A seven-point scale rates restroom design according to how effectively it reduces the possibility of spreading or catching germs.

Solis sensor faucet by Sloan Valve Co.

Flu season may be over, but there are plenty of other germs lurking in the restroom. Fortunately, hygienic hand-washing and proper restroom design can greatly reduce the chance of catching and sharing germs.

The Centers for Disease Control and Prevention (CDC) reports that just the basic rotavirus alone costs the United States $1 billion a year, resulting in 410,000 physician visits, 200,000 emergency room visits, 55,000 hospitalizations and up to 60 deaths. Globally, this stool-spread virus kills more than 600,000 children a year.

According to plumbing products manufacturer Sloan Valve Co., sensor-operated faucets, flush valves and hand dryers reduce the number of potential touchpoints in the restroom where people can pick up germs. Even when users wash their hands for 30 seconds as the CDC recommends, they can easily recontaminate their hands if they touch a surface, such as a faucet handle, after washing.

Facilities can now score how well they fare regarding restroom contamination by using the  Heatwole-Potts Lavatory Scale. The scale rates restrooms according to whether they eliminate the potential for direct hand contamination at each of seven crucial locations.

Starting with a perfect score of 7, a restroom loses one point on the scale for each place where an individual is required to touch a potentially contaminated surface:

    1) Direct hand contact required to flush toilet: (-1)

    2) Direct hand contact required to open and/or close stall door: (-1)

    3) Direct hand contact required to turn on the water at the sink: (-1)

    4) Direct hand contact required to dispense soap: (-1)

    5) Direct hand contact required to turn off water at sink: (-1)

    6) Direct hand contact required to activate hand-drying device (air dryer or paper dispenser) or to dispose of paper towel, if applicable: (-1)

    7) Direct hand contact required to open door of bathroom for exit: (-1)
Proper engineering and architectural design can result in a perfect Heatwole-Potts score. Here are the design suggestions for each of these points, which minimize infectious disease transmission:
    1) A user shouldn't have to touch a handle to flush a toilet. An automated device, such as an electronic sensor, or a foot pedal should initiate flushing.

    2) If a stall door has a lock, a user should be able to both unlock and open the stall door without using a hand. This device could be easily implemented with a locking apparatus activated via a foot movement.

    3) Faucets should not require direct hand contact to start water flow. Electronic faucets, or those activated by foot pedals, can minimize contact.

    4) A soap dispenser should dispense soap into the hand of the user without direct user contact. Again, dispensers can be sensor operated or require another hands-free approach.

    5) Direct contact with a hand should not be required to stop faucet water flow. A foot pedal or motion detection device can be used for this purpose. Even though a time release faucet, such as a metered manual faucet, automatically stops water flow after a period of time, initial activation can contaminate hands.

    6) Hand drying apparatuses should not require a user to touch any surface other than a "sterile" hand towel. Paper towel dispensers should not require the user to turn a crank or lever, and hot air blowers should be motion activated. In addition, a bathroom user should not be required to touch a surface, such as a trash can lid, to dispose of a paper towel.

    7) Restroom users should be able to leave without touching a door handle or lever. Design options include a doorless restroom with a serpentine entrance, a mechanical door triggered by a foot pedal or motion detector, and a latchless, outward-opening door.
Peter Jahrling, director of engineering for Sloan Valve, which underwrote the Heatwole-Potts study, says that businesses, schools, healthcare centers and other facilities that install sensor-operated plumbing products and systems improve restroom hygiene. This, in turn, keeps people healthier and more productive.

Hands-free, sensor-operated faucets can offer the additional benefit of conserving water. "Electronic plumbing eliminates the opportunity for users to leave faucets running," says Jahrling. He adds that sensor-operated, 0.5 gallon-per-minute faucets, which also turn off when people are lathering their hands, can save as much as 1 gallon of water per use compared to manual faucets.

Homeowners and businesses can check how much money they could save by switching to more water-efficient plumbing systems by using the calculators on www.waterefficiency.com.

Because these plumbing products are touchless, they're also less prone to mishandling and abuse. "Vandalism also becomes a non-issue without handles or knobs to kick or damage," says Jahrling. Even well-meaning restroom visitors who simply want to avoid touching germ-ridden surfaces sometimes roughly use handles on flush valves or faucets, which can result in leaks and fixture damage.