The Germiest Places in America

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The Germiest Places in America

WebMD Feature from " Health " By Ginny Graves

OK, we admit it: We're a little freaked out about germs these days.

Since the SARS scare several years ago, there's been a steady stream

of news reports about ugly bugs. West Nile virus! Microbes on our

beaches! Drug-resistant bacteria! It's enough to turn anybody into a

germophobe. Here's what you really need to know.

Germs are everywhere, and our map on pages 114 and 115 pinpoints just

a few hot spots—from fast-food health-code violations (Orlando), rats

in restaurants (Philadelphia), and infected food workers spreading

Norovirus (Minnesota) to polluted beaches on the East Coast and nasty

air in California. And talk about dirty water: In Texas, 348 of the

state's factories and utilities exceeded the amount of pollution

allowed under their Clean Water Act. When it comes to

antibiotic-resistant superbugs, Texas takes another hit. Community

Acquired-Methicillin-Resistant Staphylococcus aureus (CA-MRSA) has

emerged in epic proportions in Corpus Christi; that's the same kind of

bug that struck hospital nurseries in both Chicago and L.A. last year.

For the most cases of Streptococcus pneumoniae, Florida is the winner

(or loser, depending upon how you look at it).

We call them the dirty dozen.

It's our laundry list of the germiest places you're likely to

encounter during an average day. Sure, there are outbreaks of microbes

and viruses across the country, but these buggers are where you live.

In the office, at home, at the gym, on your vacation. " It's enough to

make even the least germophobic person a little worried, " says Dr.

Germ, a.k.a. Gerba, PhD, a professor of environmental

microbiology at the University of Arizona. After all, some of these

germs lurk where you least expect them, he says: " People are more

worried about the trash can than the kitchen sink, when it should be

the other way around. " Dr. Germ and a panel of other experts helped us

identify the dirty dozen and devise ways for you to keep clean. After

all, the fight is in your hands. Literally. Eighty percent of

infections are spread through hand contact. So wash up, people, and

get ready to wage a bit of germ warfare of your own.

1. Your kitchen sink

" Kitchen sinks are dirtier than most bathrooms, " says Reynolds,

PhD, an environmental microbiologist at the University of Arizona.

There are typically more than 500,000 bacteria per square inch in the

drain. In fact, in a recent study, half of the top 10 germiest spots

in the home were (gulp!) in the kitchen. That sponge you use to clean

the counter? Crawling with bacteria, as are the sink's basin and

faucet handles.

Reduce the risk: " Clean your kitchen counters and sink with an

antibacterial product after preparing or rinsing food, especially raw

fruits and vegetables, which carry lots of potential pathogens like

salmonella, campylobacter, and E. coli, " says Philip Tierno, PhD,

author of The Secret Life

of Germs and director of clinical microbiology at New York University

Medical Center. Sanitize sponges by running them through the

dishwasher's drying cycle. " That killed 99.9 percent of the bacteria

on the sponges we used in a recent study—and we'd gotten them really

good and contaminated first, " says Cheryl Mudd, a microbiologist with

the Agricultural Research Service's Food Safety Laboratory. As for the

sink, clean it twice a week with a solution of one tablespoon of

chlorine bleach and one quart of water. Scrub the basin, then pour the

solution down the drain. (continued)

2. Airplane bathrooms

It's not exactly a shock that there are a huge number of germs in most

public bathrooms, but experts agree that those cramped and overused

airplane loos (with only about one toilet for every 50 people) are the

worst. " There are often traces of E. coli or fecal bacteria on the

faucets and door handles, because it's hard to wash your hands in

those tiny sinks, " Gerba says. But here's the worst news: The volcanic

flush of the commode tends to spew particles into the air, coating the

floor and walls with, well, whatever had been swirling around in there.

Reduce the risk: Toilet seats are surprisingly clean,but use the paper

cover when available. After using the toilet, wash and dry your hands

thoroughly, and use a paper towel to handle the toilet seat, lid, tap,

and doorknob. Put the lid down before you flush. If there's no lid,

turn your back to the toilet while flushing and beat a hasty retreat.

3. A load of wet laundry

" Clean clothes " is a whopper of an oxymoron. " Anytime you transfer

underwear from the washer to the dryer, you're going to get E. coli on

your hands, " Gerba says. Just one soiled undergarment can spread

bacteria to the whole load and the machine.

Reduce the risk: Run your washer and dryer at 150 degrees, and wash

whites with bleach (not the color-safe type; it doesn't pack the same

punch), which kills 99.99 percent of bugs. Transfer wet laundry to the

dryer quickly so germs don't multiply, wash underwear separately

(there's about a gram of feces—a quarter the size of a small peanut—in

every pair of dirty underwear), and dry for at least 45 minutes. Wash

your hands after laundering, and run a cycle of bleach and water

between loads to eliminate any lingering bugs.

4. Public drinking fountains

Drinking fountains are bound to be germy, but school fountains are the

biggest offenders, with anywhere from 62,000 to 2.7 million bacteria

per square inch on the spigot, says Donofrio, PhD, director of

microbiology for NSF International. Other school hot spots: cafeteria

trays, sink handles, desk-tops, and computer keyboards.

Yes, kids are germy creatures. And, thanks to their slapdash hygiene,

22 million school days are lost each year to colds alone.

Reduce the risk: Send your child to school with plenty of her own

beverages. Teach her to wash her hands, especially before and after

lunch, going to the bathroom, or using the computer. Send hand

sanitizer to every school teacher and give extras to your child. And

when it's your turn to squeeze into that little desk for Open House?

Swab it off with an antibacterial wipe, Gerba says. If schools did

that every night, they'd reduce the child-absenteeism rate by half.

And, of course, don't drink from the water fountain! (continued)

5. Shopping cart handles

Saliva. Bacteria. Fecal matter. Those are just a few of the choice

substances Gerba found on shopping cart handles. Carts rank high on

the yuck scale because they're handled by dozens of people every day

and you're " putting your broccoli where some kid's butt was, " says the

professor of environmental microbiology. And, of course, raw food

carries nasty pathogens.

Reduce the risk: Many stores, aware of the ick factor, have a

dispenser with disinfectant wipes near the carts. If yours doesn't,

bring your own and give the handle a quick swab; that's been shown to

kill nearly 100 percent of germs. Or carry along a cart cover, like

the Grip-Guard or Healthy Handle, a dishwasher-safe polypropylene

cover that fits over any size cart handle. At the meat counter, follow

the lead of , PhD, co-director of the Center for

Hygiene and Health at College in Boston: " I always put raw

meat in a plastic bag.

If I get some juice on my hands, I ask the person behind the counter

for a disinfecting wipe. "

6. ATM buttons

If you're not careful, you might pick up more than quick cash from

your local ATM. Those buttons have more gunk on them than most

public-bathroom doorknobs. (The same goes for vending-machine buttons,

bus armrests, and escalator handrails.) After testing 38 ATMs in

downtown Taipei, Chinese researchers recently found that each key

contained, on average 1,200 germs. " ATMs aren't frequently cleaned,

and they are regularly touched—a perfect combination for a lot of

germs, " environmental microbologist Reynolds, PhD, says.

Reduce the risk: " Carry an alcohol-based hand-sanitizer with you and

rub it on your hands after a visit to the ATM, " Reynolds suggests.

Also, be sure to do it after you handle money. " Paper money actually

carries quite a few germs, too, " she says.

7. Your Marc s?

Dirty? Yep. Think petri dish. When University of Arizona professor of

environmental microbiology Gerba, PhD, and his team tested

women's purses not long ago, they found that most had tens of

thousands of bacteria on the bottom and a few were overrun with

millions. Another study found bugs like pseudomonas (which can cause

eye infections), and skin-infection-causing staphylococcus bacteria,

as well as salmonella and E. coli. Your makeup case is every bit as

bad, as are your guy's wallet and personal digital assistant.

Reduce the risk: Instead of slinging your bag on the floor, hang it on

a hook whenever you can—especially in public bathrooms—and keep your

bag off the kitchen counter. Stick with leather or vinyl purses, which

are typically cleaner than cloth (less-porous surfaces are more

impervious to germs). And wipe your bag down every few days with a

mild soap or disinfectant, then let it air dry. Brand name, alas,

makes no difference. continued)

8. Playgrounds

There's just no way to put this delicately: Children tend to ooze

bodily fluids and then spread them around. " When we sampled

playgrounds, we were pretty aghast at what we found—blood, mucus,

saliva, urine, " Reynolds, PhD, says. Pair those findings with

the fact that children put their fingers in their mouths and noses

more than the rest of us, and it's easy to understand why Junior (and

maybe his mom or dad) has the sniffles.

Reduce the risk: Carry alcohol wipes or hand-sanitizing gel in your

purse, and clean everybody's hands a couple of times during a park

visit, especially before snacking. Pick warm sunny days for outdoor

play: " The sun's ultraviolet light is actually a very effective

disinfectant. Most bugs won't survive long on surfaces that are hot

and dry, " says Backer, MD, MPH, an expert in communicable

diseases in Richmond, California.

9. Mats and machines at health clubs

" I see a yoga mat, and I worry, " says , PhD, who has

found antibiotic-resistant staphylococcus on yoga mats and cardio and

resistance machines. " At high schools, antibiotic-resistant-staph

infections have been transmitted through wrestling mats. The same

thing could happen at health clubs. "

Reduce the risk: Wipe down machines with antibacterial wipes before

working out. Bring your own yoga mat or cover a loaner with your

towel. " Shower after a workout and soap up your skin to rinse off any

bacteria you may have been exposed to, " says. " Thorough washing

gets rid of antibiotic-resistant staph. "

10. Your bathtub

Shocking, but true: The place you go to get clean is quite dirty. In a

recent study, , PhD, found staphylococcus bacteria, a

common cause of serious skin infections, in 26 percent of the tubs she

tested, as compared with just 6 percent of garbage cans. Tubs

typically had more than 100,000 bacteria per square inch! " It makes

sense when you think about it, " she says. " You're washing germs and

viruses off your body. The tub is a fairly moist environment, so

bacteria can grow. "

Reduce the risk: Once a week, apply a disinfecting cleaner to the tub.

" You need to actually scrub, then you need to wash the germs down the

drain with water and dry the tub with a clean towel. If you leave the

tub wet, germs are more likely to survive, " says. Pay special

attention to soap scum—a surprisingly germ-friendly environment,

author Phiilp Tierno, PhD, adds. If someone who uses the tub has a

skin infection, scrub it afterward with a solution of two tablespoons

bleach in one quart of water.

11. Your office phone

This is enough to make you dial 911: Office phones often have more

than 25,000 germs per square inch, and your desk, computer keyboard,

and mouse aren't far behind. " Phones, including cell phones, can be

pretty gross; they get coated with germs from your mouth and hands, "

says Donofrio, PhD. Although we'd like to think of ourselves as

cleaner than guys, women's offices have twice the number of bacteria

(but men's are slightly more likely to harbor antibiotic-resistant

staphyloccus). In fact, Gerba calls desks " bacteria cafeterias, "

because of all the food particles he found there. Most common office

areas—kitchens, copiers—are not as dirty as individual desks, although

the microwave is pretty bad.

Reduce the risk: Simply cleaning your desk, phone, and key-board with

a disinfecting wipe once in the middle of the day will kill 99.99

percent of the bacteria and viruses. (continued)

12. Hotel Room Remote

What's the first thing you do when you settle in at a hotel? You grab

the remote control and switch on the TV—you, and the hundreds of other

guests who've stayed there. How dirty is it? Owen Hendley, MD, a

professor of pediatrics and infectious disease at the University of

Virginia School of Medicine, and his colleagues recently tested

various surfaces for the cold virus after a group of sick people had

stayed overnight. " We found the virus on the remote, door handles,

light switches, pens, and faucet handles, " he says.

Reduce the risk: Clean the remote control, phone, clock radio, door

handles, and light switches with germicidal wipes. While you're at it,

throw on a pair of slippers and throw off the bedspread. " We've found

urine and semen on both carpets and bedspreads. " They may not make you

truly sick, but it certainly is enough to make you feel queasy.

Originally published on November 1, 2007

http://www.webmd.com/cold-and-flu/features/germiest-places-america