ of water is saved for the planet. I am simply amazed that people are so psychotic about germs; I think they must have horrible immune systems.

you say that communicable diseases cannot be acquired through toilet seats? I disagree. Diarrhea viruses can fester around toilets. We know that the hepatitis virus can live outside the body for up to a week. I've been in some restrooms where there was blood on the seat. If someone had an issue from their reproductive organs such as blood or seminal fluid the virus could remain there and should male or female organs contact this area, well you take the chance doc. Furthermore little children should be attended in public restrooms. It's terrible society has so little respect for cleanliness in public places. I grew up on a farm. While the stalls and manure were filled with animal waste and microbes, I felt much more safer around that then some public restrooms used by so called 'educated, informed humans'. I do clean up after myself and take precautions.

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