Tea towels should only be used once, then washed?

Posted on July 6, 2014 by Douglas Powell

Never be anywhere without a towel.

A tea towel (or dish towel).

But do I need 50 clean ones a day?

New South Wales Food Authority chief scientist Lisa Szabo said last week that, “Tea towels should be replaced after every use. … It’s best to wash tea towels after each use and have a good supply of fresh ones to hand.”

That’s a lot of washing for anyone who has cooked from scratch.

So I reached out to friend of the barfblog, Dr. Don ‘Data’ Schaffner, who offered what seems to be reasonable advice: use disposable paper towels after a handwash where pathogens may be present, and a dish towel for other things. He has a paper coming out on the topic, but is a strong believer, like me, in peer-review and publish before press release.

Toilet psychology: why do men wash their hands less than women?

Posted on June 15, 2014 by Douglas Powell

By hiding in toilet cubicles for a new study, psychologists observed how long people spend using the loo, and how long they wash their hands for afterwards. That men usually wash their hands less conscientiously than women is a well-established finding. Thomas Berry and his colleagues wanted to find out more about the reasons for this gender difference.

For one day, between 10am and 4pm, a male researcher secreted himself inside one of three cubicles in a gents toilet facility at a U.S. University. For optimal observational purposes he chose the cubicle adjacent to a row of three urinals. Nearby, in a similarly designed female toilet facility, a single female researcher positioned herself in one of the three cubicles available. Don’t worry, both researchers were provided with a “customised wooden bench” for comfort.

They were also equipped with stopwatches. The researchers used an “unobtrusive sight procedure” – that is, they spied on other visitors to the lavatories using the gaps beneath and by the side of the cubicle doors (for some reason, US toilet cubicles always have a gap of about a centimetre either side of the door). The researchers also used an “acoustic procedure”. That is, they listened to the visitors’ actions. The study authors explained:

“… research assistants recorded the facility [urinal or cubicle], and then started a stopwatch when the patron’s feet stood relatively still. For the men, the research assistants also recorded the orientation of the feet to gauge the patron’s use of the commode (i.e. as a commode or a urinal). When research assistants heard the flushing of the patron’s commode or urinal the stopwatch was turned off … and the duration of the restroom event was recorded.”

Similar procedures were followed for recording each visitor’s “hand washing event” if there was one. A clever twist was that for part of the study, the researchers put “out-of-order” signs over the men’s urinals. This was to see how much they’d hand wash if they were forced to urinate in a cubicle, rather than at a urinal.

The psychologists managed to observe the toilet behaviour of 34 women using cubicles; 32 men who used a cubicle to defecate; 40 men who had no choice but to use the cubicles for urinating (because of the out-of-order signs); and 64 men who used a urinal. The bare statistics show that the hand-washing rates for these four groups were 91 per cent, 87.5 per cent, 75 per cent and 59.4 per cent, respectively.

The difference in hand washing rates between women using a cubicle and men using a cubicle (for defecating) was not statistically significant. In contrast, both women using a cubicle, and men using a cubicle (for defecating), showed significantly higher hand-washing rates than men who used a urinal.

The data are somewhat compromised because, as the researchers delicately put it – the women’s “facility use is a constant (i.e., commode) and their behaviour (urination, defecation, or menstrual care) is confounded within the one environment.” However, taken together, the results suggest that the reason men wash their hands less than women overall, is not because of gender norms (i.e. men are less bothered about being clean), but because of the differences in the toilet environment and toilet behaviour for men and women. In fact, after using a toilet cubicle to defecate, men tended to wash their hands for longer than women (but remember we don’t know what the women had been doing).

A bucket with a Styrofoam cup is not a handwashing station: dirty dining: Taqueria El Palenque

Posted on May 16, 2014 by Douglas Powell

How can a restaurant operate with no running water? Not in a safe or sanitary way.

Darcy Spears of KTNV ABC Channel 13 writes that one restaurant in Las Vegas tried to do it anyway, and that landed them at the top of the health district’s demerit list in this week’s Dirty Dining report.

The health district shut the place down on April 30 and it is still closed.

When inspectors were there, they found the restaurant had been operating for nearly a week with no running water. That got us to wondering what they did to keep things clean. How could employees wash their hands? How could they wash dishes? They couldn’t even flush a toilet.

The health district’s pictures show the bathroom sink was a bucket with a Styrofoam cup. There was another bucket next to the toilet. Employees were washing their hands with room temperature water in large pots and a trashcan.

Inspectors didn’t know where the water came from.

Did you wash your hands? Soap dispenser alarm at Proctor and Gamble

Posted on April 30, 2014 by Douglas Powell

Procter and Gamble is literally sounding the alarm to get people to wash their hands after they use the restroom. A soap dispenser blares after people use the bathroom. Here’s how it works: The toilet door locks are rigged with pressure sensors that connect to an alarm on the soap dispenser. When toilet doors are opened, the alarm sounds. It stops as soon as the button for the soap is pressed. The alarms are being tdested in fast food restaurants, schools, and offices in the Philippines.

Study: hand hygiene ‘too complex’ for Australian doctors

Posted on April 28, 2014 by Douglas Powell

Doctors at most public hospitals are failing to follow national hand hygiene guidelines, a new study shows.

This is because the current five-step approach is too complex, says Professor Mary-Louise McLaws, an infectious diseases expert at the University of New South Wales.

Her study focused on how regularly health workers wash their hands before seeing a patient, which is the first hand-hygiene opportunity in the five-step plan adopted in Australia in 2009.

The approach should be simplified to focus on washing hands before and after seeing each patient, says Prof McLaws, who has published a report in the Medical Journal of Australia.

Human instinct will take care of other protocols, such as washing after coming into contact with bodily fluids.

“We need to simplify it. Five behaviour changes were thrown at the doctors and nurses all at once.

“The nurses got it. They are exemplary compared with doctors. But they work in teams and support each other.”

Proper handwashing requires proper tools

Posted on April 13, 2014 by Douglas Powell

The state government in New South Wales – that’s where Sydney is – has come out with a new push for handwashing as a cornerstone of food safety.

I agree. But proper handwashing requires proper tools – vigorous water-flow, soap and paper towels.

Almost no Australian restaurants have all three components, based on my anecdotal but extensive observation (and wet shorts because I don’t use blow-driers).

NSW Minister for Primary Industries, Katrina Hodgkinson visited the NSW Food Authority’s stand at the Sydney Royal Easter Show and said, “Handwashing is the most simple and yet the most effective means of reducing your risk of food poisoning.”

If it was simple, so many people wouldn’t get sick; proper handwashing requires access to proper tools.

80 crypto cases a year; handwashing is never enough: UK health chief warns over risk of infection from region’s petting farms

Posted on April 8, 2014 by Douglas Powell

We have a paper coming out shortly about best practices at petting zoos and farm visits and state fairs and just hanging out with animals.

I’ll follow my own best practice and wait until it’s published to talk about it, but Dr Ken Lamden, the health chief of Cumbria and north Lancashire in the UK is urging parents to be aware of potential infections that can be caught at farm attractions.

Over the past 20 years, an average of around 80 cases of cryptosporidium infection linked to visits to petting farms have been reported to Public Health England each year. This is out of a total of around two million visits to the 1,000 plus farm attractions in the UK, with peak visitor times during school and public holidays.

Dr Lamden, of PHE’s Cumbria and Lancashire Centre, said: “Visiting a farm is a very enjoyable experience for both children and adults alike but it’s important to remember that contact with farm animals carries a risk of infection because of the micro-organisms – or germs – they carry.

“Anyone visiting a petting farm should be aware of the need to wash their hands thoroughly using soap and water after they have handled animals or been in their surroundings. Children are more at risk of serious illness and should be closely supervised to make sure that they wash their hands thoroughly.

“It is also very important not to rely on hand gels and wipes for protection because these are not suitable against the sort of germs found on farms.”

Parents in Ohio say their kids not allowed to wash hands at school

Posted on March 28, 2014 by Douglas Powell

First thing I do when a kid is checked into a new daycare or school is check out the handwashing facilities. Proper handwashing requires access to proper tools: vigorously running water, soap and paper towels.

Sorenne says at her kindergarten (prep here) she always washes her hands, uses soap, but because there is only blow driers she often dries her hands on her clothes (blow driers suck, the friction from wiping with paper towel provides an extra level of safety).

Too often, hypocrites preach about the importance of handwashing without checking to ensure the tools are available.

Two parents of students attending separate Toledo Public elementary schools in Ohio say their children are not being allowed to wash their hands after using the restroom, an allegation the school district denies.

Holly, who has two kids that attend East Broadway Elementary School, said she was surprised when her children told her that they couldn’t wash their hands while at school. “They told me they are only allowed to put hand sanitizer on twice a day after we use the bathroom,” said Holly.

The mother shared the information with her sister, Heather, who has a fourth grader enrolled at Burroughs Elementary.

Heather’s son told her that while at school he had witnessed another boy walk to the sink to wash his hands after using the restroom. The boy was stopped by a school staff member who called him over, squirted hand sanitizer in his hand, and walked away, according to Heather’s son.

When asked if they were sure of what their children were alleging, the women said that their kids have always been honest about what goes on at school.

Toledo Public Schools denies that students are prohibited from washing their hands. In an email to WNWO, TPS spokesperson Patty Mazur wrote, “Teachers take students to the bathroom as a class and then watch as students exit the restroom and wash their hands. If a student didn’t wash their hands properly, they are asked by their teacher to re-wash.”

Despite the response from TPS, Heather remains convinced that her son is not allowed to wash his hands while at school. “It needs to be addressed, ” she said. “This is disgusting. It makes me wonder if this is why my child has been sick so much this year.”
TPS said it holds hand-washing classes for elementary school students at the beginning of the year. Signs are posted in the restrooms reminding students to wash their hands after they use the bathroom.

‘Why do we have to wash our hands? We wear gloves’ bad inspection forces Wisconsin McDonald’s to close, give refunds

Posted on March 28, 2014 by Douglas Powell

A McDonald’s at 3131 Mayfair Road in Wauwatosa was, according to the Journal Sentinel, closed briefly two weeks ago because of issues with handwashing, and the restaurant was forced to give customers refunds at the counter, public records from the city showed.

The restaurant closed March 12 for several hours while a hand sink was being repaired. There were none working in the kitchen for washing hands or in the rest of the restaurant,except in the bathrooms. Restaurants in Wisconsin are required to have sinks designated solely for washing hands.

The inspection yielded several other violations, including dirty utensils, accumulations of food debris and grease, wiping rags in sanitizer buckets that didn’t have any sanitizer in them and a lack of basic knowledge about food safety.

According to the inspection report, one employee said, “Why do we have to wash our hands? We wear gloves.”

The inspector also instructed staff to throw out undated foods from the refrigerators.

Owner Deborah Allen said in a statement, “Nothing is more important to me than operating a safe and clean restaurant. We follow rigorous standards for food safety and quality, and we take great pride in the food and beverages we serve to our customers every day. We take these matters very seriously, and took immediate action to make the appropriate corrections.”

The inspection report is available at the Journal Sentinel’s restaurant inspection page, jsonline.com/data, which houses restaurant inspection data from the four-county Milwaukee area and is updated monthly. Wauwatosa is not included with other cities and towns in the four-county database because the city has said it is not able to release its database. Instead, the city provides inspection reports weekly.

No: Is hot water more effective for washing hands?

Posted on March 11, 2014 by Douglas Powell

We’ve written about this before, but here is another take on the effectiveness of warm or hot water in handwashing.

Researchers surveyed 510 adults and asked them questions about their hand washing behaviours and perceptions. People were asked how often they wash their hands, for how long and how hot the water should be.

According to the published report, “70% of respondents said they believe that using hot water is more effective than warm, room temperature, or cold water, despite a lack of evidence to back that up. The research showed a, “strong cognitive connection between water temperature and hygiene in both the United States and Western Europe.”

So while many believe hot water is more effective for hand washing the study actually concluded, “the temperature of water used is not related to how well pathogens are eliminated during the process.” Additionally, warmer water can irritate the skin and can affect its protective layer, which may cause it to be less resistant to bacteria. Skin irritation has been reported as one of the main reasons many healthcare workers forgo hand hygiene for example.

Interestingly if you look at the official guidelines for hand washing from the CDC and WHO, both do not actually specify a water temperature. They do recommend using soap and water and scrubbing using proper technique for at least 20-seconds, followed by drying hands thoroughly.

Despite this there is still lots of confusion as some public health organizations still recommend, “elevated water temperature.” The FDA Food Code for example, which is a model used to enforce health standards in restaurants recommends the , “hand washing sink be equipped to provide water at a temperature of at least 100°F or 38°C.”

One subscriber to this blog recently commented, “I have come across a food safety consultant who insisted that the temperature should be 60°C (140°F). Observations revealed that staff proceeded to use cold water saying hot water was too hot! Microbiological swabbing of hands revealed an increase in Campylobacter, E.coli and Listeria counts on hands that were washed in basins when very hot water was demanded by the consultant, compared to hands exposed to water at 40 to 45 °C.”

Barry Michaels, a microbiologist and expert in infectious disease performed the only known comprehensive review of published recommendations or testing standards on hand washing and rinsing water temperatures from 1938 to 2002. He found that there was no consensus but instead temperatures ranged from ambient to “as hot as you can stand” or “as hot as possible”. Many recommendations in food and healthcare environments were not concerned with the water temperature at all, while an equal number only specified that water in the lukewarm to warm temperature regions be used. Then there was a select group including ASTM test methods, American Society of Microbiology, the FDA Food Code and experts in food and healthcare who felt that hot water from 40 to 50 degrees °C (~100-120 degrees °F) should be used. Reasoning was that hot water was needed to melt fats in food soils and increase antimicrobial effectiveness. In testing on efficacy and skin health Barry Michaels and team found that hot water should not be used.

Michaels commented, “The damage at 60°C would probably be enough to stop workers from washing hands all together. Results indicate that water temperature has only slight effect on transient or resident bacterial reduction during normal hand washing when bland soap is used. We have also tested with four other soap products each having different active ingredients (PCMX, lodophor, Quat & Triclosan) and overall, the four soap products produced similar efficacy results”.

“Although there were slight increases in Log10 reductions (ascribed to antimicrobial speed of chemical reaction), skin moisture content decreased while Visiometer skin dryness score and transepidermal water loss (TEWL) increased at higher temperatures. Results were not statistically significant for any parameter, but all trends were unmistakable.”

“In summation, water temperature should be comfortable to allow or encourage frequent hand washing with mild, but effective soaps (designed for soils to be encountered). Vigorous hand washing is the preferred method. In terms of ideal temperature, I would say from ~70 to 105 °F or ~20 to 40.5 °C. This is comfortable without the risk of skin damage,” concluded Michaels.

Reference for the research cited is: Michaels, B.; Gangar, V.; Schultz, A.; Arenas, M.; Curiale, M.; Ayers, T.; Paulson, D. Water Temperature as a Factor in Handwashing Efficacy. Food Service Technology 2002; 2:139-149.
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