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WASHROOM HYGIENE: THE HIDDEN INVADERS!
The humble toilet is a more complex subject than we think. And toilet habits, as we know, have evolved over the years. Not so long ago, hygiene in toilets and washrooms was a simple matter. A soap, towel and running water were the hallmarks of an ideal set up. But not anymore. Things have moved on quite a bit. Today, the market is flooded with an array of washroom or toilet specific products, which serve the purpose very well. And yet, with all these upgradations, good personal hygiene still depends on the USER. Attitudes to personal hygiene and toilets differ from culture to culture. However, health risks and odours remain common to all. A wide family of microbes including bacteria, viruses, and parasites thrive in the washrooms. And, the hazardous area could be the washbasin, tap, and door handles or just about any surface. It is therefore important to know the existence of the invisible danger lurking in our home environments. MICROBES IN THE WASHROOM The micro-organisms of concern in the washrooms and the toilets would be those arising from faecal contamination. Human faeces are loaded with a multiplicity of microbial flora. More than 100 distinct types of micro-organisms occur regularly in the normal faecal flora. There are an estimated 10,0000000000 bacteria / gram of faeces! Among these, the presence of a group of bacteria called the ‘Coliform bacilli - especially Escherichia coli is a sure indicator of faecal contamination. In addition to these there are others with the potential to cause diseases (Pathogenic). Some such pathogenic microbes, which get excreted include: When pathogenic micro-organisms are present along with those of faecal origin, disease is not far off in the susceptible individual. These pathogens contaminate our hands, and in the absence of good hand hygiene, they reach our mouth (or those of others too!) through many ways. It may be through eating or water source, food or cooking utensils being contaminated through hands not adequately cleaned after toilet use, or while cleaning children after they have defaecated. This could include even changing nappies. Thus start the ‘oral-faecal’ route of disease transmission. The symptoms of the disease would depend on the microbe ingested. Microbes generally thrive in wet or moist environments. Water used quite liberally, more to clean the feet (an interesting Indian tradition), than the hands, ensures that the floor, sink and surrounding areas are mostly wet. Poor hygiene by way of splashing urine on the floors, toilet seats or soiling the hands also assists microbial survival. Urine is a good medium for the multiplication of bacteria. ENVIRONMENTAL CONTAMINATION LEVELS. Recent advances in Microbiology have provided us with efficient tools for tracing, identifying, and documenting microbes that may be present in various parts of the toilet environment. And research has produced data, which show that washrooms do pose a threat to our health by the contaminants that abound in their territory. There are sanitary ware products in the market that have antimicrobial protection features to reduce growth of fungi, bacteria, mould and mildew. Antimicrobial protection of cistern knob & seat cover is a valuable additional step in infection control. Antibacterial protection works by penetrating the bacteria’s cell wall, thereby neutralising the bacteria’s abilities to function, grow and reproduce. Therefore, it provides continuous protection, even in areas that are difficult or inaccessible to clean, for example, the bottom sides of toilet seat covers. Results of clinical research done over the past few years have been surprising in some cases, and expected in others. The data provides information on areas of potential contamination or ’hot zones’. In one particular project in the United States, 130 washrooms were studied for the level of microbial contamination. Samples were collected from all the main surfaces in the toilets for Microbiological surveillance. These surfaces include toilet bowls, toilet seats, toilet flushing rims, door handles, floors, tap handles, flush handles etc.
More recently, the University of Arizona Microbiology Department conducted bacterial sampling in some of the Quick Serve Restaurants (QSR) in the Tucson area in USA. Of the 25 sites they examined, the levels of faecal coliform bacteria ranged widely. The findings are shown below.
From the above, one can surmise that these ‘hot zones’ would include toilet floor, the sink and the taps, high-touch objects such as knobs and toilet seats. In another study of hotel bathrooms, it was found that toilet seats had lower levels of bacteria such as staphylococci and Pseudomonas than bathtubs, sinks and floors. Assessment of microbial contamination of hands following varying hand drying methods has also been done. Hot air devices, paper towels and continuous use cotton towels were compared. It has been shown that in routine practice hot air driers are not as good as one would expect them to be, and have not been effective in reducing the number of bacteria carried on the hands. The rubbing of hands under the hot air devices and the propelling of bacteria by the hot air jets combined actually to increase the number of bacteria in the washrooms. Another aspect is that hot air driers take longer to dry hands than towels. Because only one person can use the drier at a time, others may become impatient and wipe their hands on their clothing or a handkerchief. In fact, one researcher has shown that the electric driers increased the bacteria on the hands by as much as 162%, while paper towels reduced them by 29%. Continuous use of cotton towels also have their problems. Once again, it has been shown that the hand count of bacteria increased after wiping on these, probably because the microbes remained on these towels due to constant use and the moisture that remained. It must be remembered that in these towels, there will be an increased risk of cross-contamination with germs from the previous user. CONCLUSION Thus it is clear that a visit to the toilet or washroom can have its problems too. The areas of potential contamination or the ‘hot zones’ need special attention. Even when a toilet looks clean, it is not really so from the point of view of the Microbiologist! There are the invisible denizens of the sewer waiting to move up as the hidden invaders. It is entirely in our HANDS to ensure we overcome them. The aspects of HAND HYGIENE need to be addressed separately. Often the most mundane activities of our lives slip our sense of scrutiny. Toilet (washroom) hygiene should never be one of them. Awareness of the environment here, should be the first step to know about the lurking dangers in a washroom! Dr.Thara Francis M.D.
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There is an old European saying that reads ‘A good plumbing system is the basis of any civilization’. Translated into our own lives, that time-honoured adage relates directly to the washrooms and toilets in our homes and work places. They are the key to health and hygiene in our homes in more ways than we can count. Not only is hygiene an important aspect of our lives, but also an area of individual sensitivity. A clean toilet is a pleasure to use, whereas the alternative is domestic anarchy.
