Today lets talk toilets and when I say talk toilets I really mean lets talk about Sexually Transmitted Diseases (STD's). Now I am pretty sure that when you think STD you don't immediately think about a toilet (you probably conjure up a disgusting image of an infected person's genitals... I know I do). You likely don't want to think about public toilets and whether or not they have organisms on them responsible for causing STD's either. However that is the topic that we are really going to discuss. I promise it won't be a super long article, but perhaps you will find it curiously interesting at least.
Today we discuss work published June 22, 2017 in the journal PeerJ tiled "Primary health clinic toilet/bathroom
surface swab sampling can indicate community profile of sexually transmitted infections."
Microbiome analysis is a useful technique and I have been discussing things in relation to the microbiome for quite a while now so you should likely be getting a bit familiar with the concept. Briefly our microbiome represents the collection of all microorganisms (bacteira, viruses, parasites, what ever) that live in our bodies. I often talk about the relationship of this microbiome on our personal health, however there is a different subset of research going on looking at the type of bacteria we leave behind in our environment. What you may be interested to learn is that research indicates that for areas we live in and frequent, the microbiome present on surfaces is very heavily related to our own microbiomes. [2]
To scientists interested in public health, this is an especially important finding. It indicates that studying the microbiome of surfaces could tell valuable information, with regards to what organisms a population of people generally have inside them. There has been recent work looking into whether or not public restrooms were a hotbed for STD's, and how likely you are to get infected by one [3], [4].
The researchers in the article we discuss today were taking a bit of a different angle and asking, 'Just how representative are STD's present in public health clinic restrooms, to those possessed by the general population surrounding said clinic?'
What Did The Researchers Do?
They took swabs from bathrooms and then looked at what sorts of STD's were recovered. They looked at two "sexual health" clinics from an urban area, two primary health clinics from small towns, and four primary health clinics from "remote indigenous" areas. So they had a pretty good sample of where a variety of different groups of people would live, from city dwellers to rural folk.
They didn't just sample each site once either!
They visited and took samples 10 separate times at each site over a period of one year. They swabbed the toilets, floors, sinks, walls and door handles.
They then correlated the microbiome data that they determined from these swabs, with the reported STD diagnoses from people in the area and wanted to see if the relative amounts of the STDs in their microbiome samples matched up well with the prevalence of diseases that the people actually had.
Lets See Some Results
So here we are looking at how well some samples correlated for a rural area. On the Y axis is the prevalence they determined for their swabs and on the X axis is the prevalence reported from actual STD diagnoses in those clinics. The points on the plot are labeled with two sets of letters the first of which is in reference to the disease (‘‘C’’: C. trachomatis (chlamidya); ‘‘G’’: N. gonorrhoeae (gonorrhoeae); ‘‘T’’: T. vaginalis (Trichomoniasis). While the second set of letters refers to the location of the clinic (and isn't important for this blog). We can see that the correlation is surprisingly pretty good (but not perfect!)
Here is the cumulative data both small town and very rural sites tested, the diseases and such aren't labeled but the trend is pretty clear. Using Microbiome samples obtained from swabbing surfaces in the bathrooms of health clinics to get a picture of the STDs present in a given community, correlates pretty well (for those curious, for this overall data they report a p value <0.0024 for the correlation).
The picture is not always perfect however
What about the data from the urban site?
It doesn't look too good, however this is likely more due to the fact that only 10 out of their 140 swabs came back positive for anything and these swabs were overwhelmingly positive for gonorrhea. As you can see, this data does not at all match up with the reported data from the clinic.
Conclusions
With large enough sample sizes, researchers are able to get a pretty accurate picture of STD prevalence in a given community just from swabbing the bathrooms at health clinics. However if the swabs are not very good, then the data is also not useful, so very large numbers of swabs would need to be collected to ensure that a statistically relevant bacterial population can be measured.
Other Conclusions
Public bathrooms at health clinics sure have a lot of gonorrhea and chlamydia in them. This really gives me the heebe jeebes and makes me wish that people spent more time cleaning these bathrooms to minimize the potential spread of diseases just from contact.
Sources
- https://peerj.com/articles/3487.pdf
- http://science.sciencemag.org/content/345/6200/1048
- https://well.blogs.nytimes.com/2015/06/08/ask-well-what-diseases-can-i-get-from-a-toilet-seat/?mcubz=1
- https://academic.oup.com/jpids/article-lookup/doi/10.1093/jpids/pit085
All Non Cited Images Are From Pixabay.com or Flickr.com And Are Available Under Creative Commons Licenses
Any Gifs Are From Giphy.com and Are Also Available for Use Under Creative Commons Licences
If you like this work, please consider giving me a follow: @justtryme90. I am here to help spread scientific knowledge and break down primary publications in such a way so as to cut through the jargon and provide you the main conclusions in short (well compared to the original articles at least!) and easy to read posts.
Man if I see a toilet like that I'd probably just ignore it and leave with disgust. Honestly I love in a poor country but that's beyond.
Otherwise hygiene is key in public places and the local authority should manage that with all sorts of test.
Cheers for the great post and Steven on :)
Thanks for reading, yeah I picked a picture of an extra gross toilet ;)
Yikes, well now I'm going to think about publicc restroom in a whole new light. I already avoid them as much as I possible can. But this just reminds that these places aren't always the cleanest and people aren't either!
Although some of the bathrooms used here, ick. Not sure anybody could use them!
Yeah and imagine how bad something like a train station bathroom is. I wonder what microbial populations would be found there...
Great :| when I'm not admitted to the hospital, I'm on clinics often for follow ups. I guess I should consider a nearby establishment for when I need to use a toilet. Or carry around a bigger alcohol bottle. Or learn to squat without touching any other surface but the floor x.x
I wonder what other surfaces in the clinics are covered with STD causing microbes. I would suspect it extends beyond the bathroom... as disgusting as that may be.
Yeah. Some pee could've spilled on the tiled floor and then someone could've stepped on said floor before walking out. Scary to think about :| I try not to touch anything when I'm out as I can't be too sure (I'm on steroids so I don't want to risk getting something)
What I want to know immediately upon hearing the title is: "Can you get these diseases from using the toilet? Is there any slight chance?
I wish the article would address that directly somewhere in bold letters. What is the risk in this regard? Is there any risk at all?
Seems many people in the comment section are inferring that there is a risk -- and that that is their basic primal concern in reading the article.
The article stirs up that specter without addressing the actual facts about it.
Apart from that, very interesting and informative article.
That wasn't what the publication was about. I did cite a NY times editorial which discusses that though, it's citation #3. :)
The answer to your question is, yes, in theory. You can pick up an STD from a toilet seat, if you had say an open sore or something. However there is no evidence that it happens readily for someone who just uses a toilet.
I should have addressed this more explicitly.
Thanks for the extra STD info. I kinda assumed that -- but was still curious for confirmation.
It is a terrific article and very clear -- about the purpose and findings of that study -- which was not about whether or not you can catch those diseases from the bathroom.
Still, I suppose it does kinda beg that question.
Thanks for your gracious and helpful response to my pesky comment.
Your comment was not pesky at all! It was an astute request, and I am glad that the information has been made more clear in the comments section. If you ever look at another of my posts and can think of more information you would like to see, please point it out. I can't keep improving as a blogger ( I'm honestly a novice still ) with out constructive input like yours. Truly appreciate it.
Thanks, 'pesky' not the best choice of word. I did get the impression that you appreciated what I said and thought it was a valid and helpful observation. Look forward to more of your postings -- and commenting along -- and have enthusiastically 'subbed.'
Thank you :)
I am shocked and appauled
I think Ill hold on till I get home to safety in future !!
Yeah... this probably isn't the post to read during breakfast!! :D LOL
Its a bit too disgusting I think. Sorry to ruin your toast!
Teehee ^^ , its my own fault I saw the subject and had to find out more!!!.. great research very informative ! :)
Thanks for reading! I appreciate it, as well as your kind words.
Have a great day !!!:)
The worst thing about all of this is that as a young adult going through education - we were always told you could not get an STD from public toilets, only through sexual contact. The research presented above says otherwise. This is more than a little disturbing and I dare say that 'you cant catch STDs in public toilet' mindset is quite possibly what is still being taught today. A very good reason to go at home before going out. Thanks for your article.
No, the research presented above says the organisms can be detected there. It says nothing of whether or not you can actually contract one of the diseases (though it is gross nonetheless). There have been zero documented cases of someone getting an STD from a toilet.
The research described above is interesting because being able to know exactly what diseases are prevalent in a given community, quickly, and with out the need to test hundreds of individual people can lead to quicker determining the best treatments for that particular community (IE which drugs work best on the particular variants present there).
Well, this is a really shitty situation.
Nassstttyy~
No more public toilets for us!
Cheers
Punny
This post received a 3.3% upvote from @randowhale thanks to @justtryme90! For more information, click here!
Thanks me! You're the best me! So generous :D
Very well, thank you for sharing such important information
Thank you for reading and commenting.
Great article :) followed
Thank you for reading :)
This is pretty disturbing for sure. Trichomoniasis fortunately die very quickly in unfavorable conditions (when under a microscope they will die in minutes and are actually hard to visualize in time).
A good public health solution is to have wrapping around the seat of the toilet that can be switched after each user. I actually saw these in the Chicago airport awhile ago.
Nice research!
It's not so much a health issue (it is pretty gross though), but perhaps could be a useful tool for getting a feel for what strains of bacteria are prevalent in a given population. Could help in allowing for faster identification of the best possible treatments. More info for doctors is never a bad thing.
For sure! We may know a lot about health but there are way too many studies to be fully up-to-date!
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thanks.
Wow , I really hoped the butt gaskets provided some protection but paper can harbor bacteria too!! I suppose you need to carry a trial size of Clorox clean up to spray down the loo before you poo!!!!
Yeah pretty much lol. A bit too much gonorrhea for my liking...
I was expecting a way more disgusting article after seeing the topic but you handled that quite well. ;-)
Oh come on now, I write about science :)
I am not going to show disgusting images. :D
I thought about it... but I didn't want to look at them either.
Very informative post...a must upvote deserved...The community Toilets could be a source of many infections along with STD unless proper cleaning of these community toilets is done(most unlikely). The condition of community toilets is pathetic in our country...System has failed once and again in maintaining the hygiene of Public Toilets....Thanks for a deep insight...Steem on and Also support my blog...☺
Yeah, cleaning public toilets is definitely a must. Even clean toilets are still a big environment for potentially pathogenic microbes, unclean... much worse.
I feel aweful to think that this is true but you should have expected it if you look at the state of some of our public toilets. Will be very wary using one now.
This study was done on public toilets in health clinics. One would think these would actually be cleaner... since they would be regularly disinfecting/bleaching...
I agree but sadly that is not always the case thanks for your reply.
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great
Thanks for reading :)
Your post is really vesry usefull. keep posting
No plans to stop :D, thanks again.
following you.
Right back at cha.
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This is fascinating!
Thanks! I like how the simplest things like swabbing a toilet may lead to the generation of better information for physicians about STD strain prevalence in a given population. Seems like a quicker way to get data in new locations then waiting for the data to be generated in clinics.
Not upvoted cos low SP, but followed!
This reminds me of a Penn & Teller Bullshit episode (according to google, probably S02E02 Safety Hysteria), but they reached the opposite conclusion there. Glad to know my placing toilet paper on public toilet seats is more than mere germaphobia!
Pen and Tellers conclusion is correct. At least with regards to you getting infected. The bacteria are there but with out any open sores people just don't contract the diseases from the toilet seats. Now why not? That is an interesting question, because one would think that they should.
I will now think twice before using any public bathroom... Brrr.... Or will just go there after the cleaning crew ^^
Oh my gosh, that's kind of a scary thing to know! I never really want to touch a public toilet, so I do the squatting thing if I really have to go. Just can't be sure how often (and how well) they get cleaned... If at all possible though, I just wait until I get home!
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Sounds good, always nice to see more people interested in chatting about science.