The importance of hand washing in the transmission of infection has been recognised since 1847 (Semmelweis, 1861(1)), and the global COVID-19 pandemic reminded us all about the need for regular and effective hand hygiene(2) to reduce viral infection and spread. According to UNICEF (3), the simple act of cleaning hands with soap and potable water can save lives and reduce illness by helping prevent the spread of infectious diseases caused by pathogens transmitted through air, contact surfaces, human faeces, or food. Many key foodborne pathogens can be controlled through proper hand hygiene, including noroviruses, Salmonella, Campylobacter, E. coli, Listeria, and Vibrio cholerae.
The impact of poor hand hygiene on food safety is well documented (Greig et al., 2007(4); Todd et al., 2007a&b(5&6)).
Handwashing is a basic, yet critical personal hygiene practice for preventing contamination and disease within food handling establishments, but, even when food handlers do wash their hands, it may not be enough. Monitoring of hand hygiene(7) after handwashing revealed a pattern of commonly missed areas:
Source: istockphoto.com. See *Note below.
As illustrated above, the greatest concentration of microbes (including pathogens), and dirt exist under the fingernails, which is unsurprisingly the most difficult area to properly clean. Other areas of concern are around the webbing of hands, skin ridges, palm lines, knuckles, and wrists.
Regulatory and standard requirements
Hand hygiene is a requirement in the UK, EU, and other CODEX-based regulated food handling operations, and is an integral component of global food safety standards, including IFS, SQF, BRCGS, and FSSC22000.
FSSC22000 (ISO/TS 22002-1)(11)
Cleaning of the areas highlighted above, and of the hands in general, could be improved by using an effective handwashing method.
1. Wet hands with water.
2. Apply soap.
3. Rub hands together for ~40 seconds (sing the “Happy Birthday” song twice).
4. Use one hand to rub the back of the other hand and clean in between the fingers. Do the same with the other hand.
5. Rub your hands together and clean in between your fingers.
6. Grip the fingers of each hand together with the backs of your fingers against the palms of your other hand.
7. Rub your fingertips together and rub the back of your fingers against your palms.
8. Rub one thumb using your other hand. Do the same with the other thumb.
9. Rub the tips of your fingers on the palm of your other hand. Do the same with other hand.
10. Rinse your hands with water.
11. Dry your hands completely.
A handwashing poster (illustrated example below) at visible locations can be a helpful communication aid:
Source: istockphoto.com. See *Note below.
Hand hygiene compliance
Effective handwashing is easy to achieve if the steps outlined above are followed. Getting people to follow these steps and wash their hands at an appropriate frequency, or at all, is more of a challenge.
The following are key to improving handwashing compliance:
(1) Availability of staff facilities and resources – Handwashing must be done only at a properly equipped station that has dedicated handwashing facilities conveniently accessible to employees. These stations should be fitted with sinks supplied with potable water at a suitable temperature and pressure, appropriate hand cleansers, and a proper method of hand drying. The absence of any of these requirements will result in poor hand hygiene. It is also essential to note that wearing clean gloves to handle exposed food is never a substitute for proper handwashing.
(2) Enhanced awareness – Handwashing education (on the why), training (on the technique), and refresher training (at least annually, or if any requirements have significantly changed) need to be mandatory, especially for food workers and contractors dealing with exposed food in the establishment.
(3) Understanding the importance of hand hygiene in food safety systems – Employees need to learn about hand hygiene, cross-contamination prevention, and its role in food safety. It is equally as important to understand that dirty hands may contaminate surfaces, equipment, utensils, and exposed food products, and that unhygienic or insanitary conditions may re-contaminate clean and hygienic hands.
(4) Focusing on food safety culture – Fostering a hand hygiene culture is an important part of a site’s food safety and quality plan. Management leadership and commitment toward providing the necessary resources, competencies, and tools will help encourage more frequent and consistent handwashing compliance by employees.
Many foodborne illness outbreaks happen because of inadequate handwashing by food employees. Helping employees learn better hand hygiene methods and encouraging compliance will raise the bar for food safety and sanitation in your facility.
*Note: The images provided have been sourced from istockphoto.com. The closest author references we can give credit to are as follows:
- Webster, S., & Benson, L. (2007). Hand hygiene guidelines. Manchester, England: NHS Manchester Infection Control.
- Smith, D. (2009). Guideline no. 62. Hand hygiene: guidelines for best practice. Campden BRI, Station Road, Chipping Campden, Gloucestershire, GL55 6LD, UK
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