The risk of getting COVID-19 from a public toilet is low if people keep up good hand hygiene and the bathroom is well maintained, states ANU health expert Professor Sotiris Vardoulakis.
In a systematic review, published in Science of Total Environment, researchers looked at the risk of transmission of viral and bacterial infections through inhalation, surface contact, and faecal-oral routes in public toilets in studies published over 20 years from 2000 to 2020.
Researchers found no evidence of airborne transmission of pathogens, including COVID-19, in public washrooms, Professor Vardoulakis said.
“We realise people are worried about using public washrooms during the pandemic, but if you minimise your time in the bathroom, wash and dry your hands properly, and don’t use your mobile phone, eat or drink, then bathroom use should remain low risk.”
But you should strictly follow public health measures.
“People still need to stay safe and follow their local public health advice,” Professor Vardoulakis said.
Appropriate hand hygiene, cleaning surfaces, disinfection, maintaining washrooms, and ventilation can minimise the risk of infectious disease transmission. So can electric doors and closing the lid of the toilet before flushing.
Other studies had suggested that COVID-19 could be airborne, Professor Vardoulakis said, but ANU researchers did not find any evidence of that in public toilets in studies published during the first year of the pandemic.
“There are a number of reasons it is low risk in public toilets – people don’t spend a long time in bathrooms, and don’t interact with others.
“You may inhale aerosols when you flush the toilet – but they come from your own waste, so the risk of cross contamination is not very high.”
However, the study, funded by Dyson, found that defective plumbing may increase risk, and recommended more studies to assess SARS-CoV-2 transmission risk in public places.
Public washroom surfaces can become contaminated with bacterial and viral pathogens, Professor Vardoulakis said. Environmental samples from toilets in COVID-19 hospital wards in Singapore, China, England, and Italy showed SARS-CoV-2 presence on common bathroom surfaces, including the toilet bowl and lid, sink, tap and drain, and toilet door handle.
“Contamination is different from transmission,” Professor Vardoulakis said. “Effective hand hygiene, surface cleaning and good maintenance minimise infection risk.”
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