Hand hygiene, infection prevention and food safety:

(Sarwat Ghouri, Karachi)

How this one simple habit can protect you from communicable diseases.

Did you know that 10 million bacteria would fit very comfortably on something as small as the head of a pin? Given the right conditions, those 10 million bacteria would double every 20 minutes. Unfortunately, these invisible germs are passed around our communities easily with the workplace being the main recipient. Although we are unable to see bacteria, the fact remains our hands are responsible for the spread of an estimated 80 per cent of common infectious diseases. The vast majority of these illnesses last a short time and cause minor symptoms such as nausea, vomiting and diarrhea.

Controlling this problem is difficult because bacteria may survive food processing or foods may become contaminated during preparation, cooking or storage. While there are many occasions food can become contaminated during processing, 40 per cent of all food-borne illness outbreaks are a direct result of hand cross contamination. This often happens when food workers fail to wash their hands effectively after using the bathroom (microbes from the employees’ gastrointestinal tract are transferred to food). With food being produced and processed at a higher volume than in the past, there is a greater chance of food borne bacteria being spread to a large number of people.

Personal hygiene begins at home, with the essential elements for good hygiene being a clean body, clean hair and clean clothing. Hair in food can be a source of both microbiological and physical contamination. Hairnets and beard covers should be worn to assure food product integrity. Long-sleeved smocks should be worn to cover arm hair. Clean uniforms, aprons and other outer garments that are put on after the employee gets to work can help minimise contamination. While working clothing should be kept reasonably clean and in good repair. Removal of smocks, lab coats or aprons should take place when leaving the work area to go to the employee break room, restroom or exiting the building. Personal items such as meals and snacks should be stored in a locker or break room area that is located away from processing areas or areas where equipment and utensils are washed.

Food being prepared for consumption at homes should be kept safely if it is in abundance but it ought not be wasted. Having home cooked food is more beneficial for human health than that of hotels and restaurants. It is necessary to avoid frequent visits to restaurants to remain healthy as one cannot possibly get disinfected nourishments in these places. For example, the men making roti at tandoors, one can find them cleaning sweat from their foreheads and using the same perspired hands to prepare the rotis.

During our research work, I requested the people to drink boiled water if a filter plant was not available in their areas, especially in cities. “The more you keep your areas clean, the more you are healthy and safe,” I maintained and advised the people not to have pakoras, samosas and such things available in the bazaars for living a better life. Later, dust bins were distributed in a school as a symbol to develop among students the habit of throwing garbage into the dust bins.

The best way to prevent the spread of viruses to food is to ensure that hands are washed and that they are clean and protected when handling food. Anytime a human hand touches something, there is a risk of contamination with harmful microorganisms or chemicals.

Consumption of food, drink, smoking or tobacco should be permitted only in authorised areas. All of these actions would generate saliva which could contaminate the food. Additionally, employees should never spit in the building. Lunches should be stored in designated areas and refrigerators emptied weekly. No food should be permitted in employee lockers or at work areas and no objects such as toothpicks, matchsticks or similar objects should be allowed in the mouth while on the job.

The hand-washing facility should have liquid soap, cold and hot water that is 100° F and able to run for at least 20 seconds at that temperature. The employee must scrub the surface of their hands and arms vigorously for 10 to 15 seconds. The friction itself can remove many microorganisms. They should scrub the areas between the fingers and under the nails and then rinse the hands thoroughly. Hands should be dried with paper towels or warm air dryers. Adequate waste containers should be supplied for used towels. Hands and fingernails must be kept clean. Fingernails should be short and absent of fingernail polish or false fingernails.

Cuts or burns on the food worker’s hands should be thoroughly bandaged and covered with clean gloves. The use of gloves often creates a false sense of security but does not eliminate the need for hand washing and when necessary, sanitising. Improperly used gloves may become a vehicle for spreading pathogens. Non-disposable gloves should be washed and sanitised before starting work and as needed. Disposable gloves should be changed whenever contamination is a possibility, such as taking out the trash, handling cleaning chemicals, handling any animals, or picking up dropped items. Under no circumstances should a live or dead rodent be touched. Hands must be washed before putting on a new pair of disposable or non-disposable gloves.

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Hand or glove dips may also be used but only after washing hands. Sanitisers are designed for this purpose and should be monitored frequently to ensure proper concentration is maintained. These dips are not a substitute for proper hand washing. Management should serve as role models for good work habits and acceptable hygienic practices. They should continually emphasise on how important it is. Policies should reassure the employees that they will not lose their jobs if they report an illness or a communicable disease. Once employees understand what is expected of them, effective supervision of employee practices should be used to ensure that employees follow proper procedures. Training should be conducted annually and reviewed whenever incorrect practices are observed.

Reducing the risk of food borne illness

Hand washing, when done correctly, is the single most effective way to prevent the spread of communicable diseases. Good hand washing techniqueis easy to learn and can significantly reduce the spread of infectious diseases. High risk areas such as food preparation require the highest level of compliance. When teaching hand washing remember to always follow best practice:

Place your hands together under water (warm if possible)
Apply soap
Rub your hands together for at least 20 seconds
Wash hands thoroughly, including wrists, palms, back of hands and under the fingernails
Clean dirt from under the fingernails
Rinse the soap from your hands
Dry hands completely with clean towelling (good quality, absorbent paper towel helps to remove germs)
Pat your skin rather than rubbing to avoid chapping and cracking
If soap and water are not available, use alcohol-based hand sanitiser
Common sense indicates that hands should be washed before handling food, but there are many other occasions when hands must be washed when working in a food-processing environment.

Immediately before handling food
After touching body parts
After using washrooms
After coughing, sneezing (into sleeve/crook of elbow and not into hands) or using a tissue
After changing tasks, especially if switching between working with raw meat and working with ready to eat or cooked foods
After handling money, garbage or tools/equipment
After touching dirty surfaces
After picking up something from the floor
After engaging in any activity that contaminates hands
Education and training are vital elements of a food safety programme in all sectors of the food industry. In any organisation, however small, the instructions provided here should ensure that all employees understand the basic principles of food safety and their own responsibilities in that respect. Food-handling staff should receive instructions in food safety and personal hygiene and should be required to undergo a test of their knowledge on the subject.

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