Food Protection Trends - August 2008 - (Page 570)

to poor hygiene practices in the working environment. This study attributed food-handler contact with food during processing to be the greatest cause of food contamination (9.2%), followed by cross contamination by dirty equipment (5.7%) and/or infected food ingredients (3.4%) (100). It has also been demonstrated that the health risk due to unhygienic food handling is exacerbated when temperature abuse occurs within the food supply chain (96). Research in the United States also identified poor personal hygiene as one of the major factors influencing the incidence of foodborne illnesses (45). This is particularly true for human viruses. Hepatitis A virus infections are frequently caused by the consumption of food contaminated by food operators as a result of poor hand hygiene (10, 49). The rapid spread of pathogens through the consumption of infected food can easily cause severe epidemics of foodborne illnesses (40). Considering the fact that a low infectious dose is sufficient to cause illness, an epidemic can originate from a single pathogen-infected employee in the food supply chain (10). Poor hand hygiene: A significant source of food contamination Bacterial and viral pathogens or parasites present on hands can be transferred directly to food and pose a substantial risk, depending on a multiplicity of factors. The microbial species, the number of microorganisms, the microbial population’s ability to survive and the hydration condition of the skin all influence the quantity of bacteria that can be transferred to or by hands (16, 47, 83, 109). Diverse microorganisms can exist on the hands of food workers because hands frequently make contact with other parts of the body, miscellaneous objects that may be contaminated, domestic animals, or contaminated food. In addition, fecal contamination of fingertips may occur after toilet use even when toilet paper is used (81). Recent data indicate that contamination of the hands by fecal microorganisms during defecation occurs more frequently than expected (78). People with long natural or artificial nails and people who use an inadequate quality or quantity of toilet paper show an increased risk. If these people fail to disinfect or wash their hands effectively after toilet use, the risk of transmission of fecal microorganisms to food increases considerably (78, 79). Especially when these people suffer from a gastro-enteric disease, human pathogens are spread via the fecal-oral route, potentially resulting in an outbreak of foodborne illness. For instance, large numbers (up to 1010 CFU/g) of Salmonella can be found in the stool of an infected person and are easily transferred to the hands if no appropriate measures are taken (33, 105). It has also been shown that transfer of Enterobacter aerogenes from contaminated chicken to the worker’s hands is substantial during food processing. Cutting up chicken artificially infected with 108 CFU/portion results in the transfer of between 106 and 107 CFU to the hands (84). The average incidence of transfer of bacteria from chicken meat to hands during processing is approximately 4%, which is considered highly significant (66). Like bacteria, viruses present on hands can be transferred easily to food during processing. It was shown that the handling of lettuce by Hepatitis A contaminated hands resulted in a substantial (9%) transfer of the virus to lettuce leaves (10). The Norovirus and Hepatitis A virus are currently major viral vectors of foodborne illnesses in the Western world (11, 49). In addition to direct food contamination by the food handler’s hands, indirect contamination can occur via other sources such as water taps, working surfaces, cutting boards, food equipment, etc. Cross contamination occurs when surfaces contaminated by an original source contaminate other surfaces (100). In the food industry, cross contamination of foodstuffs with pathogenic microorganisms is the primary cause of sporadic as well as periodic epidemics of foodborne illnesses (Table 1). For instance, Campylobacter species are known to spread frequently by cross contamination during the preparation or processing of chicken meat (109). Contaminated hands are considered to be a major cause of cross contamination and consequently of foodborne illnesses. Furthermore, most pathogens, such as Salmonella spp., Staphylococcus spp., and Escherichia coli, are able to survive several days on hands, clothing, work surfaces, and equipment, which increases the risk of cross contamination (8). It is important to keep in mind that microorganisms always flow in both directions. For instance, such microorganisms may be transferred from contaminated hands to a water tap, and subsequently from this or other contaminated water taps to clean hands. Numerous researchers have studied the transfer of bacterial pathogens to foods through cross contamination (Table 2). HAND HyGIENE TECHNIQUES TO REDUCE THE RISK OF FOOD CONTAMINATION The risk of contracting foodborne illnesses by cross contamination depends mainly on two factors: the ability of microorganisms to transfer from one surface to another, and the microbial load on surfaces in the working environment (16). The transfer of microorganisms from hands to surfaces or vice versa can be reduced in two ways. First, the microbial load on the hands can be reduced by applying good hand hygiene practices. For example, hands can be washed either with regular or with antimicrobial soap (discussed in the next section) or hands can be disinfected, usually by alcohol rubs (discussed in a later section). Second, transfer of microorganisms can be reduced by providing an additional physical barrier that the microorganisms have to cross, for instance by wearing gloves, thereby hampering their transfer to other surfaces. Additional measures that also minimize the risk of cross contamination are discussed later. Washing hands with soap: simple but effective Regular soap. Washing of hands with soap is generally regarded as a good measure in reducing the risks associated with poor personal hygiene. Data from several studies indicate that washing hands with soap results in a 50% reduction of diarrhea cases (12, 23). Although regular soaps have little or no antibacterial effect, they are very effective in the physical removal of microorganisms (27). Rubbing hands together and/or using a nail brush, thereby causing friction, is the primary mechanism of removal; a second component is dilution of the microorganisms that are present on the skin by rinsing hands after washing. However, not all microorganisms are 570 FOOD PROTECTION TRENDS | AUGUST 2008

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Food Protection Trends - August 2008 Contents Sustaining Members Lone Star Perspective from Your President Commentary from the Executive Director Hand Hygiene in the Food Industry: Resolving an Enigma? Food Safety Awareness: Concerns, Practices, and Openness to Change of College Students with Health and Non-Health Majors Highlights from the Brazil International Food Safety Conference Audiovisual Library Listing Audiovisual Library Order Form New Members Updates News Industry Products Coming Events Advertising Index Journal of Food Protection� Table of Contents Booklet Order Form Membership Application

Food Protection Trends - August 2008

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