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Keeping it clean: The Importance of Hand Hygiene

Since the outbreak of SARS in recent years and the possibility of a new strain of Bird Flu causing a pandemic, wide attention is being given to inefficient antiviral drug supplies and emergency action plans.

However, experts are saying that to protect ourselves the solution may be a lot simpler; to wash our hands.

For employees in the food-retail, food-service or food-processing industries, choices made about handwashing affect not only the employee, but also other people: consumers, restaurant diners and the general public. Handwashing amongst food workers is crucial to prevent the spread of germs that can lead to foodborne illnesses and food poisoning.

According to the global health and care organisation BUPA, "more than 150 million working days are lost each year through flu-related illnesses at a cost of £6.75 billion to the UK economy".[i] With such high figures efficient hand hygiene needs to become automatic. Hand washing is a simple and cost-effective way of preventing the transmission of germs. The US Center for Disease Control and Protection sites hand washing as "the single most important means of preventing the spread of infection".[ii]

According to World Health Organisation guidelines, hand washing should not be limited just to the hands; it should also include wrists. The whole area should be washed for a minimum of 10-15 seconds with soap and running water. In the healthcare and food industries hands should then be decontaminated with an alcohol-based waterless hand gel or rub for 15-30 seconds. This stage must be carried out on physically clean hands, as it may be ineffective if the hands are soiled with protein or fat.

Along with soap and clean running water, hands-free controls are ideal. Soap, if in the form of a bar, should be left on a soap rack so it has the chance to drain. It should not be allowed to sit in a pool of water as this encourages micro-organisms to grow such as pseudomonas, an opportunistic pathogen, meaning that it exploits the break in the host defences to initiate an infection. Liquid dispensers of soap should be cleaned thoroughly every day, and when empty the cartridge should be discarded not refilled. Disposable towels should be used for drying hands ideally with a non-touch dispenser. If there is not a clean, dry towel available then air drying hands is best. Common towels should particularly be avoided as they facilitate the transmission of infection. It is important to dry hands thoroughly because if wet they will spread bacteria easily.

Further care should be given to preparation. Nails are best kept short, sleeves should be rolled to the elbow, and jewellery should be removed. The process should be thorough, from lathering with soap to making sure all areas, particularly in-between fingers, are covered ensuring that all residue is thoroughly rinsed off. Finally, hands should be dried thoroughly.

Hand hygiene should also be concurrent with hygienic food preparation. Not only should hands be washed thoroughly before and after preparing food, but caution should be taken when dealing with food with a high microbial loading such as uncooked meats. Every day thousands of people become ill from the food they eat. Dangerous micro-organisms, including bacteria, viruses, mould and parasites can be transferred between surfaces, hands and other foodstuffs in a process known as cross-contamination. This happens directly through contact between hands, cutting boards, towels, clothes, utensils and work surfaces. Raw meat in particular contains harmful bacteria that spread easily with anything it touches. It is particularly important to keep raw meat away from ready-to-eat foods, such as salad, cooked meats, fruit and bread. These types of food won't be cooked before being eaten, so any bacteria that may get onto the food will not be killed. Raw meat should also be covered and stored on the bottom shelf of the fridge where it can't touch or drip onto other foods. Hands should be washed thoroughly after touching raw meat and before touching anything else.

Every time a food worker washes his or her hands, that worker could reduce the threat of people becoming ill every year. Another reason to wash frequently is to prevent cross-contamination (the spread of germs from one place to another), which occurs most often when hand-to-hand or hand-to-surface contact occurs.

Food service or food processing employees need to know when it is crucial to wash hands. Employees should wash their hands in the following instances:

When they first enter the work area, and anytime workers are coming from outside the work area, whether they are first coming in for the day or coming from another part of the building, they need to wash their hands to get rid of any germs they might have picked up in other areas;
Immediately before touching or working with food, food-processing equipment that comes in contact with food, or packaging materials that would come in contact with food;
Immediately after taking a break or using the toilet. If workers have to open doors or touch surfaces to get to their specific work area, they should wash their hands again once they get to where they are going to be working;
Immediately after coughing, sneezing, using a tissue or hankerchief, or smoking or eating;
After touching dirty utensils or equipment, or when the potential for cross-contamination between dirty items and clean items or food exists;
Whenever they are switching from working with raw, uncooked food to food that is prepared or cooked;
After wiping hands on apron, uniform or body parts other than clean hands or arms;
Prior to and after removing gloves; people often treat gloves as if the gloves are preventing the spread of foodborne germs, but the purpose of gloves is more to act like a second layer of skin for protecting employees, not the food or others;
After they have handled money or after interacting with people at a counter or drive-thru and before they go back to working with food; and
Any time they need to remove oil or grease from their hands. Also, workers should wash their hands after taking rubbish out or after using a dustbin

The benefits of hand washing are endless and universal; from reducing the common cold in schools to preventing cross-contamination of germs in food preparation, and helping to stop the spread of infection in hospitals and care homes. Therefore what is the simplest and most cost-effective solution to reducing these problems should be the first place we start to protect ourselves with the threat of new infection.

[i][i] BUPA Fact Sheet Colds & Flu

[ii] Access Excellence, The National Health Museum, Handwashing

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