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!

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