Guidelines for Hand Hygiene Process Control

Process control drives almost all food safety measures, with the exception of handwashing and hand hygiene. These remain a frontier without meaningful, measureable, and manageable standards.

Operators are often content for hand hygiene to be covered in their FDA-promulgated good manufacturing practices, seeing little need for specific standards to drive enhanced hand hygiene. The FDA’s Model Food Code has been unable to provide guidance for a situation in which behavioral science is key to compliance. Codes and operational standards work best for physical measurements like temperature control or chemical factors such as pH. Logs can be easily maintained and monitored.

Solving handwashing issues in the food industry is not about knowledge, training, products, or equipment. It is all about linking best practices in a structured, sustainable solution.

Risks of Poor Hygiene

Poor hand hygiene is the most frequently mentioned contributing factor in outbreak reporting. Juxtaposing this risk with the advice of the Centers for Disease Control and Prevention (CDC) highlights the risk reduction potential in pursuing improved hand hygiene process control:

“Handwashing is the single most important means of preventing the spread of infection.”

The food processing industry has made amazing advances when it comes to minimizing dangerous line-worker touches. Now the risk of hand contamination comes mainly from processing speed, batch size, and food prices.

Food service continues, however, to involve many hands in the race to serve tasty, safe food. In fact, as chefs recognize the value of visuals to a satisfying dish, more hands become involved. Garnishes and plating priorities often require the skill and touch of a clean bare hand. The challenge now becomes serving food that is tasty and artful but is still safe to eat.

Measuring risk is an exercise in approximation; the fact that it is not a true science must not prevent common-sense interventions.

The media has a strong influence on operator risk assessment and priorities. Sprouts. Cantaloupes. FDA Food Safety Modernization Act. Based on the headlines of the past year, one could easily put hand hygiene improvements on the back burner.

Shielding food safety from political partialities is impossible. From neighborhood issues to United Nations priorities, food safety permeates and affects our reality—from farms to the forks of the world. The recurring stories of 48 million foodborne illness-stricken Americans, the 128,000 hospitalizations, and the 3,000 deaths that occur each year are eclipsed by popularly provocative politics.

If the media were risk-based, poor hand hygiene would likely dominate, and we would be celebrating the comparative safety levels of our nation’s food processors.

A Range of Risks

Operators have a range of responsibilities, including moral, financial, and legal, when it comes to minimizing restaurant-acquired illness. And, while foodborne illness is a major part of this risk category, it is important not to minimize the risk of other illnesses that could be acquired by patrons of a restaurant, perhaps from a contaminated restroom or the table of a pathogenic patron.

The focus on food preparation by the FDA and its army of 30,000-plus inspectors tends to skew the restaurant’s risk reduction actions to the kitchen and largely to those tasks that can be easily measured during a one-hour visit. Current food temperatures, from refrigerated storage to prep, and hot-holding numbers are priorities.

Looking at risk from a scientific perspective causes food safety auditors to include restrooms, especially those that are used by the public and staff. Many outbreaks arise from service areas where the public introduces pathogens, particularly norovirus, the dominant foodborne pathogen (58% reported in CDC 2011 Estimate.www.cdc.gov/Features/dsFoodborneEstimates/).

And what about the flu and the common cold? These are not monitored like foodborne illnesses, nor will operators be sued for spreading them. The payoff for restaurants building barriers to these most common afflictions is reduced staff absenteeism. Out-front programs that include hand sanitizers for all to use, together with an increased focus on high-touch surfaces, protect employee health as well as that of customers.