The toilets can be a source of infection for many diseases. Toilets are a risk of infection in places that are frequently used, like offices, schools and hospitals.
The washroom is a place where hygiene can be a problem due to its use (human waste), the number and types of surfaces people touch, as well as the small space. This makes it difficult for more than one person to maintain hygienic distance. By touching surfaces or inhaling contaminated air, a wide variety of infectious microorganisms can be transmitted between people. These include Norovirus and Salmonella as well as other gut microbes.
Three areas can be identified as posing the greatest risk to users’ health.
1. Air Hygiene
When water droplets form, such as when flushing toilets or urinals, splashing water in drains and sinks, or aerosols from leaking sewerage systems, airborne diseases can spread. Aerosols and droplets are created by normal respiratory activities such as talking, coughing, sneezing, and breathing.
Poor ventilation can cause microbes and bad smells to remain in the bathroom, causing an unpleasant experience. Aerosols of finer particles can stay in the air for several hours, and spread to other areas by opening and shutting the door.
The toilet sneeze poses a significant infection risk. The “sneeze-effect”, caused by cascading waters when the toilet flushes, creates plumes of droplets in varying sizes which are launched into air. These droplets may contain viruses and bacteria that are found in urine and faeces. The larger droplets fall on nearby surfaces, such as the seat, tissue, and flush button. However, the smaller droplets can be carried around by air currents and contaminate other surfaces.
The concentration of C. was reduced by closing the lid on the toilet before flushing. It is effective in preventing the spread of C. difficile. It is therefore important to promote the use of the lid as a way of reducing the spread and transmission of infection.
In a study of COVID-19 cases in China, 45% carried SARS-CoV-2. This virus was still present in the feces for weeks after respiratory tests had been negative. The faulty bathroom ventilation system in an apartment building and the wastewater plumbing system caused SARS-CoV-2 to spread in Hong Kong during the SARS epidemic in 2003. This was done by sucking in air through the dry U-bends into the apartments. The result of this was 342 infections and 42 deaths.
During the COVID-19 epidemic in China, more cases of spreading in apartments were found. These cases demonstrate that air quality is a key factor in reducing the risk for COVID-19, and other airborne diseases.
Poor maintenance of toilets, urinals and drain pipes can also cause bad odours. The accumulation of bacteria, uric acids and calcification in washrooms can cause lingering bad smells.
Moisture, which can be caused by faulty plumbing or poor ventilation, and spore production in the room’s air are the main causes of mould growth.
To keep washrooms clean, you will need to use air cleaners to reduce aerosols, pollutants and other particulates, including mould spores.
2. Surface Hygiene
In the washroom, there are many surfaces that can be touched by people. They may pick up microorganisms from these surfaces or they may transfer them with a contaminated hands. Bacteria and virus can survive on surfaces for several days, creating reservoirs that can spread infections.
The early fears about fomite (surface transmission) of the SARS virus appeared to have overstated the risk. In real-life situations , studies of have shown that the risk is only present for 1-2 hours following an infected individual’s cough or sneeze on a surface. Some pathogens can survive on surfaces for much longer. can survive on surfaces for many months, but respiratory viruses only last a few weeks.
Droplets containing microbes from a toilet sneeze may land on any surface. This includes door handles, flush buttons, the toilet floor, feminine hygiene units, wash basins, faucets, soap dispensers, and toilet paper or paper towels that are not protected. Urinals can also produce a spray when flushed and used.
Surfaces within the cubicles are the most likely to be contaminated by toilet sneezes, including items brought into the cubicle. As washroom users move from the cubicle into the basins they can cross-contaminate surfaces as they dry their hands and wash them. In a survey of 4800 surfaces from office buildings, the taps in the washrooms were the most contaminated with microbes. 75% of them were classified as dirty.
The people themselves can also be sources of contamination. Droplets of saliva and mucus from coughing, talking and sneezing behave the same as toilet sneezes and can spread microorganisms.
Clothing, shoes, and personal items may carry dirt and dust containing bacteria, viruses and fungal spores from the outside of the building into the washrooms and other parts of the building. Handbags and other personal items can cause cross-contamination from cubicle floors or door hooks to sink counters, the owner’s workspace, even their home.
It is important to clean and disinfect all surfaces regularly with a cleaning liquid that is effective in killing pathogenic bacteria, viruses and fungi. There are also solutions that offer a residual protection several hours after use.
3. Hand Hygiene
Hand hygiene is widely acknowledged as being one of the most critical factors for in preventing the spread infectious diseases. This is especially true in the context of food safety, and in environments. Hand hygiene is closely related to surface cleanliness in the washroom, because the hands must touch many surfaces.
Hand hygiene is maintained by the user’s personal hygiene, the cleanliness of the washroom, and the availability of adequate facilities to wash and dry hands.
Washroom users can bring in their own selection of skin microbes, both resident and transient. They can then transfer these microbes to any surface and accumulate high levels after using the cubicle.
The best way to eliminate bacteria and viruses is to encourage users to wash their hands with soap, then rinse them for 20 seconds. The physical action of rinsing is most important for removing viruses, as they are more difficult to remove than parasite cysts or eggs.
There are several factors that can improve hand hygiene .
- No-touch technology is recommended for all faucets, soap dispensers and paper dispensers. Also, sanitizer dispensers are available.
- Use a dispenser to protect toilet paper and paper towel from contamination through airborne particles and by hand.
- Hand sanitiser and antibacterial soap are available to protect your hands.
- Hand-drying options that dry hands quickly will help users to fully dry their hands, as moist hands can pick up and spread many more microorganisms.
In the US, studies have shown that regular hand sanitiser use led to a reduction of 30-40% in respiratory and digestive illnesses in dormitories at universities, an army base in the US and an office.
When compliance rates are low, hand hygiene may also require a psychological intervention to change bad behaviour. It may be necessary to educate outside of the washroom. However, adding a pleasant scent to the washroom can increase compliance.
Holistic Approach to Hygiene
In order to prevent infection, washrooms must adopt an integrated approach. This includes a combination air, surface, and hand hygiene measures. There are many solutions available to help protect each area at risk and stop the spread pathogens.
Included in this are the following.
- Wipes and solutions for disinfecting and sanitising surfaces
- Handwashing, drying and moisturising products to protect and prevent the spread of disease by hand.
- Air purification solutions for washrooms to enhance and protect the air, and make it more pleasant.