Hand Hygiene: The Cornerstone of Food Safety Improper washing impacts safety and health of patrons and business By Mike Kapalko SCA Tissue North America, Environmental and Tork Services Manager H ow safe do we feel about our food? Do we worry about foodborne illness, which affects one in four Americans at some point in their lives? A study conducted in 2006 by the nationally recognized Food Safety Policy Center at Michigan State University offers some insight. The study 1, which was based on telephone interviews with more than 1,000 U.S. adults, found: While 96 percent of the respondents trust themselves to prepare food safely at home, only 58 percent say they know a lot or quite a bit about food safety. Sixty-three percent of Americans say they are very or fairly concerned about the safety of the food they eat. 46 percent said they think about food safety when eating at a restaurant. 88 percent feel the federal government specifically the FDA and USDA is capable of keeping food safe. However, only 49 percent feel the government has adequate resources to do the job properly. Clearly there is room for improvement. And the place to begin should be obvious. Mom Was Right Nearly everyone knows that proper handwashing is the single most important element in hygiene. People know they should wash and dry their hands before and after handling food just as they know they should wash and dry their hands after using the washroom. But do they? Do you? If you re like most people, you claim that you always wash after using the restroom but you also think that most other people aren t as consistent as you are. In a national online survey 2 conducted this spring, 94 percent of U.S. adults said they always wash their hands after visiting a restroom. However, when asked what percentage of other people they thought washed their hands each time after using a public restroom, 99 percent of U.S. adults felt that other people don t do so each time, and almost half (48 percent) felt that people wash their hands less than 50 percent of the time after using a restroom. The commissioned survey was conducted February 26-March 2, 2009, by Harris Interactive on behalf of the Tork brand of SCA Tissue North America. It drew 2,516 U.S. adult respondents 18 or older 46 percent male and 54 percent female. Asked which situations raise health and hygiene concerns, the most frequent answer among adults was visiting a public restroom. Not surprisingly, visiting a public restroom is the situation that ranks highest in terms of health and hygiene concerns for U.S. adults. Asked during which situations they would be most concerned about health and hygiene risks, adults selected: Visiting a public restroom, 44 percent Preparing food or meals, 26 percent Contact with other adults, 9 percent Clearly people think public restrooms present a hygiene risk and claim they are washing their hands after using those restrooms. But their observations of others in public restrooms indicate that a large percentage of us are not actually doing so.
There also is quite a bit of misunderstanding about the recommended length of time to actively wash hands with soap and water after using the restroom. In the same online survey, 38 percent said 30 seconds and 28 percent said 20 seconds, followed by: 60 seconds, 14 percent; over 60 seconds, 8 percent; 40 seconds, 6 percent and 10 seconds, 6 percent. The actual recommended procedure for washing hands in restrooms is to wet them, then thoroughly wash with soap for 20 seconds before rinsing off and drying them completely with a paper towel. If faucets are not touchless, it is further recommended that the paper towel be used to shut them off to keep from re-contaminating your hands. well-known restaurant chain that had to close a store in Illinois several years ago after an outbreak of salmonella sickened hundreds of patrons. The restaurant never recovered. Today, it s a jewelry store. And that was salmonella, an old familiar foe. Now factor in recent challenges such as H1N1 (swine flu), MRSA and avian flu. The potential impact of poor hand hygiene becomes even more alarming. H1N1 is respiratory, for example, but those sneeze droplets land somewhere, waiting to be touched. The implications of the poll for the foodservice industry is both clear and unnerving since there is no evidence that foodservice employees act differently than the general adult population when it comes to practicing good hand hygiene or understanding what constitutes proper handwashing. And that s just the washroom. What about in the back of the house? Are foodservice employees consistently washing their hands between tasks such as chopping vegetables, washing dishes, rotating stock, cleaning or taking out the trash? Why foodservice operators should care According to the Centers for Disease Control and Prevention (CDC), the food supply in the United States, while remarkably safe, can become contaminated with a variety of germs. After eating contaminated food, people can develop anything from a short, mild illness, often mistakenly referred to as food poisoning, to life-threatening disease. The CDC estimates that 76 million Americans approximately one in four get sick, more than 300,000 are hospitalized, and 5,000 die from foodborne illnesses each year 3. The CDC also says that 34 percent of all documented cases of foodborne illness are directly caused by poor hand hygiene. From a financial perspective, foodborne illness can deal a crippling and sometimes fatal blow to a restaurant. Take the highly publicized case of a Health and hygiene liabilities aside, even the appearance of a less-than-pristine restroom can have a direct impact on a restaurant s bottom line. In another Harris Interactive survey 4, restaurant patrons reported they are far less likely to return if they find restrooms that are unhygienic or poorly maintained. The survey, conducted online by Harris Interactive among a sample of 2,175 U.S. adults, found that of the 97 percent who visit restaurants, 86 percent think restaurant hygiene is very important to their dining experience. Also, 88 percent of those who visit restaurants agree that restroom cleanliness reflects the hygiene standards throughout the restaurant including kitchen and food prep areas.
88% of those who visit restaurants agree that restroom cleanliness reflects the hygiene standards throughout the restaurant including kitchen and food prep areas. The survey, sponsored by SCA Tissue North America, also found that 29 percent said they would never return to a restaurant with an extremely unclean or unsanitary restroom. As for spreading the bad word, the poll found that 50 percent of those who visit restaurants said they would tell their friends and family about a negative experience with an unclean or unsanitary restaurant restroom, and 46 percent said they would avoid going to a restaurant because of a bad experience with a restaurant s restroom that they had themselves or one they heard about from others. 50% of those who visit restaurants said they would tell their friends and family about a negative experience with an unclean or unsanitary restaurant restroom. Simply put, restaurant patrons associate the conditions in the restroom with the facility s overall cleanliness and hygiene standards. A dirty or poorly serviced restroom drives away repeat business and spreads poisonous word of mouth. So how do you keep your patrons and your bottom line safe? It starts with training. Hygiene in handling When it comes to assuring food safety, the ServSafe Food Safety 5 program is the industry s gold standard for training and certification. Whether a restaurant or foodservice program is just getting started or needs to keep current with emerging technologies, issues and practices, www.servsafe.com should be a first and frequent stop for managers. The ServSafe Food Protection Manager Certification process is accredited by the American National Standards Institute s Conference for Food Protection as valid, reliable and legally defensible. Following the ServSafe model, operators can ensure the highest level of food safety while also providing protection from the kind of devastating legal consequences that can stem from an outbreak of foodborne illness. More than 3 million ServSafe Food Protection Manager certifications have been awarded. With the variety of cultures and languages represented in the foodservice industry, it is important to note that both the training and exam materials are offered in a wide variety of languages. The program covers every stage of food handling, from the time supplies are received to how they are stored, prepped, cooked, served and handled as leftovers or waste. Topics covered include basic food safety, personal hygiene, cross contamination and allergens, time and temperature, and cleaning and sanitation. Equipment and resources designed for addressing foodservice safety issues also are available. ServSafe does a remarkable job in providing the tools and resources to ensure food safety from the back of the house to the front. And while much of the focus is on mechanics such as time, temperature, storage and handling requirements, ServSafe s inclusive training and materials also cover proper handwashing techniques and systems. But handwashing is such a critical element in the food safety chain that some saw a need to focus specifically on that issue. Hygiene in hands The Handwashing for Life Institute 6, founded in 1999, and its sister organization, the Handwashing Leadership Forum, were created by executive director Jim Mann, a chemist by training with extensive experience in foodservice operations. Mann s organization has developed a highly effective five-step program to reduce the risk of foodborne illness through proper and consistent handwashing. His underlying philosophy is that if handwashing
A log of handwashing results would prove far more meaningful than the periodic inspection to see if the handwashing sink is wet or a visual check to see if gloves are being worn. After all, who knows who made the sink wet or when the gloves were last changed? Another underlying principle of the Handwashing for Life program is that handwashing needs to be task driven, not time driven. From a cross contamination standpoint, it is fairly meaningless if an employee washes his hands at the top of every hour, but then goes from handling raw chicken to chopping vegetables at quarter past the hour. It is fairly meaningless if an employee washes his hands at the top of every hour, but then goes from handling raw chicken to chopping vegetables at quarter past the hour. isn t convenient, comfortable and monitored, it doesn t happen. The five steps of the program include: realistic risk assessment; establishing site-specific safe levels; optimizing processes, equipment and supplies; training and monitoring and motivating; and monitoring and rewarding performance. Because measurement is such a critical step, a key component of the program involves the use of a tracer such as GlitterBug, a black light and a paper template called ProGrade. What show up under the black light are the places that were under-washed or missed completely. The visual evidence is easy to understand and surpasses any language barriers that might exist in verbal coaching. The GlitterBug/ProGrade method offers an inexpensive way for managers to ensure that from Day 1, employees can easily see the results of their handwashing as measured against a benchmark of what they need to achieve. Periodic use of the test and logs of the results can be kept and used not only to reward compliance or stimulate further coaching but also to share with inspectors. But underlying all the emphasis on handwashing hygiene is the simple fact that until it becomes a priority for managers, consistent safety is not likely to be achieved. Too often, lip service is given to handwashing with the real attention only coming after an outbreak or a citation. Foodservice managers and operators should ask themselves to honestly answer how high on the priority list their handwashing program is, assuming they have one. Even the best system for handwashing compliance can go out the window when the rush hits and the staff find itself short-handed because someone didn t show up hardly an uncommon occurrence. Handwashing all too often is among the first casualties when the pace gets frantic. People seldom get fired for not washing their hands but they do get fired for slow service. Finally, there is the need to lead by example. As a manager, ask yourself how often your employees see you washing up, even if you re just passing through the kitchen or the prep area. Give yourself an honest assessment of your own hand hygiene behavior. Then ask yourself: Would mom be pleased?
About the Author: Mike Kapalko is Environmental & Tork Services Manager for SCA Tissue North America, one of the largest providers of Away From Home towel, tissue and napkin dispensing systems. Before joining SCA Tissue in 2003, Mike accumulated years of experience in foodservice. He started his foodservice career with Sodexo and managed a variety of operations, from a small 50-seat pub to a 2,000-plus meals cafeteria. He also managed a snack bar with multiple concepts in one location: deli, pizza and small fast food franchise. He has held roles as a cash operations manager, catering manager, assistant director, operations manager and chef manager. About SCA Tissue and Tork Products: SCA Tissue North America, headquartered in Philadelphia, is a leading manufacturer of Away From Home tissue products, serving the foodservice, commercial, industrial, healthcare and automotive market with its global Tork brand of towels, tissues and wipes. SCA Tissue is a member of the Handwashing Leadership Forum. Parent company SCA is a $17 billion (US) global consumer goods and paper company that is headquartered in Stockholm, Sweden, and has more than 50,000 employees doing business in 90 countries. To learn more about SCA Tissue, visit www.torkusa.com. Footnotes: 1. www.servsafe.com/foodsafety/news 2. Survey conducted online Feb. 26-March 2, 2009, within the United States by Harris Interactive via its QuickQuery SM online omnibus service on behalf of SCA Tissue North America among 2,516 U.S. adults, ages 18 years and older. Results were weighted as needed for region, age within gender, education, household income and race/ethnicity. Propensity score weighting was also used to adjust for respondents propensity to be online. No estimates of theoretical sampling error can be calculated. 3. www.cdc.org 4. Survey conducted online Aug. 1-5, 2008, within the United States by Harris Interactive via its QuickQuery SM online omnibus service on behalf of SCA Tissue North America among 2,175 U.S. adults ages 18 and older, of whom 2,108 visit restaurants. Results were weighted as needed for region, age within gender, education, household income and race/ethnicity. Propensity score weighting was also used to adjust for respondents propensity to be online. No estimates of theoretical sampling error can be calculated. 5. www.servsafe.com 6. www.handwashingforlife.org