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
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
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.
I get lots of barfblog.com fan mail like the piece below.
Normally I just cc Chapman on my reply, so someone can take over when I die (me in the hospital last week with gall bladder issues, my partner and daughter bought me a nice light robe for the Australian summers, and I was with Larry, my portable IV unit I shared a shower and bed with), or get tired of doing this, or my brain sufficiently rots, but this was too ripe, so welcome to the daily insults of an unpaid blogger.
Hello Doug I trust all is well. I have a question for you. Do you (brilliant Scientist, food safety guru) really think the Fox host has not washed his hands in 10 years? Doug you used a pile of E. dung to purposely smear the President of a country that you are not a citizen of. I ask you to please rebuke your political opinions and stick with what has and always will help advance food safety – you!
I am an American citizen. I worked long and hard for that distinction, given my Canadian prison record. I voted in the last election, and not for Mr. Trump. The Fox News dude is now saying his lack of handwashing was a joke, but given the discourse on Fox, I kinda doubt it. More like covering his ass (like a HACCP plan).
I am a citizen of three countries and have three passports – Canadian, American and Australian. So does Sorenne. Amy has two. It’s not a secret and could easily been discovered, but you chose to assume rather than ask. That’s a problem for science and journalism: People making up shit.
Others might call it fake news.
To paraphrase what I told sceptics in 1987 when I started the University of Guelph alternative newspaper, if you don’t like my blog, don’t read it, start your own, and stop wasting my time.
Peace.
And here’s a video from another citizen of Canada and America.
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
Following on all things Schaffner, a professor of food science at Rutgers, who has been studying hand washing for years and says the conventional wisdom shouldn’t be ignored.
“It doesn’t matter whether you’re peeing or you’re pooping, you should wash your hands,” he told Business Insider.
Here’s why.
Germs can hang out in bathrooms for a long time
Each trip to the restroom is its own unique journey into germ land. So some occasions probably require more washing up than others.
“If you’ve got diarrhea all over your hands, it’s way more important that you wash your hands than if… you didn’t get any obvious poop on your fingers,” Schaffner said. “My gosh, if you’ve got poop on your hands and you have the time, certainly, get in there, lather up real good and do a real good job.”
Compared to feces, urine can be pretty clean when we’re not harboring any infections, though it’s not totally sterile.
“People who use urinals probably think they don’t need to wash their hands,” Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy, said to the New York Times. (In studies, women tend to be better about adhering to hand washing than men.)
But it’s best to wash your hands after every trip to the toilet because human feces carry pathogens like E. coli, Shigella, Streptococcus, hepatitis A and E, and more.
You can also easily catch norovirus by touching bathroom surfaces that have been contaminated with a sick person’s poo or vomit, then putting your hands into your mouth. The super-contagious illness is the most common food poisoning culprit, and causes diarrhea, vomiting, nausea and stomach pain.
“I think a good general rule of thumb is you should wash your hands any time you feel that they might be dirty,” Schaffner said. In other words, seize the opportunity when you’re near a sink.
He said he’s not “super paranoid” about making sure his own hands are always squeaky clean, but some of his favorite times of day to wash up are after walking the dog, working in the dirt, or handling raw meat.
Even a quick “splash ‘n dash,” as researchers like to call the practice of rinsing with water but no soap, can help fight off some bacteria that causes infections. But that shortcut is not advised if you might have raw meat or feces on your mitts, and a lather with soap and water is more effective at disinfecting hands than any wipe or sanitizer.
Here are Schaffner’s best tips for your next journey to the toilet
Follow this simple, three-step hand-washing plan to lower your chances of getting colds, self-inflicted food poisoning, and diarrhea.
First, don’t worry about the temperature of the water; Schaffner’s studies have confirmed that doesn’t make a difference. He suggests that you “adjust the water temperature so it’s a nice comfortable temperature, so you can do a good job.”
Second, give yourself enough time to “get some soap in there, lather it up real good, clean under your finger nails,” Schaffner said. Spending even five seconds washing your hands can help reduce the amount of bacteria on them, but 20 seconds is better. The Centers for Disease Control recommends humming the Happy Birthday song to yourself twice as a timer.
Third, dry off before you leave the room. This step is key because wet hands transfer more bacteria than dry ones.
“If your hands are still wet, you go to touch that door of the bathroom, having your wet hand might actually help transfer bacteria,” Schaffner said. He’ll even dry his palms on his pants if there’s no paper towel around.
Despite all the evidence demonstrating the health benefits of regular hand washing, Schaffner knows his advice can only go so far.
“I’m not in charge of you washing your hands, just because I’m a guy who did some science and did some research on hand-washing,” he said. “You do what you want.”
Well said.
We ain’t preachers, just provide evidence-based advice.
Got me a job at Kansas State University, got me dismissed.
My friend, who has been canoeing down the Moose River for the last week found this in the restaurant at Moose Factory (you aren’t Canadian unless you know how to make love, or just have sex, in a canoe).
Bob Whitaker, Ph.D., chief science and technology officer for Produce Marketing Association (PMA), writes that because it provides inherently healthy, nutritious foods, the fresh produce industry is uniquely positioned to help solve the nation’s obesity epidemic. To do so, consumers must have confidence in the safety of the fresh fruits, vegetables, and nuts they eat and feed their families.
A green row celery field is watered and sprayed by irrigation equipment in the Salinas Valley, California USA
Following a large and deadly outbreak of foodborne illness linked to fresh spinach in 2006, the U.S. produce industry couldn’t wait for government or other direction. After finding significant knowledge gaps and a lack of data needed to build risk- and science-based produce safety programs, the industry created the Center for Produce Safety (CPS) in 2007.
CPS works to identify produce safety hazards, then funds research that develops that data as well as potential science-based solutions that the produce supply chain can use to manage those hazards. While two foodborne illness outbreaks in the first half of 2018 associated with leafy greens demonstrate the industry still has challenges to meet, CPS has grown into a unique public-private partnership that moves most of the research it funds from concept to real-world answers in about a year.
Each June, CPS hosts a symposium to report its latest research results to industry, policy makers, regulators, academia, and other produce safety stakeholders. Key learnings from the 2017 symposium have just been released on topics including water quality, cross-contamination, and prevention. A few highlights from those key learnings are summarized here, and for the full details, you can download the Key Learnings report from CPS’s website.
Know Your Water (we were doing that in 2002, long before youtube existed)
Irrigation water is a potentially significant contamination hazard for fresh produce while it is still in the field. While CPS research has revealed many learnings about agricultural water safety in its 10 years, many questions still remain. Meanwhile, the U.S. Food and Drug Administration (FDA)’s proposed Food Safety Modernization Act (FSMA) water testing requirements—which offers some challenges for producers in specific production regions—recently raised even more questions.
New CPS research illustrates the risks of irrigating with “tail water” from runoff collection ponds. With water becoming a precious resource in drought-stricken areas, the objective was to learn if tail water might be recovered and used for irrigation. We learned that differences among pond sites—for example, water sources, climate, ag management practices—can strongly influence the chemistry and microbiology of the water. Further, water pH can influence disinfection treatment strategies.[1]
CPS research continues to investigate tools for irrigation water testing, looking specifically at sample volumes,[2] and searching for better water quality indicators and indexing organisms including harnessing next-generation DNA sequencing.[3] Following a CPS-organized colloquium on ag water testing in late 2017, FDA subsequently announced it would revisit FSMA’s ag water requirements, and postponed compliance.
Bottom line, CPS research demonstrates that growers must thoroughly understand their irrigation water before they can accurately assess cross-contamination risk. CPS’s findings clearly point to the need to take a systems approach, to understand and control the entire water system to help achieve produce safety. Long term, this may mean prioritizing research into ag water disinfection systems to better manage contamination hazards that can also operate at rates needed for field production. Cross-Contamination Can Happen across the Supply Chain
While conceptually and anecdotally the fresh produce industry knows that food safety is a supply chain responsibility, research is needed that documents the role of the entire supply chain to keep fresh produce clean and safe from field to fork. At the 2017 CPS Research Symposium, research reports were presented focusing on cross-contamination risks from the packinghouse to retail store display.
In the packinghouse, CPS-funded research found that wash systems can effectively control cross-contamination on fruit, when proper system practices are implemented.[4] Post-wash, CPS research involving fresh-cut mangos also demonstrated that maintaining the cold chain is critical to controlling pathogen populations.[5] Across the cantaloupe supply chain, CPS studies show food contact surfaces—for example, foam padding—are potential points of cross-contamination.[6] See the full 2017 Key Learnings report for details, as these brief descriptions only scratch the surface of this research.
CPS studies clearly demonstrate that food safety is a supply chain responsibility—a message that must be internalized from growers and packers to transporters, storages, and retailers to commercial, institutional, and home kitchens. While translating this research into reality will present engineering and operational challenges, our new understanding of produce safety demands it. Verifying Preventive Controls
The produce industry must know that its preventive controls are in fact effective. That said, validation can be tricky. If validation research doesn’t mimic the real world, industry ends up fooling itself about whether its food safety processes work—and the human consequences are real.
Numerous scientists presented research at the 2017 CPS Research Symposium that validates various preventive controls, from heat treating poultry litter[7] to pasteurizing pistachios[8] to validating chlorine levels in wash water systems.[9] Some researchers effectively used nonpathogenic bacteria as a surrogate in their validation studies, while another is working to develop an avirulent salmonella surrogate, and another. Wang used actual Escherichia coliO157:H7 (albeit in a laboratory).
Importantly, CPS research finds that the physiological state of a pathogen or surrogate, and pathogen growth conditions themselves, are critically important to validation studies.[10] Meanwhile, suitable surrogates have been identified for some applications, the search continues for many others.
The research findings described here are just some of the real world-applicable results to emerge from CPS’s research program. To learn more, download the 2017 and other annual Key Learnings reports from the CPS website > Resources > Key Learnings page at www.centerforproducesafety.org.
We were doing these videos in the early 2000s, long before youtube.com existed, and weren’t quite sure what to do with them. But we had fun.
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.
