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Down and Dirty

Sirius Radio's Dr. Steve on whether toilet seat covers actually protect you from disease and illness

Whenever I use the bathroom at work, I put down one of those paper seats on top of the bowl. Is this actually protecting me from anything or is it just there for mental comforts? And what kinds of diseases or sickness can you actually catch from a toilet seat? — J. Kahn, Queens, New York

I actually researched this question in 2004 when I had to use a portable toilet at a microbrew festival in Virginia. Apparently, all the beer swilling resulted in a higher piss-volume-per-hour than the organizers expected and the damn things were so full there was no way to sit without drenching your nether parts in a soup of urine, feces and toilet paper. I won't bore you with images of me eventually squatting over the bowl, but I was paranoid about the number of diseases I could catch. In a barrel that deep, at least someone had to have hepatitis A, right? Incredibly, despite befouling my socks (don't ask), I survived without contracting any illnesses.

Most viruses and bacteria that are transmitted by stool are by the fecal oral route. Generally, this means the pastry chef takes a dump, doesn't wash his hands before he cooks, and suddenly there's a Hepatitis A outbreak in the community. On the other hand, sexually transmitted diseases generally require skin-to-skin contact. It turns out your skin is a really resilient disease barrier — as long as it is intact and lesion-free. Unless there's a lesion on the person's ass that sat before you, it's unlikely that his or her genitalia came in contact with the seat itself. Most organisms can't live outside the body for long. The exception to this might be herpes simplex virus. It can survive on an inanimate object for several hours under the proper circumstances, but I could not find a single case of transmission by toilet seat in the medical literature.

This doesn't mean it has never happened, but it's not recognized as common. The Journal of Travel Medicine in 2006 did relate a case of a kid getting lip-herpes from a scuba regulator used in a dive class (ugh...seriously if you run a scuba school, I'm checking to make sure you clean the gear between classes), but that's the closest I could find. Diseases that can be transmitted through the fecal-oral route include typhoid fever, shigellosis, hepatitis A and others. To get one of these diseases from a toilet seat, the person in front of you would have had to defecate on the toilet seat. Then you would have to sit on it and then get it on your hands, forget to wash your hands and THEN eat with your fingers or otherwise lick them.

I think the paper seat-protectors offer some psychological relief, but little disease protection. You'll have more success actually preventing disease by making sure you routinely wash your hands after using the bathroom. Oh, and then don't touch anything on your way out. Use a paper towel to open the door and toss it into the trash as you exit, because other people aren't as hygienic as you are. In a 2005 study, only 74% of men at Turner Field in Atlanta washed their hands after using the bathroom. The image of the 26% who voided their awful bladders and then touched everything before returning to their seats to enjoy a hot dog with their bare unwashed hands is enough to drive any self-respecting germ freak to distraction.

Dr. Steve is The Opie & Anthony Show's resident medical expert and the host of his own Sirius XM Radio program, Weird Medicine.

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