Norovirus – known in Britain as the Winter Vomiting Disease – heads the list of foodborne pathogens, although in some countries it is reported as a person-to-person disease rather than a foodborne issue. As a greater proportion of meals are prepared and served away-from-home, norovirus is more likely to be classified as a foodborne threat.
Of course, now that machines dominate the work environmental in the food and beverage industry, food that is processed and packaged for home preparation encounters few hands. Here, HACCP systems control, measure and document the critical control points. In contrast, when meals are prepared away from home, many much less controllable relating to human behavior and motivation come into play. When you dine away from home you expect service, and that service means people… and hands.
Norovirus enters the food chain from the people handling that food - workers and fellow guests – the most common route being faecal-hand-oral. The body’s defence against norovirus then becomes part of the problem. The explosive expulsion produces a microbe-laden invisible cloud, which creates a cross-contaminating fallout that is ready to be picked up and transferred hand-to-hand, hand-to-door, hand-to-plate, hand-to-glove, hand-to-food and, finally, hand-to-mouth.
Viral contaminations further elevate the risk of outbreaks. The infectious
dose for norovirus is very low, about one tenth of that of the common bacterial
culprits. It is also capable of surviving many hours, even days, on inanimate
surfaces. Virus has replaced bacteria as the leading cause of foodborne illness
and thus demands higher handwashing standards.
Determining a standard for hand cleanliness is important despite the lack of agreed industry standards. A safe level must first be established for the quality of the handwash. A simulation of germs using tracer lotion (GlitterBug) and manual recording systems (ProGrade) helps employees to visualise the invisible threat, document skill levels and serve as a quality standard. Food handlers are able to see the importance of handwashing, see the results of their current handwashing techniques and then practice until they consistently meet the established standard.
A safe level for handwashing frequency can also be defined and tracked. Based on the level of at-risk people being served, the menu, the level of staff control and the facility itself, when should employees be washing their hands? The answer to this is then translated into a shift total. A digital counter in the soap dispenser is one practical option; once an employee takes soap, a handwash almost always follows. The chosen dispensers should include a programmed function whereby multiple doses of soap are counted as one handwash (GOJO/Signol).
It is important that safe levels are balanced with, not compromised by, productivity requirements. Workflow and employee convenience can help to define the savings that arise from worker-friendly layouts and wise equipment choices. Numbers, progressing in a positive pattern, are in themselves a component in the staff motivation package.
In the Hands-On System (www.handwashingforlife.com), weekly employee success is printed in graph form and posted by the busy hand sinks. These actual results make up one of the most effective kitchen posters – which works across the language barriers often presented in today’s professional kitchen.
While auditing is deeply rooted in the foodservice culture, handwashing is rarely included in kitchen audits. It is also often not subject to the rigours of an HACCP system because the metrics of clean hands are lacking. The primary cause of cross-contamination in the kitchen, poor hand hygiene, is however technically ready to be considered as a HACCP component.
Poor handwashing is primarily a management issue, first encountered as kitchen design are reviewed and productivity starts to dominate decisions. Productivity trumps hand sink location without a previously agreed cross-departmental risk assessment. It is an understanding of the risk and a joint commitment that drives sustainable improvement in handwashing. Without this step, enhancements will only be temporary, and will join the files of previous failures. These repeated cycles entrench the cynic’s point of view that the current risk level is as good as it gets.
Assessing risk secures commitment, but exposes an uncomfortable reality – “What is our level of acceptable risk? We know zero risk is impossible.” Compromise is important, but leadership is critical for the multi-department group that answers this question and then translates it to handwashes per meal served or handwashes per employee hour.
Ideally, data is automatically collected, feeding easy-to-read reports in a format that is integrated with other key measurements of success. One common element in these snapshots will be compliance vs. standards and a comparison with prior years to ensure progress is made.
What gets measured gets done. Viral risks can be significantly lowered through handwashing motivation, measurement and monitoring. An enduring system replaces random behaviours with integrated best practices and safe levels. A foundation is then set for continuous improvement.