From the duh files: Study suggests handwashing compliance in child care facilities insufficient

Except the authors get it wrong.

This is the most telling quote from the PR, and I’m not sure who reviewed this shit:

handwashing-loads“The guidelines outline sequential handwashing steps that need to be followed, including use of warm water, soap, paper towels, and continuing for 20 seconds. This study confirms the results of previous studies in this area that there is a need for funding of education and training about proper hand hygiene.”

Water temp doesn’t matter. 20 seconds doesn’t matter. And give us more money to ingratiate ourselves with future funders.

Anyone who has worked in a daycare or restaurant, for lousy pay, knows that time constraints and screaming babies sometimes interfere with best practice. Did anyone follow the guidelines? Acknowledge the realities of the world we’re in, and offer practical advice. But you’ll probably get funded in the next round.

Child care personnel properly clean their hands less than a quarter of the times they are supposed to, according to a study published in the December issue of the American Journal of Infection Control, the official journal of the Association for Professionals in Infection Control and Epidemiology (APIC, http://www.apic.org).

A new study from the University of Arkansas used video cameras to record handwashing habits and compliance among child care workers at an early childhood center in northwest Arkansas. The researchers found that personnel and parents at the facility on average followed proper handwashing procedures only 22 percent of the time before and/or after tasks such as wiping noses, emptying garbage cans, preparing food, changing diapers, or using their cell phones. Caregivers washed 30 percent of the time it was called for, with paraprofessional aides at 11 percent, and parents at 4 percent.

“Handwashing is an important component of reducing illness transmission among children in early childhood centers, especially for the adults in charge of their care,” said lead study author Jennifer Henk, PhD. “As we seek to improve overall quality in early childhood settings, our study shows the need to adopt creative strategies to increase handwashing compliance and efficacy.”

amy-sorenne-handwashingSurveillance cameras were used to randomly record 25 hours of handwashing compliance in ten different classrooms. The center was aware of the cameras, but not alerted to the primary purpose of the study. There were a total of 349 handwashing opportunities in the 25 hours; 78 corresponding handwashing events took place for an overall compliance rate of 22 percent. Handwashing opportunities and events were based on guidelines for early child care established by the American Academy of Pediatrics. The guidelines outline sequential handwashing steps that need to be followed, including use of warm water, soap, paper towels, and continuing for 20 seconds. This study confirms the results of previous studies in this area that there is a need for funding of education and training about proper hand hygiene.

“Hand hygiene in early childhood centers is especially important because children under five years of age have only partially developed immune systems, increasing their susceptibility to communicable diseases,” said Susan Dolan, RN, MS, CIC, FAPIC, president of APIC. “Studies have shown that children who spend time in an early childhood care center are two to three times more likely to acquire infections than children cared for in the home, with respiratory and gastrointestinal infections posing the highest risks.”

Handwashing can prevent about 30 percent of diarrhea-related sicknesses and about 20 percent of respiratory infection in children, according to the Centers for Disease Control and Prevention.

So what are the creative strategies to increase handwashing compliance? Waste of time.

DC bartender and artist Chantal Tseng makes poop murals in bathrooms

According to bizjournals.com the murals are about poop. Not made out of poop (sadly).screen-shot-2016-10-19-at-5-20-30-pm

Regular Washington imbibers may notice something if they take an extra minute in the restrooms at the new REI flagship store in NoMa: the name of one of D.C.’s favorite bartenders, Chantal Tseng, inscribed on a roll of toilet paper held by a cartoon bear on the wall.

Washington City Paper even included her in a piece it did on D.C.’s mixologists turned chalk artists — which is how the folks at REI found her when they were looking for artists for murals at the new store.

After the call, Tseng enlisted D.C.’s go-to chalk artist, Patrick Owens, for help on the project.

screen-shot-2016-10-19-at-5-20-47-pmTseng and Owens drew extra animals in addition to the bear, and added leaves, animal tracks and, yes, piles of poop to the mural, which is titled “Poop in the Woods: Droppin’ Deuces Wild.” Tseng likes to incorporate haiku into her drawings, so she added a thematic one written backward that can only be read in the bathroom mirrors: “Last chance to soap up/ before heading back out there/ think of the children.”

Yes. Think about the children. And all the other folks who might get poop from your hands onto their hands or in their food.

Check if there’s paper towels in the kids’ bathrooms: Evidence-based interventions of Norovirus outbreaks in China

In resource-limited settings where laboratory capacity is limited and response strategy is non-specific, delayed or inappropriate intervention against outbreaks of Norovirus (NoV) are common. Here we report interventions of two norovirus outbreaks, which highlight the importance of evidence-based modeling and assessment to identify infection sources and formulate effective response strategies.

norovirus-bathroomMethods

Spatiotemporal scanning, mathematical and random walk modeling predicted the modes of transmission in the two incidents, which were supported by laboratory results and intervention outcomes.

Results

Simulation results indicated that contaminated water was 14 to 500 fold more infectious than infected individuals. Asymptomatic individuals were not effective transmitters. School closure for up to a week still could not contain the outbreak unless the duration was extended to 10 or more days. The total attack rates (TARs) for waterborne NoV outbreaks reported in China (n = 3, median = 4.37) were significantly (p < 0.05) lower than worldwide (n = 14, median = 41.34). The low TARs are likely due to the high number of the affected population.

Conclusions

We found that school closure alone could not contain Norovirus outbreaks. Overlooked personal hygiene may serve as a hotbed for infectious disease transmission. Our results reveal that evidence-based investigations can facilitate timely interventions of Norovirus transmission.

BioMed Central Public Health

Tianmu Chen, Haogao Gu, Ross Ka-Kit Leung, Ruchun Liu, Qiuping Chen, Ying Wu and Yaman Li

DOI: 10.1186/s12889-016-3716-3

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3716-3

Is there anybody out there? Physicians and handwashing

Our objectives were to evaluate the utility of electronic hand hygiene counting devices in outpatient settings and the impact of results feedback on physicians’ hand hygiene behaviors.

big-brother-1984We installed 130 electronic hand hygiene counting devices in our redesigned outpatient department. We remotely monitored physicians’ hand hygiene practices during outpatient examinations and calculated the adherence rate as follows: number of hand hygiene counts divided by the number of outpatients examined multiplied by 100. Physician individual adherence rates were also classified into 4 categories.

Results

Two hundred and eighty physicians from 28 clinical departments were monitored for 3 months. The overall hand hygiene adherence rate was 10.7% at baseline, which improved significantly after feedback to 18.2% in the third month. Of the clinical departments, 78.6% demonstrated significant improvement in hand hygiene compliance. The change in the percentage of physicians in each category before and after feedback were as follows: very low (84.3% to 72.1%), low (8.6% to 14.3%), moderate (2.9% to 8.9%), and high (4.3% to 4.6%), from the first to third month, respectively. Based on category assessment, 17.1% of physicians were classified as responders.

Conclusions

Physicians’ adherence to hand hygiene practices during outpatient examinations was successfully monitored remotely using electronic counting devices. Audit and feedback of adherence data may have a positive impact on physicians’ hand hygiene compliance.

Utility of electronic hand hygiene counting devices for measuring physicians’ handwashing

American Journal of Infection Control, DOI: http://dx.doi.org/10.1016/j.ajic.2016.08.002

A Arai, M Tanabe, A Nakamura, D Yamasaki, Y Muraki, T Kaneko, A Kadowaki, M Ito

http://www.sciencedirect.com/science/article/pii/S0196655316307532

 

Inevitability of reproduction – TV cooking show edition

In 2004, my laboratory reported (and by reported I mean published in a peer-reviewed journal) that, based on 60 hours of detailed viewing of television cooking shows, an unsafe food handling practice occurred about every four minutes, and that for every safe food handling practice observed, we observed 13 unsafe practices. The most common errors were inadequate hand washing and cross-contamination between raw and ready-to-eat foods.celebrity_chefs4

The abstract is below.

Once the paper was published, it made headlines around the globe.

And then it started getting replicated. Texas, Europe, a few other places, and now Massachusetts.

Compliance With Recommended Food Safety Practices in Television Cooking Shows

Nancy Cohen, Rita Olsen

Journal of Nutrition Education and Behavior, 2016 Aug 28. pii: S1499-4046(16)30715-1. doi: 10.1016/j.jneb.2016.08.002. [Epub ahead of print]

Objective

Examine compliance with recommended food safety practices in television cooking shows.

Methods

Using a tool based on the Massachusetts Food Establishment Inspection Report, raters examined 39 episodes from 10 television cooking shows.

Results

Chefs demonstrated conformance with good retail practices for proper use and storage of utensils in 78% of episodes; preventing contamination (62%), and fingernail care (82%). However, 50% to 88% of episodes were found to be out of compliance with other personal hygiene practices, proper use of gloves and barriers (85% to 100%), and maintaining proper time and temperature controls (93%). Over 90% failed to conform to recommendations regarding preventing contamination through wiping cloths and washing produce. In only 13% of episodes were food safety practices mentioned.

Conclusions and Implications

There appears to be little attention to food safety during most cooking shows. Celebrity and competing chefs have the opportunity to model and teach good food safety practices for millions of viewers.

 Mathiasen, L.A., Chapman, B.J., Lacroix, B.J. and Powell, D.A. 2004. Spot the mistake: Television cooking shows as a source of food safety information, Food Protection Trends 24(5): 328-334.

Consumers receive information on food preparation from a variety of sources. Numerous studies conducted over the past six years demonstrate that television is one of the primary sources for North Americans. This research reports on an examination and categorization of messages that television food and cooking programs provide to viewers about preparing food safely. During June 2002 and 2003, television food and cooking programs were recorded and reviewed, using a defined list of food safety practices based on criteria established by Food Safety Network researchers. Most surveyed programs were shown on Food Network Canada, a specialty cable channel. On average, 30 percent of the programs viewed were produced in Canada, with the remainder produced in the United States or United Kingdom. Sixty hours of content analysis revealed that the programs contained a total of 916 poor food-handling incidents. When negative food handling behaviors were compared to positive food handling behaviors, it was found that for each positive food handling behavior observed, 13 negative behaviors were observed. Common food safety errors included a lack of hand washing, cross-contamination and time-temperature violations. While television food and cooking programs are an entertainment source, there is an opportunity to improve their content so as to promote safe food handling.

Pools or animal farms: 223 sick UK crypto could be anywhere

Janet Hughes of Gloucestershire Live writes that scientists are checking to see if summer holiday visits to animal attractions are behind a massive spike in the number of toddlers with cryptosporidium.

crypto.petting.farmPublic health chiefs are asking affected families to fill in questionnaires about where they have been and what they have eaten in an effort to trace the source of the outbreak which is particularly bad in Gloucestershire and Wiltshire.

Children aged between one and five years are most at risk from the parasite cryptosporidium which is three or four times more prevalent than normal this summer.

Doctors believe a small number of cases could be linked Oasis leisure centre in Swindon, which has been closed as a precautionary measure, and say swimming in contaminated lakes, rivers or swimming pools can cause the disease to strike.

But many of those struck down are young toddlers so other possible theories include the prospect that children might not have washed their hands after petting animals at attractions during the summer holidays.

Hand washing is never enough.

 

Nosestretcher alert: Australian food safety type talks shit

Food poisoning and gastroenteritis affect 4.1 million Australians a year.

y a t il un pilote dans l'avion ? airplane flying high 1980 réal : Jim Abrahams David et Jerry Zucker Leslie Nielsen Collection Christophel Collection Christophel

If you do find yourself stricken with something nasty, it might be tempting to put a big, black mark against the last restaurant you ate in. But, according to Dr Vincent Ho, clinical gastroenterologist and lecturer in medicine at the University of Western Sydney, eating out isn’t always to blame. “It’s more common to get food poisoning with home meals, and that’s because people eat at home more often than they go out,” he tells Time Out. “Generally speaking, in Australia, and other developed countries where we have good sanitation, the vast majority of the time when we go out, there isn’t any food poisoning or gastroenteritis.”

Another so-called expert talking shit.

For instance there was an outbreak caused by contaminated lettuce in NSW recently. They were able to trace that back by looking at the people affected, asking about what they were eating and looking for common elements.”

Some would call it epidemiology.

Poultry products and meat are the most common sources of food poisoning, but most cases of gastroenteritis can be traced back to inadequate hand washing.

Nosestretcher alert.

Can’t image a more factually incorrect and condescending statement.

Fresh produce is the leading source of foodborne illness in Western countries and has been for over a decade.

But it’s still 1978 here in Australia.

jon.stewart.handwashing.2002In Australia and other developed countries, “we’ve taken special preparations to reduce the incidences of food-borne infections.” We have health inspections, food safety laws and signs everywhere that say “all staff must wash hands” when we’re eating out.

Seriously, you think those signs work?

How did you get to be a professor of anything?

At home, we have to rely on ourselves, and it turns out, many people are not that reliable. It only takes 10 seconds of washing your hands with soap and water to seriously reduce your chance of passing around a stomach bug, and yet, most people aren’t doing it properly.

That’s the reason you’re more likely to pick up an illness at home, or in a closed-off environment like a cruise ship, day care or nursing home, where you’re exposed to lots of people’s germs, than you are from a restaurant. At a restaurant, “although there are always occasions where food isn’t prepared optimally” there are structures in place to ensure caution. At home, you’re on your own.

Dr. Ho, I’ll gladly go to your home and watch you prepare a meal.

Most people don’t invite me to dinner because they know who I am.

But I’ll give you a tip-sensitive digital thermometer.

Parents hate my food safety stories, so just a face palm: 611 sick with Salmonella from backyard chicks

Sorenne rode her bike to school on Friday for the first time.

After months of angst, probably because she saw daddy wipe out and get 23 stiches a couple of years ago when she was on training wheels, she rode her bike.

Today (Wed) they had a bike-to-school day to play-bicycle-polo-on-the-tennis courts, and the number of kids and bikes was a bit much to handle.

But that’s a good problem.

picard.face.palmI was chatting with a parent after school, while the kids retrieved their bikes that were stored at the swimming pool due to overload, and I said it was a nice problem to have, and then we chatted about the weather – depths of winter, 24C in Brisbane – and he said I guess spring has sprung, our backyard chickens laid two eggs yesterday, so I guess spring is here.

I smiled but inside I was doing my best Jean-Luc.

The U.S. Centers for Disease Control and Prevention reports there are now eight multistate outbreaks of human Salmonella infections linked to contact with live poultry in backyard flocks.

In the eight outbreaks, 611 people infected with the outbreak strains of Salmonella were reported from 45 states.

Illnesses started on dates ranging from January 4, 2016 to June 25, 2016.

138 ill people were hospitalized, and one death was reported. Salmonella infection was not considered to be a cause of death.

195 (32%) ill people were children 5 years of age or younger.

Epidemiologic, traceback, and laboratory findings have linked the eight outbreaks to contact with live poultry such as chicks and ducklings sourced from multiple hatcheries.

Regardless of where they were purchased, all live poultry can carry Salmonella bacteria, even if they look healthy and clean.

These outbreaks are a reminder to follow steps to enjoy your backyard flock and keep your family healthy.

Always wash hands thoroughly with soap and water right after touching live poultry or anything in the area where the birds live and roam.

baby.chickDo not let live poultry inside the house.

Do not let children younger than 5 years of age handle or touch chicks, ducklings, or other live poultry without adult supervision.

These outbreaks are expected to continue for the next several months since flock owners might be unaware of the risk of Salmonella infection from live poultry or participate in risky behaviors that can result in infection.

Ill people reported purchasing live baby poultry from several suppliers, including feed supply stores, Internet sites, hatcheries, and friends in multiple states. Ill people reported purchasing live poultry to produce eggs, learn about agriculture, have as a hobby, enjoy for fun, keep as pets, or to give as Easter gifts. Some of the places ill people reported contact with live poultry include their home, someone else’s home, work, or school settings.

Public health officials collected samples from live poultry and the environments where the poultry live and roam from the homes of ill people in several states. Laboratory testing isolated four of the outbreak strains of Salmonella.

Handwashing rarely observed by Yellowknife restaurant inspectors

Seems like Larry has taken up the throne of food safety dude in Canada.

see.no.evil.monkeysI remember the days when I taught Larry and Kevin Allen – who’s been sidelined by a concussion but is still a hockey goon at heart – the basics of risk analysis at the University of Guelph.

I have other NSFV Larry stories, but will leave those for another day.

Priscilla Hwang of CBC News reports Yellowknife’s restaurant inspectors have been checking off the “not-observed” box on their inspection sheets, indicating they’re not seeing handwashing in over a quarter of all city restaurants and food-handling locations.

That means workers in one in four food locations in Yellowknife are not checked by inspectors to see if they’re complying with one of the critical inspection items — “hands clean and properly washed,” according to a CBC News analysis of the territory’s most recent restaurant inspection data.

“It seems like not only are those critical things not followed by the restaurant, but the inspectors themselves are not necessarily looking for them or spending long enough time to observe them,” says Lawrence Goodridge, a food safety professor at McGill University.

“And in my opinion, handwashing is probably the most important part of food safety.”

Goodridge says workers generally need to wash their hands frequently, especially after touching something that may contaminate them, or after using the washrooms.

He cites one U.S. study that suggests restaurant employees should wash their hands 29 times per hour. “So, you tell me,” he chuckles.  

Goodridge admits the critical things, like handwashing, are more difficult to observe and “are the ones that tend to be missed.” But he says that handwashing is right at the top of the critical list.

“They should stay long enough to see all the critical points in the inspection are being met, at the least,” says Goodridge.

More than a quarter of the city’s restaurants also received “not observed” status for proper sanitizing and storing of cloths used for wiping tables and dirty dishes, a non-critical item on the list.

 

‘It’s a good thing the standard greeting in Japan is bowing not shaking hands’ Handwashing in Japan

Surveys suck, but can be entertaining.

japan.handwashingCasey Baseel of Rocket News 24 reports Creative Survey recently polled a group of 600 Japanese men and women (75 of each gender in their 20s, 30s, 40s, and 50s) about their bathroom habits, and came away with some pretty gross statistics regarding how many of them properly wash their hands after going to the bathroom

Almost one in five people polled said that they occasionally skip washing their hands after dropping a deuce or unleashing an uno. Things get more cringe-provoking still when examining the breakdown of how the respondents “wash” their hands.

Only slightly more than 40 percent of those polled seemed to understand that the use of soap is really the deciding factor in whether or not you’re “washing” something (which is why walking around in the rain for five minutes doesn’t count as taking a shower). Also disturbing is the one percent of respondents who gave “other” as their answer.

It’s probably a good thing that the standard greeting in Japan is bowing, not shaking hands.