From the industry sponsored survey files: More paper towels and soap needed in restrooms

Ask a bunch of people about their bathroom habits and you get a bunch of answers. Maybe there’s some truth to the self-reported behaviors. Bradley Corporation the commercial washroom people report in a non-peer-reviewed survey that folks in the U.S. don’t always wash their hands (not new) that women self-report handwashing compliance rates higher then men (seen in observation studies) and there’s a lot of texting/Facebooking/Snapchatting in the stalls (sometimes in a creepy way).bathrooms-900x600

The Healthy Hand Washing Survey queried 1,062 American adults online Dec. 10-13, 2015 about their hand washing habits in public restrooms and concerns about germs, colds and the flu. Participants were from around the country, were 18 years and older, and were fairly evenly split between men and women (47 and 53 percent).

Some gems:

Americans take cell phone breaks in restroom stalls.
Using cell phones in restroom stalls is not off limits for the majority of Americans. Texting, checking/sending email, checking/posting on social media and surfing the web are the most common activities. Surprisingly, six percent of all survey respondents admit they’ve taken a photo in the stall while eight percent of men say they’ve checked their fantasy sports league.

They skip the suds….especially men.

While consumers look to businesses to improve their restroom cleanliness, they have room for improvement when it comes to washing their hands in these locations. Almost 80 percent say they frequently or occasionally see others leave a public restroom without washing their hands, especially in the men’s room. Men also admit they are less likely to wash up than women – 20 percent disclosed they skip washing because they “didn’t feel the need.”

They identify facility issues that get in the way of washing hands (there may be some bias in here, with a survey coming from a facilities company -ben)

Of those who acknowledge not washing their hands, most say there was a lack of resources in the wash area – no soap or paper towels. They also blame the sinks, which were either not working or simply appeared too unclean to use.

They think poorly of businesses with dirty restrooms.
An unclean restroom tarnishes the image of a business in consumers’ minds. Most Americans say that a messy restroom signifies poor management and shows the business doesn’t care about its appearance or its customers.

Clean restrooms don’t mean safe food.

Dirty restrooms don’t correlate to foodborne illness outbreaks

While making a recent pilgrimage from Raleigh to Southern Ontario (and back) via minivan I saw a bunch of dirty restrooms. One was so bad (right, exactly as shown) that Dani made us go to the next exit; things almost got messy in the car.

DSC05623A dirty restroom is gross, and might be a good source of a pathogen like norovirus from a previous, uh, user, but do dirty bathrooms say anything about the food handling practices in the kitchen? Or does a clean bathroom mean that the cooks know their stuff and are reducing cross-contamination? Some argue that a dirty restroom is an indicator of poor sanitation throughout the system (maybe), but analysis of inspection results seem to disagree that dirty bathrooms are correlated with outbreaks. We talked about this a bit in a paper published earlier this year (D.A. Powell, S. Erdozain, C. Dodd, R. Costa, K. Morley, B.J. Chapman. 2013. Audits and inspections are never enough: A critique to enhance food safety. Food Control).

Some good stuff that friend of barfblog Ruth Petran published last year also showed that for certain pathogens there was little correlation between inspection factors related to sanitation and outbreaks. Sanitation of facilities and non-food contact surfaces only came up in noro outbreaks with a relative risk of less than the lack of single use/service articles and weirdly proper cooling and date marking. Dirty facilities wasn’t seen as a risk factor popping up in Salmonella or C. perfringens outbreaks at all. What matters are things like keeping ill employees out of the kitchen and controlling temperatures.

Evidence often isn’t enough to sway public opinion though. UPI reports that in a survey funded by restroom hygiene equipment that cleanliness matters to patrons.

Almost 30 percent of U.S.adults say they will never return to a restaurant with a dirty bathroom, a survey indicates.

Elliott Greenberg, owner of said a recent survey conducted by Harris Interactive for SCA Tissue North America found 50 percent of restaurant patrons who have a negative experience with the restroom — bad odors, grimy soap dispensers, dirty toilets and other cleanliness problems — will discuss it to friends and family.”

“We live in a world that is consumed with hand sanitizers and green living. The consumer is acutely aware of those things that cause the spread of germs and bacteria,” said Donna Santoro, senior product manager of the washroom solutions global business team for Rubbermaid Commercial Products. “And it is all about touching.”

Poorly cleaned public cruise ship restrooms may predict norovirus outbreaks

Chapman says that while dirty bathrooms can be gross, like the gotcha moments on hidden camera programs, there really isn’t any information that suggests a place with a dirty bathroom is any more or less likely to cause an outbreak than a place with a clean bathroom. Lots of restaurants have separate handwashing facilities in the kitchen, and risk-based inspection systems focus on factors that lead to illness as identified by the CDC and WHO — not the floors, walls and ceilings, and how many flies are on a fly strip.

But what about on cruise ships?

A team of researchers from Boston University School (BUSM), Carney Hospital, Cambridge Health Alliance and Tufts University School of Medicine, have found that widespread poor compliance with regular cleaning of public restrooms on cruise ships may predict subsequent norovirus infection outbreaks (NoVOs).

This study, which appears in the November 1st issue of Clinical Infectious Diseases, is the first study of environmental hygiene on cruise ships.
Outbreaks of acute gastroenteritis (AGE) often occur in close populations, such as among cruise ship passengers. Recent epidemiologic investigations of outbreaks of AGE confirmed that 95 percent of cruise ship AGE outbreaks are caused by norovirus.

Despite biannual sanitation monitoring and hand hygiene interventions among passengers and crew members, 66 ships monitored by the United States Centers for Disease Control and Prevention experienced NoV infection outbreaks (NoVOs) between 2003 and 2008.

Trained health care professionals evaluated the thoroughness of disinfection cleaning of six standardized objects (toilet seat, flush handle or button, toilet stall inner handhold, stall inner door handle, restroom inner door handle, and baby changing table surfaces) with high potential for fecal contamination in cruise ship public restrooms.

The researchers found only 37 percent of the 273 randomly selected public restrooms that were evaluated on 1,546 occasions were cleaned daily. The overall cleanliness of the six standardized surfaces on each ship ranged from four to 100 percent. Although some objects in most restrooms were cleaned at least daily, on 275 occasions no objects in a restroom were cleaned for at least 24 hours.

Bathroom blogging in New York City

Amy, Sorenne and I just got back from a whirlwind trip to New York City.

And when we’re all in the same hotel room, and I wake up early to do some writing, I’ll go to the bathroom, shut the door and blog away.

If I go to NYC for five weeks Thanksgiving to New Year’s holiday orgy in the U.S., I could make $10,000 – for blogging about bathrooms.

Procter & Gamble Co. is looking for five people who will, in return for $10,000, spend five weeks in a Charmin-branded, Manhattan bathroom and blog about the experience.

The five “Charmin Embassadors” will work in the Charmin Restrooms in Times Square from Nov. 23 to Dec. 31. Job requirements include interacting with hundreds of thousands of bathroom guests, maintaining their own blogs and content on Charmin-branded Web sites and popular social media sites, and sharing family-friendly video from the restroom space and surrounding areas.

How is friendly-family video defined? Reminds me of one of the earliest episodes of South Park where adults protesting apparently scandalous TV content inundate the studio and are stricken with foodborne illness – the green apple splatters.

Grandma knows best

I arrived in Kansas City International Airport Saturday evening after a long flight from Rome, Italy. Like many other passengers, once I gathered my belongings from the overhead compartment and the seatback pocket, I headed to the airport bathroom. After I was finished, I washed my hands (just like you’re supposed to) and was delighted to observe what I presumed to be a grandmother and her granddaughter.

“Don’t just slap your hands together, you have to rub them together to get the soap everywhere, then rinse them,” grandma said to granddaughter. It made me smile to know that handwashing is still being taught to the youngsters.

Wolfgang Puck sued for crappy bathroom

Celebrity blog TMZ reports that celebrity chef Wolfgang Puck is being sued over a restaurant bathroom.

A woman claims she just wanted to take care of some toilet business during a lunch at Puck’s most famous Beverly Hills restaurant, Spago back in 2007. But according to the lawsuit, filed in L.A. County Superior Court, the bathroom floor was covered in "standing pools of urine and feces" — and the only usable toilet didn’t have a lock on the door.

The woman also claims she had to use one of her hands to hold the door closed while she took care of business on the throne. But mid-squat, with her hand stuck firmly on the handle, another woman allegedly yanked the door open causing Linden to fall "face-first onto the tile floor."

Reps for Spago claim the woman is completely full of crap when it comes to the cleanliness of their bathrooms — "In our 27 years of business we’ve never had an issue close to this … that portion of the claim is totally without merit."

Wolfgang had some hepatitis A problems back in 2007.


Dirty restaurant restrooms send customers out the door

Rating bathrooms is one of those stories that just won’t go away.

But are restrooms really indicative of restaurant cleanliness?

The Detroit Free Press reports this morning that an online survey of 2,175 adults by Harris Interactive last year found that 88% of people who visit restaurants believe that restroom cleanliness reflects the restaurant’s overall hygiene, including sanitary standards in the kitchen and prep areas.

But is that assumption correct — or just a myth?

Health Department officials contacted about the survey said they couldn’t say because they’ve never studied the subject — and they wouldn’t speculate.

Ben says that while dirty bathrooms can be gross, like the gotcha moments on hidden camera programs, there really isn’t any information that suggests a place with a dirty bathroom is any more or less likely to cause an outbreak than a place with a clean bathroom. Risk-based inspection systems focus on factors that lead to illness as identified by the CDC and WHO — not the floors, walls and ceilings, and how many flies are on a fly strip.

Gross bathroom behavior at LAX

Maybe it’s the delirium from 20 hours of traveling back from Australia with another 12 to go (that’s air-time and wait-time), but as I was dutifully washing my hands at the Los Angeles airport bathroom, a middle-aged well-dressed dude walked in eating an apple. I pulled a Howard Hughes and got a little compulsive about my hands, to see what this guy would do. He wandered around the bathroom, looking for an empty stall, all the while eating his apple.

He went into a stall while continuing to eat his apple.

I left.

Going poop in public — Rocky Mountain Chocolate edition

With four daughters, I’ve changed a lot of diapers over the years.

Almost all the diapers were cloth; at least for the first two children. Then, after too many green apple splatters seeping through, migrated to the seemingly more absorbent disposable diaper.

And then there were the emergency dumps that, well, we’ve all had, regardless of age. On Weeds last night, Nancy Botwin, played by Mary Louise Parker (right), peed into a cup while waiting to cross the Mexican-U.S. border.

Sometimes it’s not nearly that neat.

A reader told The Consumerist yesterday that,

"Last night we were out with friends and went to the Rocky Mountain Chocolate Factory at Bella Terra/Huntington Beach. We were eating outside as my 5 year old daughter got an uncontrollable urge to use the bathroom and began crying and screaming ‘diarrhea, diarrhea.’ I ran into the store with her in my arms, begging to use the bathroom and they refused multiple times.

“I explained she had diarrhea and couldn’t hold it and told them she was about to go on the floor. They refused again and never offered me any alternatives. I begged them to have a heart and that she was 5 but by that time she had lost it all over herself and me. I ran with her in my arms to the movie theater that let me use their bathroom. I cleaned her up, threw out some of her clothes and went back to the Chocolate Factory – asking for names and number of management. I again pleaded with them to use their heart in situations like this.”

Almost a year ago, a similar incident happened at a Jo-Ann Fabrics in Indiana. With similar results.

Today, California’s Orange County Register reported that officials with Rocky Mountain Chocolate Factory issued an apology, and that the story sparked a backlash that led to death threats, according to store owner, Bonnie Overturf, who was not there during the incident last Thursday.

Overturf said her employees were following insurance policies for her store, and there were at least a dozen restrooms near the store the mother could have used.

Bryan Merryman, chief operating officer for the Colorado-based candy company, issued an apology to the mother Tuesday, saying "the actions of one franchised store’s employees do not represent the values of the company … We truly regret this situation occurred."

"We are a very family friendly company and would never encourage any policy that does not take individual facts and circumstances into account,” he wrote.

Overturf, who said she apologized to the mother earlier, contacted police once death threats began and her home address was posted on an unknown Website. People also threatened to throw feces at her home, she said.

People shouldn’t throw piles of shit at store owners and their homes; or leave burning bags of poop on the front step. Poop is the source of many pathogens, stores are not all equipped to handle public poop, and some people don’t clean up after themselves (or pick up their dog’s shit).

But when kids (or others) gotta go, it’s better to isolate the mess to a bathroom.

I’ve cleaned up lots of shit. And expect lots more.

Bathrooms in Japan

Michelle Mazur has been working with me for several months. She’s starting vet school in the fall and came up with the cryptosporidium-in-pools infosheet.

Michelle just returned from two weeks in Japan. I asked her to take some pictures of Japanese hand washing facilities and the like. In her own words,

"I’m a bit embarrassed at how many pictures I took during the trip.  At first my group members made fun of me taking photos of bathrooms, but by the end of the trip they would walk out of the bathroom saying "Cool, Michelle, you’ve got to go in and take a picture of that awesome bathroom!"
Michelle’s photo odyessy is available at:

Her commentary is quite funny.