When the H1N1 influenza began appearing around the world last spring, it seemed to be a fairly mild ailment. But by June 2009, the World Health Organization signaled that a new pandemic flu was under way and warned that if H1N1 followed the behavior of other pandemic flu viruses, it could restrengthen and worsen in the fall and winter—when children are back in school and when people tend to congregate more in closed public settings.
That prediction proved correct. By late September and early October of 2009, hospital emergency rooms were filled with patients concerned that they or their children had H1N1. Between April and October of 2009 more than one million Americans were diagnosed with the H1N1 virus. More than 10,000 Americans were ill enough to require hospitalization and about 1,000 had died including 76 children.
“Swine flu infections seem to be dropping, but the number of children with the illness who died in the United States has risen by about 30, according to a government report releases in December 2009. Widespread infections of swine flue were reported in 32 states as of Nov. 21—down from 43 states the week before,” the U.S. Centers for Disease Control and Prevention officials said.
To prevent further spread of this new flu, health professionals frequently repeated a simple remedy: sneeze and cough into your sleeves, and wash your hands frequently.
How well has the public complied with that recommendation? Bradley Corp.—a leading manufacturer of restroom and plumbing fixtures—surveyed a representative cross-section of the American population about their hand washing habits in public facilities. The results were surprising.
- 54 percent said they wash their hands no more nor less frequently in public restrooms since the H1N1 virus emerged;
- 87 percent said they washed their hands with soap and water after using public bathrooms but other responses indicated that some may have exaggerated how often they actually did the job correctly. For instance, 55 percent also admitted they have on occasion just rinsed their hands before leaving a public restroom; and
- When asked about kids, 68 percent of parents said they believed their school-age children wash their hands after using the restroom. If that is accurate, it still leaves 1 in 3 children walking around with germ-laden hands.
Blame it on the restroom
With the threat of a serious infection like H1N1, why are so many people lax about hand hygiene? The respondents’ reasons should be of special interest to facility managers. According to the Bradley Corp. survey, many cited the quality of public restrooms.
When respondents were asked why they did not wash their hands before leaving a public restroom, they complained of nonworking sinks and unclean or crowded wash areas. However, some admitted that they simply didn’t feel the need to wash—although 28 percent of them said they used a hand sanitizer instead. The primary reason respondents cited for not using soap or rinsing only with water, was that the soap dispensers were empty.
Clean hands are critical
Can clean hands really prevent H1N1? Yes—according to Dr. Judy Daly, spokesperson for the American Society of Microbiology and director of the clinical microbiology laboratories at Salt Lake City’s primary children’s medical center.
Viruses like the swine flu can be easily destroyed through proper hand hygiene, she says, adding: “Flu viruses most frequently enter the body when contaminated hands touch mucous membranes of the nose, eyes and mouth.”
The U.S. Centers for Disease Control and Prevention (CDC) calls hand hygiene “the best way to prevent infection and illness.” For proper hand washing, the CDC says nothing beats soap and water, with alcohol-based sanitizers as a good second option.
Most, least preferred restrooms
When it came to the type of public rest-rooms they preferred, 45 percent of survey respondents chose casual dining restaurants, followed by retail stores (15 percent) and airports (13 percent). Restrooms in movie theaters, fast-food restaurants and grocery stores scored below 10 percent—with parks, sports arenas and zoos all earning just a 1 percent approval.
The least favorite public restroom type?
Gas stations and convenience stores.
The reasons some restroom categories ranked high or low were not surprising. They were considered dirty, poorly maintained, not well stocked or unattended, and cramped.
Parents helping their children were espe-cially frustrated by factors such as empty or jammed towel dispensers, having no space to put belongings, water collecting on sink counters, and sinks and soap dispensers that were too high for children to reach.
Making public restrooms more inviting
Studies have shown that about 80 percent of those who enter a public building will visit its restroom. In fact, a consumer’s first impression of a business, government agency, school or health care facility is often based on how inviting its restrooms look. For facility managers, it’s important to ensure that the experience is a positive one.
Below are some factors and features to consider if you are in the process of building or upgrading the public restrooms you manage.
Feminine appeal
In retail stores, whether it’s buying a car or buying groceries, women influence 95 percent of all purchase decisions and actually make 85 percent of them. So if restroom ambience affects consumers’ first impressions, it’s important to ensure that those facilities appeal to women. If you manage facilities in supermarkets or entertainment venues, make sure your restrooms don’t fall into that sub-10 percent category found in the Bradley survey.
Sustainable design experts have also found that women are put off by cramped, sloppy restrooms, which can in turn affect their purchasing decisions. Therefore, cleanliness and design speak volumes in this case. Because women shoppers are often accompanied by children as well as aging or disabled family members, it’s important to make the hand-washing area universally accessible. When women have to lift children to sink height to help them wash their hands, restroom stops can become a burden.
Universal access
To make it easier for shoppers or visitors, consider multi-height, solid-surface lavatories that incorporate a standard-height sink and a lower sink. The lower sink makes it easier for children and wheelchair-bound customers. Some models are designed with wave patterns that make the room not only more accessible but also attractive.
For women with children, provide enough space in the toilet stall to park a stroller or help little ones navigate the restroom. Providing coat hooks on the back of toilet partition doors are helpful for hanging coats and purses; the alternative is putting them on the floor to collect germs or become damp—both unappealing and unclean.
Eye appeal
To keep restrooms from feeling institutional and cold, select warm-colored natural stone or ceramic tile. Opt for durable solid-surface lavatory systems in earth shades that coordinate with other accessories in the restroom.
Lighting
Lighting plays an important role in creating a welcoming space as well. Keep lighting in the warm temperature range and stay on the softer side. Good lighting also lets patrons see how clean restrooms are. With poor, dim lighting, even the cleanest restrooms can seem poorly maintained.
Sustainable design cuts utility costs
In addition to a facility’s restroom appearance, a solid restroom design strategy incorporates sustainable features that curb maintenance as well as utility costs.
Light-activated sensors
Light-activated lavatory systems help maximize energy savings and environmental efficiency. Photovoltaic cells integrated into the top of a lavatory system can convert either normal restroom lighting or daylighting into energy that is stored and used to power valves and sensors in the hand-washing fixtures. These fixtures eliminate the need for batteries and electrical hookups. By eliminating replacement batteries, these products not only cut operating costs but also help reduce the 2.5 billion pounds of batteries that are sent to landfills each year.
Low-flow fixtures
Specifying low-flow fixtures, metered faucets and waterless urinals can reduce water consumption by more than 30 percent. This can provide huge savings in water and sewer bills, as well as energy costs for hot water.
Sensor-activated flush meters
These can be used to control water at peak times, saving scarce resources and reducing utility charges. Large-scale projects are also finding ways to reuse storm water or gray water for toilet flushing. Depending on local codes, water used by lavatories varies from 2.5 gallons per minute (gpm) to 2.2 gpm, with many public restrooms using just 0.5 gpm.
Infrared sensors on faucets and lavatory systems save additional water by ensuring that water is only running while someone is washing his or her hands. Metered faucets have a flow rate limit of 0.25 gallons per cycle, which is the amount of water used during each activation.
Hands-free fixtures
Besides reducing waste, infrared fixtures provide the added benefit of reducing germs. With increasing publicity about widespread flu epidemics and other contagious infections, the public is sensitive to hygiene and wary of touching objects that have been handled by scores of other patrons. Hands-free faucets in public facilities can encourage more hand washing—and help prevent infections.
In restrooms, germs tend to concentrate in damp areas and on door handles. Space permitting, it is best to design restrooms with maze-like open entrances, which afford privacy and eliminate the need to touch door fixtures.
Hands-free, sensor-operated soap dispensers, motion-activated towel dispensers and automatic hand dryers are popular among facility managers. It’s important to consider placement of soap, towel dispensers and hand dryers to both encourage use and prevent water and soap spills on floors, which can be a major safety hazard for public facilities.
Some manufacturers also provide anti-microbial coatings on door handles as another option to minimize germs and bacteria.
Solid surface materials
Using solid-surface lavatory systems or countertops in restrooms promotes an attractive appearance while ensuring long-term durability and ease of cleaning. Some solid surface materials are comprised of eco-friendly recycled content. The integrated bowl design used with solid surface material eliminates crevices where microbes can hide. Plus, the material is naturally resistant to bacteria.
Unisex and family restrooms
Unisex restrooms are single-user lavatory rooms that can be used by either men or women. Family restrooms can have multiple unisex toilet rooms and may also have common space for other purposes, such as hand washing or diaper changing.
Benefits for everyone
Attractive and efficient public restrooms offer significant benefits. For the facility manager and building owner, they can attract repeat users. And for the health of the community and general public, clean and functional restroom facilities can encourage hand washing and prevent flu and other serious infections.
About the author
Jon Dommisse is director of marketing and product development for Bradley Corporation of Menomonee Falls, Wis.—a manufacturer of locker room products, plumbing fixtures, washroom accessories, partitions and emergency fixtures. Bradley serves the commercial, industrial, health care, recreation, education and corrections markets worldwide. For more information, call +1-800-BRADLEY or visit www.bradleycorp.com.
