Me and Chapman, we love the covert studies (for science)

Hand hygiene is one of the most effective method for preventing cross-contamination. Food handlers have a major role in the prevention of foodborne illness during food production1 , consequently food handler hand hygiene failures are frequently reported to be implicated in foodborne illness2 . Although informative, food safety cognitions are not indicative of actual practices and may be subject to biases3 , therefore food handlers may demonstrate awareness of food safety, however may fail to translate knowledge into safe practices4 .

For this reason observational data are superior to survey data5 . However, during direct observations, researcher presence can increase subject reactivity6 , whereas covert video observation provide a more comprehensive analysis over a sustained period, where familiarity reduces reactivity bias7 . Previous video observation research have assessed food handler behaviours at retail/catering settings8-10 , however, this method has been under-utilised in food manufacturing business environments. Covert observation may allow the comparison of practices in different areas of manufacturing over the same period of time.

A comparison of hand hygiene compliance in high-care and high-risk areas in a Welsh food manufacturing business using covert observation

Cardiff Metropolitan University

Ellen Evans, Catherine Bunston and Elizabeth Redmond

https://www.metcaerdydd.ac.uk/health/zero2five/research/Documents/Hand%20hygiene%20two%20areas%20EE_04_04_2019%20Final.pdf

Proper handwashing requires proper tools: Alton Brown’s handwashing tutorial is funny, informative, and a little bit gory

Everyone says wash your hands in the wake of Coronavirus.

But proper handwashing requires proper tools.

I go to my local grocery store (when I’m let out of the house, and usually only with a carerer) and the bathroom for the shops has these stupid Dysan machines that just blow microbes around.

I got my job at Kansas State in 2005 because their handwashing thingies just blew stuff around, I wrote something up, they hired me, I did enough work to become full professor, and then they fired me.

Whatever.

Every time there is some weird outbreak at a local school, the first thing I do is check out the bathrooms – that’s right, I’m the creepy guy watching you kids wash their hands – and invariably they have no soap and no paper towel (the later is required for the friction).

Even the 20 seconds is probably overstating things: Can you imagine working in food service and having to wash your hands for 20-30 seconds every time you did something food safety risky?

You can keep imagining because you wouldn’t be working long.

Yes, wash your hands, my daughters have all had this engrained in them, but keep the messaging on a level people might actually follow.

Good Eats host Alton Brown is here to explain it in a 4-plus minute video that illustrates why soap is a solid line of defense against viruses, that demonstrates how to wash every square inch of your mitts, and that wraps up with one of the most surprising endings you’ll see outside of an M. Night Shyamalan flick.

“I’m happy that someone finally wants to talk about handwashing,” he says within the first minute. “I’ve been wanting to do a handwashing video for twenty years, but everybody was like ‘Oh no, hygiene’s boring, do cheese pulls.’ What do you think is going to save us now? Cheese pulls, nanorobots, lasers, hot yoga? I don’t think so.”

We did one 20 years ago.

So yeah, what might give us a shot at getting through… all of this is a bar of soap. (Regular soap, Brown emphasizes, not hand sanitizer. “Not the stuff you’ve been fighting over in drugstore parking lots,” he adds.)

Brown says that he actually travels with his own bar of soap, carrying it with him in a small tin. He also keeps his own zip-sealed bag of paper towels handy, to ensure that he can dry his hands properly too. (So take that, Dyson Airblade!) His handwashing technique takes a full 30 seconds to complete, and he adds a few ticks to the 20-second-minimum wash that has previously been suggested. He goes through a number of steps, for the front and backs of the hands, in-between the fingers, and under the nails. There are a lot of five-counts, but it works. And if that fails to do the job? Well, that’s where Brown’s sense of humor takes a darker turn.

I carry a tip-sensitive digital thermometer wherever I go.

Before Corona virus: Handwashing works, but requires proper tools (soap, vigorous waterflow and friction, paper towels)

The risk for a global transmission of flu‐type viruses is strengthened by the physical contact between humans and accelerated through individual mobility patterns. The Air Transportation System plays a critical role in such transmissions because it is responsible for fast and long‐range human travel, while its building components—the airports—are crowded, confined areas with usually poor hygiene.

Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) consider hand hygiene as the most efficient and cost‐effective way to limit disease propagation. Results from clinical studies reveal the effect of hand washing on individual transmissibility of infectious diseases. However, its potential as a mitigation strategy against the global risk for a pandemic has not been fully explored. Here, we use epidemiological modeling and data‐driven simulations to elucidate the role of individual engagement with hand hygiene inside airports in conjunction with human travel on the global spread of epidemics.

We find that, by increasing travelers engagement with hand hygiene at all airports, a potential pandemic can be inhibited by 24% to 69%. In addition, we identify 10 airports at the core of a cost‐optimal deployment of the hand‐washing mitigation strategy. Increasing hand‐washing rate at only those 10 influential locations, the risk of a pandemic could potentially drop by up to 37%. Our results provide evidence for the effectiveness of hand hygiene in airports on the global spread of infections that could shape the way public‐health policy is implemented with respect to the overall objective of mitigating potential population health crises.

Hand-hygiene mitigation strategies against global disease spreading through the air transportation network

Risk Analysis

Christos Nicolaides, Demetris Avraam, Luis Cueto‐Felgueroso, Marta C. González, Ruben Juanes

https://doi.org/10.1111/risa.13438

https://onlinelibrary.wiley.com/doi/full/10.1111/risa.13438#.XkIFeNVlfWw.twitter

Ethanol may not be so good: Better hand hygiene for flu prevention

The American Society for Microbiology says rubbing hands with ethanol-based sanitizers should provide a formidable defense against infection from flu viruses, which can thrive and spread in saliva and mucus. But findings published this week in mSphere challenge that notion — and suggest that there’s room for improvement in this approach to hand hygiene.

The influenza A virus (IAV) remains infectious in wet mucus from infected patients, even after being exposed to an ethanol-based disinfectant (EBD) for two full minutes, report researchers at Kyoto Profectural University of Medicine, in Japan. Fully deactivating the virus, they found, required nearly four minutes of exposure to the EBD.

The secret to the viral survival was the thick consistency of sputum, the researchers found. The substance’s thick hydrogel structure kept the ethanol from reaching and deactivating the IAV. 

“The physical properties of mucus protect the virus from inactivation,” said physician and molecular gastroenterologist Ryohei Hirose, Ph.D, MD., who led the study with Takaaki Nakaya, PhD, an infectious disease researcher at the same school. “Until the mucus has completely dried, infectious IAV can remain on the hands and fingers, even after appropriate antiseptic hand rubbing.

The study suggests that a splash of hand sanitizer, quickly applied, isn’t sufficient to stop IAV. Health care providers should be particularly cautious: If they don’t adequately inactivate the virus between patients, they could enable its spread, Hirose said. 

The researchers first studied the physical properties of mucus and found — as they predicted — that ethanol spreads more slowly through the viscous substance than it does through saline. Then, in a clinical component, they analyzed sputum that had been collected from IAV-infected patients and dabbed on human fingers. (The goal, said Hirose, was to simulate situations in which medical staff could transmit the virus.) After two minutes of exposure to EBD, the IAV virus remained active in the mucus on the fingertips. By four minutes, however, the virus had been deactivated.

Previous studies have suggested that ethanol-based disinfectants, or EBDs, are effective against IAV. The new work challenges those conclusions. Hirose suspects he knows why: Most studies on EBDs test the disinfectants on mucus that has already dried. When he and his colleagues repeated their experiments using fully dried mucus, they found that hand rubbing inactivated the virus within 30 seconds. In addition, the fingertip test used by Hirose and his colleagues may not exactly replicate the effects of hand rubbing, which through convection might be more effective at spreading the EBD.
 For flu prevention, both the Centers for Disease Control and Prevention and the World Health Organization recommend hand hygiene practices that include using EBDs for 15-30 seconds. That’s not enough rubbing to prevent IAV transmission, said Hirose. 
 The study wasn’t all bad news: The researchers did identify a hand hygiene strategy that works, also sanctioned by the WHO and CDC. It’s simple: Wash hands, don’t just rub them. Washing hands with an antiseptic soap, they found, deactivated the virus within 30 seconds, regardless of whether the mucus remained wet or had dried. 

Food Safety Talk 176: Bug Book

The show opens with a discussion about privacy, whether you should cover the microphone on your computer, or how you can scare your kids using Alexa. The guys talked briefly about what they’re watching, Ben’s trip to Athens Georgia, and celebrity feet. From there the show moves into listener feedback talking about the safety of eating Canadian seaweed. Listener feedback makes a interesting segue into failure, and the things we can learn from it. The show returns to listener feedback with a discussion about citrus safety and infused water. For some reason Don wants to talk about smoke detectors, before returning again to listener feedback and “Contamination Corner”, and ways to learn about stuff you don’t know about (like filibusters). Ben and Don talk about an interview that Don did for Cooking Light, before Don wants to talk about fixing his broken software. Ben ends the show with a long discussion regarding safe cooking directions for frozen vegetables, and why no one can agree.

This episode is available at foodsafetytalk.com or on iTunes.

 

Show notes so you can follow along at home are below:

Trump gets his news here: Fox News host says he has not washed his hands in 10 years ‘Germs are not a real thing’

To the chagrin of his co-hosts, Fox and Friends presenter Pete Hegseth told the show’s audience Sunday morning that he hasn’t washed his hands in a decade.

Katherine Hignett of Newsweek writes the revelation came after co-hosts Ed Henry and Jedediah Bila questioned Hegseth’s off-camera consumption of pizza left out after National Pizza Day Saturday. Hegseth had argued that pizza “lasts for a long time.”

Bila then quipped Hegseth “might take a chomp out of” anything on a table “that’s not nailed down”—including mugs.

“My 2019 resolution is to say things on air that I say off air… I don’t think I’ve washed my hands for 10 years. Really, I don’t really wash my hands ever,” Hegseth continued, prompting laughter from his co-hosts.

“Someone help me,” Bila said. “Oh man.”

“I inoculate myself. Germs are not a real thing. I can’t see them. Therefore the’re not real,” Hegseth said.  

“So you’re becoming immune to all of the bacteria,” Bila replied, rolling her eyes. “My dad has that theory too.”

Hegseth later shared a Tweet in support of his unusual concept of health and hygiene with the hashtag “DontWash.”

But the Centers for Disease Control and Prevention states that handwashing is a vital way to prevent the transmission of disease. By washing your hands—especially after using the bathroom—you prevent the spread of harmful bacteria like Salmonella and E.coli that can persist in tiny, invisible particles of human feces

It’s also important to wash your hands after handling raw meat, as this can harbor germs leftover from animal feces.

“A single gram of human feces—which is about the weight of a paper clip—can contain one trillion germs,” the CDC reports.

Filion, K., KuKanich, K.S., Chapman, B., Hardigree, M.K., and Powell, D.A. 2011. Observation-based evaluation of hand hygiene practices and the effects of an intervention at a public hospital cafeteria. American Journal of Infection Control 39(6): 464-470.

Background

Hand hygiene is important before meals, especially in a hospital cafeteria where patrons may have had recent contact with infectious agents. Few interventions to improve hand hygiene have had measureable success. This study was designed to use a poster intervention to encourage hand hygiene among health care workers (HCWs) and hospital visitors (HVs) upon entry to a hospital cafeteria.

Methods

Over a 5-week period, a poster intervention with an accessible hand sanitizer unit was deployed to improve hand hygiene in a hospital cafeteria. The dependent variable observed was hand hygiene attempts. Study phases included a baseline, intervention, and follow-up phase, with each consisting of 3 randomized days of observation for 3 hours during lunch.

Results

During the 27 hours of observation, 5,551 participants were observed, and overall hand hygiene frequency was 4.79%. Hygiene attempts occurred more frequently by HCWs than HVs (P = .0008) and females than males (P = .0281). Hygiene attempts occurred more frequently after poster introduction than baseline (P = .0050), and this improvement was because of an increase in frequency of HV hand hygiene rather than HCW hand hygiene.

Conclusion

The poster intervention tool with easily accessible hand sanitizer can improve overall hand hygiene performance in a US hospital cafeteria.

Wilson, S.M., Jacob, C.J. and Powell, D.A. 2011. Behavior-change interventions to improve hand hygiene practice: A review. Critical Public Health 21: 119-127.

http://www.informaworld.com/smpp/content~content=a934338802~db=all~jumptype=rss

Despite the role of hand hygiene in preventing infectious disease, compliance remains low. Education and training are often cited as essential to developing and maintaining hand-hygiene compliance, but generally have not produced sustained improvements. Consequently, this literature review was conducted to identify alternative interventions for compelling change in hand-hygiene behavior. Of those, interventions employing social pressures have demonstrated varying influence on an individual’s behavior, while interventions that focus on organizational culture have demonstrated positive results. However, recent research indicates that handwashing is a ritualized behavior mainly performed for self-protection. Therefore, interventions that provoke emotive sensations (e.g., discomfort, disgust) or use social marketing may be the most effective.

277 sick from Noro: Carribean cruise from hell

CBS News reports one of the world’s biggest cruise ships, Royal Caribbean’s Oasis of the Seas, is returning to a Florida port a day early and giving passengers full refunds of their fare after 277 guests and crew members were hit with an outbreak of norovirus as it sailed to Jamaica.

Cruise line spokesman Owen Torres told The Associated Press, “We think the right thing to do is get everyone home early rather than have guests worry about their health.”

He says the ship will return to Port Canaveral on Saturday. It sailed from there Sunday on a seven-day Caribbean cruise.

Passengers took to social media on Wednesday, tweeting they were forced to stay onboard after docking in Falmouth, Jamaica, for what was supposed to be a day of excursions.

Torres said returning a day early gives the cruise line “more time to completely clean and sanitize the ship” before it sails again.

Food Safety Talk 166: Surprising lack of cannibalism questions

Don and Ben traveled to SUNY Geneseo for a live version of the podcast sponsored by the Center for Integrative Learning, and hosted by the amazing Beth McCoy. The episode title comes from an unrecorded after dark which may or may not have taken place in a bar in Geneseo.

Episode 166 is available on iTunes and here.

Show notes so you can follow along at home.

Party on: It’s Global Handwashing Day- October 15

Kids, kids. It’s global handwashing day.

Join CDC expert, Dr. Vincent Hill for a Facebook Live handwashing demonstration on October 15 at 11:00 AM EDT in observance of Global Handwashing Day. Global Handwashing Day is an occasion to support a global and local culture of handwashing with soap, and promote handwashing with soap as an easy and affordable way to prevent disease in communities around the world.

The Facebook Live presentation will feature a handwashing contest between two volunteers to help viewers understand the importance of proper handwashing techniques. Tune in via CDC Facebook at www.facebook.com/cdcgov

I don’t do hashtags.