Jim Mann | Food Safety News

Letter to the Editor: Hand Hygiene Committee should be re-established

Jim Mann — Sun, 14 May 2023 04:05:00 +0000

— OPINION —

The pubic is the primary loser of last month’s decision by the Conference of Food Protection (CFP) to cancel the proposed re-establishment of the Hand Hygiene Committee, an issue advocated by The Center for Foodborne Illness Research and Prevention (CFI). The biennial meeting, in Houston, TX, took this action, ignoring the impact of a Model Food Code without a standard for a Clean Hand for at least 2 more years:

Operators are forced to make hand hygiene decisions without the science.
Inspectors are forced to fill in boxes on their reports that give little direction to improve compliance. What is “compliance” without a standard?
Deprived of this standard, Operators’ efforts to create a Food Safety Culture are compromised.
Would-be technology developers are discouraged without the science. Official opinions change quite frequently i.e., handwash temperature, time, use of a nail brush, wipes, and COVID driven acceptance of alcohol-based hand sanitizers (ABHS).
It is incompatible with the FDA’s “New Era of Smarter Food Safety” initiative.

The recreation of the Hand Hygiene Committee was recommended to gather and interpret the latest hand hygiene research and provide direction for new studies. Their findings could then have been operationalized by those foodservice and food processors to better serve the away-from-home public, their customers.

Council I’s 22 members reviewed the issue, including this definition of a Clean Hand:

A Clean Hand in the foodservice and food processing industries is one that is unlikely to transfer pathogens from the hand to food, surfaces or directly to other people.

This verbal description was developed as a common ground starting point as researchers look to add the science, the evidence, needed by operators to make better informed hand hygiene decisions. Secondarily, this action demonstrated how a diverse group of food safety professionals could work together in the interest of public health.

The unlikely to transfer phrase lights the path to the essential research protocol. An established independent laboratory responded to the call and submitted a proposal. If Operators truly want the science behind a Clean Hand, might they directly fund it. If 12 sponsors could be recruited at $4,500 each, the research could be completed this Summer. The research protocol would be shared with all “investors”. Invoices would be sent from the lab with no added third-party fees.

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Person-to-Person sub-classes emerge in COVID-19 classifications

Jim Mann — Sat, 03 Oct 2020 04:00:02 +0000

Opinion

The CDC states that the death-dealing virus that causes COVID-19 spreads predominantly from person to person (P>P). A deeper dive into assessing this transmission route — and its presence in the food industry — may help sharpen intervention tactics.

This assessment starts with a look at an infected person’s cough, sneeze, singing and talking, all giving rise to a discharge of particles from the mouth or nose. Where the term “person” is used, it refers to the internal system of a person where a pathogen either has entered or is given entry.

Heavy particles quickly fall to the floor or any surface in between people. Lighter aerosolized ones remain airborne for up to three hours or more. A room’s air filtration system can be effective in trapping these contaminants. The wearing of masks is a critical intervention. Physical distancing is also a meaningful transmission-preventive action.

If that infected person’s cough or sneeze is self-covered with his or her bare hand instead of the crook of an elbow, it becomes one of those surfaces between the mouth/nose and the floor. Here handwashing or hand sanitizing is the obvious intervention of choice. If that hand were gloved, the glove would need to be changed, with a handwash before donning the new gloves. The better intervention is prevention by catching that cough or sneeze in one’s elbow.

Person-to-person, person-to-surface-to-person & person-to-surface-to-hand-to-person

It can get pretty complicated.

What is the dominant vector transmitting Coronavirus from one person to another? Is it the air we breathe or the hand that moves the virus from a long list of surfaces (fomites) to the nose, eyes or mouth? The CDC recently released an advisory that indicated the aerosolized form was the primary route of transmission. These particles can cause infection when “inhaled into the nose, mouth, airways, and lungs.” “This is thought to be the main way the virus spreads.”

Three days latter this news was withdrawn with this notice: “CDC is currently updating its recommendations regarding airborne transmission of SARS-CoV-2 (the virus that causes COVID-19),” “Once this process has been completed, the update language will be posted.” The current guidance makes no mention of aerosol transmission.

Person-to-surface-to-person (P>S>P) is a legitimate route for the coronavirus to move from one person to another with the surface (fomites) acting as a bridge or a “bus terminal” where the virus awaits a touch, a touch from a living host, needed to sustain its biological activity. This pathogen path is probably reported as a person-to-person transmission. The receiving person is most likely going to self-contaminate by transferring the coronavirus from the hand to the nose, eyes or mouth, completing the trip from Person-To-Surface-To-Hand-To-Person, P>S>H>P. The mouth route is contested by some scientists who say that stomach acids will kill the virus.

The P>S>P route is mostly a P>S>H>P transmission and clearly calls for frequent hand washing or sanitizing as it is all but impossible to keep surfaces TouchReady® clean between re-contaminations. Coronavirus can live on stainless steel and plastics for 2 to 3 days. How often is any high-touch surface touched — like the refrigerator, microwave, bed table or rails? Yes, these surfaces should be cleaned frequently but handwashing or hand sanitizing are the better controls.

A handshake transfer of the virus is an intermediate stage of the more circuitous Person-To-Person trip One’s hand is either contaminated by a self-fielded cough or sneeze or touching a contaminated surface. The handshake moves the pathogen to the next hand where it harmlessly resides until it is moved to the nose, eyes or an open cut or scratch.

Studies have also shown that restroom surfaces could spread this virus as they do with norovirus. According to the CDC, vomiting and diarrhea are both considered symptoms of COVID-19 in some patients. These conditions raise the risk for restroom surfaces. This area is not known to be a major contributing factor in the spread of the virus, however.

Healthcare kitchens and restaurants in general may want to consider their potential exposure to legal actions if a cluster of COVID-19 infections are traced back to foodservice where the legal principle of strict liability may apply. While COVID-19 is not considered a foodborne illness, its contraction in a dining environment may well bring strict liability into play. There is precedent for this in the Chipotle norovirus outbreaks and subsequent litigation.

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Few things are as sure a bet as handwashing; restaurants should act now

Jim Mann — Fri, 07 Feb 2020 05:01:26 +0000

Opinion

Lost in the clutter of Millennial trend tracking and menu minutia is the reality of restaurant risk related to poor handwashing. This is a no-fault failure as there are no operational standards, no rewards or discipline, no behavior changing help from the Model Food Code, and no supporting research.

There is very little relevant data other than the headcount at hospital emergency rooms and precipitous drops in market value for the relatively few major outbreaks.

Meaningful foodservice handwashing research is rare. The conclusions create a list of top ten truisms;

Handwashing…

compliance is low
is about process, not products
shortfalls are the industry standard
shortfalls are not disciplined — poor service is
is trumped by almost all employee training topics
training has no measurable goal
competes and loses to measured productivity factors
deficiencies are the No. 1 cited contributing factor in outbreak investigations
accountability has no ownership in foodservice
more research is needed

Healthcare research filled this void in 2019 with studies that clinically prove that handwashing performance monitoring not only increases frequency but more importantly reduces customer illness — patient infections — more commonly measured and reported as HAIs, Hospital Acquired Infections. RAIs, Restaurant Acquired Infections, are not published.

These studies are awakening some industry leaders that there is now a financial reason to protect their brand values with sustainable and affordable handwashing data. This is a game changer for the restaurant industry. It makes added customer safety an option, a very attractive option for those looking for more transparency.

Operators are slowly taking notice. Crushed Red, a salad concept based in St. Louis, now incorporates voice recognition in every store they open. Their goal is customer safety, achieved by rewarding staff for handwashing compliance. This is a key component in their customer loyalty program.

Larger chains are now testing a variety of technologies. The beginning of this new decade will see a mayor shift to handwashing monitoring in health care and a level of foodservice testing and introductions that will further define industry leadership.

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Exploring the technology of food safety culture with FDA’s Yiannas

Jim Mann — Mon, 14 Oct 2019 04:04:50 +0000

Opinion

Frank Yiannas, nearing completion of his first year as FDA’s Deputy Commissioner for Food Policy and Response, opened the 2019 Food Safety Consortium Conference recently in Schaumburg, IL. This was his third time to present at the event. His first two were while serving as Walmart’s global vice president for food safety.

The man’s passion for food safety continued to be evident as he revisited a topic he has long raised as a mission critical flag — the culture of food safety.

Yiannas literally wrote the book on the topic with the publishing of his “Food Safety Culture: Creating a Behavior-Based Food Safety Management System.” Food safety was defined simply as “behavior” and Yiannas shared his vision of the sea change we are experiencing. He described the creation of a “new era of smarter food safety.”

Technology investment is leading a “revolution” where food systems are increasingly digitized, according to the FDA’s top food safety person. Deep-dive data is driving actionable information and innovation.

Comments about the Food Safety Modernization Act were woven though much of Yiannas’s presentation, highlighting the 2011 introduction of it as a valuable foundation on which to apply many new and emerging technologies. He also reflected on his industry experience when he advised the audience that “. . . only the simple solutions will be implemented.”

Market complexities, including international sourcing, social media and home delivery, are raising the value of all things traceable, Yiannas said. This “gives more weight” to the FDA in achieving more effective and efficient food safety systems — smarter food safety systems as Yiannas described them.

We at the Handwashing For Life Institute welcomed the perspective presented by Yiannas and loudly applaud the call for data, particularly when addressing what the Centers for Disease Control and Prevention considers the biggest unresolved risk, unwashed hands.

Electronic monitoring has been demonstrated to change handwashing behaviors in a sustainable way.

Successful implementation of new technologies such as voice recognition is lighting the path to smarter food safety systems. For more details search for “Crushed Red” on hanwashingforlife.com.

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Handwashing self compliance addresses skeptics’ doubts about electronic systems

Jim Mann — Sun, 05 May 2019 04:03:02 +0000

Editor’s note: Jim Mann, founder and chief scientific officer for the Handwashing For Life Institute, will be at Booth 136 at the Food Safety Summit, May 6-9, at Rosemont Convention Center in suburban Chicago.

Contributed

The magic element is employee engagement.

The top 100 restaurant chains have good trainers but they almost all fail to change employee handwashing behavior in a sustainable way. That has been, is, and according to many, will be its likely future. If good trainers can’t do it, there is a silent conviction by the C-Suite that efficiency requirements and the restaurant industry’s available workforce result in a risk that can only be managed by insurance. Each passing year further secures the status quo.

Savvy foodservice operators are stepping up. Their tolerance for risk is lower and perhaps their customer commitment is higher. These groundbreakers are few but their findings are profound as they discover new mission critical technology and the protocols of implementation.

Enduring behavior change demands employee engagement and commitment. Compliance becomes a personal source of professional pride once data is available to move handwashing performance from an aspiration to a verified reality. The goal of policy compliance is converted to self-compliance.

Electronically monitored handwashing has been commonly criticized, usually by those foodservice operators who have good trainers but poorly engaged workers. Such operators see these tracking systems as number generators rather than the key to employee engagement, self-motivation and self-compliant performance.
The reminders for employees to wash their hands is no longer a matter of signs on the restroom mirrors or the manager’s constant niggling when tracking systems are applied, but rather simple feedback on personal performance.
The most sustainable fix for ailing handwashing situations requires three components:

Reliable equipment
Data-dathering software
Real-time staff feedback

This is the 1-2-3 fix that sticks.

Resolving foodservice’s age-old handwashing perplexity has now become a matter of choice, resting on the shoulders of ownership and the people in the C-Suites. Affordable technological advancements are available to both protect and even build brand values.

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Going for the gold in the sink at the 2018 Food Safety Summit

Jim Mann — Fri, 20 Apr 2018 04:01:14 +0000

Editor’s note: This is part of a series of articles leading up to the 20th annual Food Safety Summit. The event, from May 7-10 at the Donald Stephens Convention Center in suburban Chicago, includes certification courses; a trade show with exhibitors from industry, academia and government; an extensive list of seminars and panel discussions; and a Town Hall meeting with top officials from the FDA, USDA and CDC. Visit www.foodsafetysummit.com for more details and to register.

Food safety professionals gathering for the 2018 Food Safety Summit, May 7-10 in Rosemont, IL, will have the unique opportunity to experience the power of handwash gamification in reducing the risk of brand-damaging outbreaks and costly recalls.

Handwashing For Life has recruited the recognized experts in electronic handwash monitoring to share their expertise, all at a single location, Booth No. 431, on the summit’s trade show floor at the Donald E. Stephens Convention Center.

Handwashing For Life is an advocacy group dedicated to lowering operator risk through enhanced and verified handwashing. Demonstrations at the Food Safety Summit will include a competition: The Handwashing For Life Olympics.

Food safety athletes will compete, illustrating a tool that has been used successfully for 17 years by the chefs of the 12-location Clyde’s Restaurant Group to motivate handwashing compliance. Old Ebbitt Grill, an historic restaurant just steps from the White House, is their most famous location.

Athletes and spectators will be treated to a tour of three new technologies that monitor and report handwashing behaviors. All three have been effective in getting the food handling staff to visit the the hand sink frequently and automatically recording their hand wash frequency, and in one case the process itself is tracked.

Summit attendees will have the opportunity to take a deep dive into the three competitive technologies from HandScan LLC, Clean Hands Co. and CloudCleanTM. Together they offer solutions to a wide spectrum of operator cultures. Their message is one that Handwashing for Life has been promoting for years: Continuous improvement starts with C-Suite commitment and tracking data.

The risk of foodborne illness outbreaks has been proven to be dramatically reduced when compliance exceeds 90 percent. Current data shows that rate to be only 30 percent.

Stop by Booth No. 431 to enter the Handwashing For Life Olympics and witness the drama of dueling electronic hand hygiene monitoring technologies. What you measure you can change. What you measure you can reward.

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NoroCORE’s final meeting celebrates successes, looks forward

Jim Mann — Sun, 25 Mar 2018 04:01:07 +0000

More than 150 leading norovirus minds gathered in Atlanta this week to celebrate one of the most successful food safety collaborations among industry, academia and regulatory entities known as NoroCORE at the group’s “Final Showcase Meeting.”

To watch a 4-minute video presentation by Lee-Ann Jaykus, scientific director of NoroCORE, click on the image.

NoroCORE’s full name is Norovirus Collaborative for Outreach, Research, and Education

The output of the 157 noro warriors since its first stakeholders’ meeting in 2012 opens new paths in dealing with the No. 1 source of foodborne illnesses: Norovirus. The final meeting event showcased progress and provided an opportunity to dive deeply into the topic of next steps.

The battle with norovirus has been ongoing since its discovery in 1968, when it was originally known as Norwalk Virus, named by the location of the original outbreak in Norwalk, OH. Globally, norovirus results in about 685 million illnesses and more than 200,000 deaths annually.

By 2011 little progress had been witnessed. The magnitude of the problem called for a proportional response. The U.S. Department of Agriculture stepped up with a $25 million grant.

The NoroCORE multidisciplinary collaboration was formed at North Carolina State University under the leadership of Scientific Director Lee-Ann Jaykus. Subcontracts pulled in an array of specialists, fueling its growth to now include 26 collaborative institutions with more than 30 investigators and more than 100 stakeholder organizations.

The flagship of NoroCORE progress is the work of scientists at Baylor College of Medicine in Texas, who developed a way to grow human norovirus in cells that line the human intestine. It is estimated that the net value of this single outcome, 40 years after the elementary school outbreak in Norwalk, OH, more than justified the investment of $25 million.

NoroCORE’s overarching objective is one of public health. For those serving the away-from-home public, its findings form a foundation for new levels of safety for those being served. The breath of benefactors includes restaurants, schools, nursing homes, hospitals, supermarkets, food processors, cruise lines, the hospitality industry, military operations and more.

Researchers form another group of stakeholders benefiting from NoroCORE. They have already started to leverage the learning, which will lead to new worldwide life-saving products and services.

Jaykus closed the collaborative’s final meeting with heartfelt thanks for her entire team, with special mentions to fellow collaborators at Emory University led by Christine Moe. The final sound from NoroCORE as it closed in its current form was from Don Schaffner of Rutgers University who led a thunderous call to keep the network in place to nurture the seeds created by this amazing collaboration.

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Handwashing for Life Olympics: Battle at Waterloo

Jim Mann — Mon, 20 Nov 2017 05:00:21 +0000

Jim Mann, with microphone, explains the rules of the Handwashing for Life Olympics. The screen, right of center at top, shows how effective a contestant is when they’ve finished their turn at the sink.

Pathogens met their Waterloo as more than 400 culinary professionals staged a two day pursuit of the latest advances in nutrition and food safety. The annual campaign is sponsored by Martin Brothers, a regional distributor focused on the culinary needs of hospitals and nursing homes.

The location was the Waterloo Convention Center, celebrating the famous five Sullivan Brother patriots who fought together and unfortunately died together in WWII.

The two-day event opened Nov. 15 with an afternoon of competition to determine the best-of-the-best culinary handwashers. The Handwashing for Life Olympics continued the spirit of war, a war on healthcare acquired infections, the dreaded HAIs. Contestants pledged to do their part by stepping up their handwashing, the single greatest contributing factor to the 380,000 annual deaths attributed to infections acquired in long-term care residences across the United States.

Participants learned by active engagement. The goal was to deliver the knowhow and support materials to conduct this unique behavior-changing training program back at their base facilities.

The instructional design of the program is based on the power of personalized and visualized learning. Contestants discover for themselves that effective handwashing is a skill and must not be trivialized at any organizational level. Many were surprised to discover that their handwashing was less than perfect and in a few cases, far less. They learned how calloused skin is hard to clean and how important it is to keep hands hydrated.

Jim Mann, left, congratulates Gold Medalist Mark O’Connell at the Handwashing for Life Olympics.

Scoring of the handwashing skills followed the Handwashing for Life ProGrade protocol. Brevis simulated germ UV-lotion is applied and washed off.

Missed spots get a 1 point deduction and missed areas cost contestants 5 points. A perfect score of 100 was achieved by one person, Mark O’Connell, who is culinary services coordinator at Evergreen Senior Living in Chillicothe, IL.

Administrators were reminded of their role of leadership in the pursuit of enhanced handwashing as they rolled up their sleeves and entered the competition. There was a common concern expressed in the chitchat surrounding the event. Implementing responses to the constant flow of new regulations is a “major competitor” to hand-washing training.

Multi-topic training sessions and motivational presentations rounded out an the agenda. Roxanne Hassman, a Martin Brothers category manager, summed up the event: “Our culinary clients return every year hungry to learn and appreciate the environment created by our staff, a staff that truly cares and it shows.”

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‘Desktop dining’ moves food safety issues into the workplace

Jim Mann — Fri, 15 Sep 2017 04:05:02 +0000

LAS VEGAS — This week’s conference of ISSA, also known as the Worldwide Cleaning Industry Association, attracted more than 16,000 people and more than 700 exhibitors from 25 countries to the Las Vegas Convention Center.

Engineer Stephanie Fleming demonstrates an innovation from the Italian company De Nora at ISSA 2017 this week at the Las Vegas Convention Center. This unit converts water into a powerful, odorless, bleach-free, ready-to-use disinfectant for any food contact surface. Its effectiveness on norovirus adds to its uses from customer service areas to restrooms. (Photo by Jim Mann)

The show theme was best expressed in the single watchword: Uncover. This challenge to change flowed through an extensive array of 60-plus training sessions imploring operators and their distributors to establish cleanliness programs built on the standard of continuous improvement — Uncover the excellence accessible through open-mindedness and innovation. Uncover the extraordinary.

Data became the gold-standard currency in understanding the environmental challenges in all the places now serving as a dining space. More than 60 percent of office workers are “desk diners.” Breakrooms have become satellite kitchens. The desktop epicureans face all the usual food safety challenges, including unwashed hands, unwashed refrigerator door handles and unwashed microwave buttons. Consensus supports the science that indicates these surfaces are not currently cleaned to food safe standards.

The ISSA constituency includes a large groups of food safety consultants who visit schools, office buildings, hospitals and nursing homes. They carry the news and help tailor systems of continuous improvement.

Roxanne Hassman, marketing manager at Martin Brothers Distributors of Cedar Falls, IA, said providing information is part of standard operating procedure nowadays.

“Cleanliness technologies are advancing everyday and we as distributors have become more distributors of solutions rather than products,” Hassman said. “We need data and best-in-class products to help set up enduring solutions for those we serve and the folks they serve.”

This week’s ISSA event served as a timely introduction to next week’s International Clean Hands Week.

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Food safety in health care kitchens impacts patient healing

Jim Mann — Thu, 22 Jun 2017 05:00:51 +0000

The 44th annual conference of the Association for Professionals in Infection Control brought together an international array of expertise to the convention center in Portland, OR.

Presentations and an abundance of creative posters were shared, each primarily based on unique experiences. Many sessions covered the importance of kitchens and food safety protocols in the healing of patients and residents in hospitals and long-term care facilities.

The most common theme was the wide range of challenges in achieving acceptable hand washing compliance rates. Hand washing was clearly the dominant intervention of choice to lower infection rates. Reports from Ho Chi Minh City University, the University of Lagos Nigeria and the University of Chicago all called for process improvements. In the underdeveloped countries having clean water available at points of care was the top concern.

A presentation by Emily Landon of the University of Chicago’s Center for Healthcare Delivery, Science and Innovation, was a true rendering of today’s best practices in action. Her multi-year experience with electronically assisted hand washing monitoring provided insights for starting such programs as well as covering the hurdles in sustaining the process improvements. Her message stressed the importance of departmental collaboration and verified compliance data to change behaviors from the C-Suite level down to bedside patient care.

Landon monitors over 100,000 hand washes each day. A 10 percent increase in compliance at University of Chicago could save $1.2 million per year in MRSA costs alone.

Another Chicago area hospital reported using data to double their hand washing compliance within six months. Many competing technologies were studied in depth. Only 3 percent of hospitals currently are using one of the automated technologies, but if attendees at APIC 2017 are representative of the trend, the other 97 percent are busy considering data as the driver to get to the next level of risk-reduction and patient safety.

Don Schaffner Photo courtesy of Rutgers

A recent publication by Rutgers University’s Donald Shaffner debunked the hot-water hand washing theory, which was welcomed by the nursing profession where frequent hand washing is a must and irritant hand dermatitis is a risk. Washing with “cooler but comfortable” water protects the skin’s natural protective barrier.

Discussions on disposable glove changing, echoed the typical foodservice issues. Are the gloves protecting the caregiver or the care-receiver? The unchanged glove is every bit as bad as the unwashed hand or possibly worse.

Now that handwashing can be verified, does this change glove usage? Deb Burdsall, a doctoral candidate at the University of Iowa, is an internationally renowned expert on this complex subject. She used a comedic approach to demonstrate the plight of a conscientious caregiver attempting to follow the standard gloving policy in a nursing home toileting situation. It dramatized the challenge of needed glove changing in times of patient distress and opened a discussion as in foodservice on the merits of double-gloving.

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Patient experience drives health care food safety leadership

Jim Mann — Sat, 10 Dec 2016 06:01:42 +0000

This week Crothall Healthcare summoned a team of experts to collaborate by “mastering and integrating what you are good at” and challenged them to define new standards to light a path of continuous improvement in lowering health care acquired infections — starting with hand washing and food safety.

Thirty leaders and experts gathered this week at the Crothall Healthcare Summit to develop strategies to decrease health care associated infections, including those acquired through food safety failures. Photo courtesy of the University of Pennsylvania.

The team of 30 included of a cross section of direct health care operational leaders plus a group of stakeholders and thought leaders representing a wide range of advanced technologies.

They gathered Dec.7-8 in Wayne, PA, at the headquarters of Crothall, which specializes in health care management services. This two-day event focused on industry realities and how to overcome financial and regulatory obstacles to set new standards of patient- and resident-focused care.

The challenge was put forth by Rich Feczko, national director of standards and innovation for Crothall. He asked the group “to work together with a singular focus of patient and resident experience.” This team will meet annually for a summit to amend its White Paper and accelerate the adoption of new information and technologies.

Their specific challenge was to define actions leading to the reduction of pain, suffering and the 479,000 annual deaths — in acute and long-term care according to CDC — caused by health care associated infections (HAIs). Such scenarios often arise along the trail connecting kitchens with the bed-table diner. This two day event focused on the industry realities and how to overcome the financial and regulatory obstacles, to set new standards of patient and resident focused care.

Summit sessions this week included discussions of today’s best practices and laid out a path for future priorities with a blend of technology, process control and behavior change from the executives in so-called C-suites to all the caregivers who have direct contact with patients and residents.

Topics like norovirus interventions were covered for nursing and culinary, both in hospitals and long-term care operations. Current voids in health care’s hand washing compliance monitoring were acknowledged and two pilot kitchen studies are being pursued as a result of this innovation-oriented event.

This meeting kicked off a 10-month focus to define optimum integration of manpower and technology to assure the health and healing in acute and long-term care.

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Complacency kills: Challenging the protectors of the status quo

Jim Mann — Sat, 29 Oct 2016 05:00:37 +0000

CHICAGO — Rob O’Neal, former Navy Seal and keynote speaker at the International Sanitary Supply Association meeting here this week, reminded the audience of food safety and away-from-home wellness professionals that “complacency kills,” a message that really hit home with those leading the charge to use new technologies in the war waged in the darkness of the microbial world.

A company representative (above) discusses how the measurement of cleanliness is a reassuring reward to workers tasked with deep cleaning. After a simple spray and wipe procedure, workers can swab surfaces and use the scanner (below) to measure, document and report successful cleaning. The system measures Relative Light Units using ATP, Adenosine TriPhosphate. (Photos by Jim Mann)

O’Neal’s passion about action vs. complacency illustrated for the listeners that their mission goes well beyond the cosmetics of their away-from-home environments; diving deeply into the business of saving lives by creating safe zones for the people they serve.

The ISSA brings together a cross section of those protecting lives where we work, study, play and heal. About 700 trade show exhibitors were supported with an array of educational seminars all geared to light a path of continuous improvement in the standards of cleanliness.

ISSA distributors add value to everything they sell by helping define, train and implement integrated solutions. High-touch surface care was a prevailing theme.

There also was a noticeable advance in technologies geared to measure cleanliness and control the many processes involved.

Several cutting-edge technologies were on display, speaking to the minds of those looking to raise efficacy and efficiency while lowering cost and going green. These included on-site generated versions of electrolyzed water and stabilized ozone.

News of a ready-to-use surface sanitizer with 30-second kill of norovirus was celebrated at one booth by a constant flow of interested operators and distributors. Norovirus was the most frequently cited pathogen of interest to the ISSA attendees, many of whom are serving nursing homes, hospitals, the hospitality industry, schools and the workplace where the transmission of cold and flu viruses result in costly absenteeism.

Value-based purchasing (VBP) was a common conversation heard along the many aisles and miles of the McCormick Place Convention Center, driven partly by healthcare’s Affordable Care Act.

The ACA attempts to link the quality of care to reimbursements by Medicare. This is driving the need for numbers to set national standards. But, the many factors in the healing process are difficult if not impossible to measure and compare nationally.

The primary danger lies in the industry’s ability to precisely measure activities like time and out-of-pocket costs associated with the care while being quite limited in measuring outcomes and its variables. A constant downward pressure on costs can deter investment in the very innovations needed to improve outcomes.

Complacent cleaning of hands and high-touch surfaces is likely responsible for many of the 380,000 annual deaths resulting from nursing home acquired infections. The ISSA is committed to help drive this number down.

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Restaurant study group calls for back-to-basics approach

Jim Mann — Mon, 10 Oct 2016 05:00:13 +0000

A record setting number of attendees for the National Restaurant Association’s Quality Assurance Study Group’s annual session filled the Millennium Conference Room at Loews Philadelphia Hotel this past week for a three-day introspection of the industry’s food safety policies and practices. Day 1 was headlined with a keynote address by Frank Yiannas, Wal-Mart’s vice president of food safety and health and author of the book “Behavior = Food Safety.” He offered attendees tips on how to build and maintain a culture of customer care and cleanliness. His book has quickly become a leading manual on the why and how of culture change in foodservice. Hal King, president and CEO of Public Health Innovations LLC, opened Day 2 of the “Back to Basics” conference with a deep dive into implementing AMC, Active Managerial Control. He stressed the need for real-time data as the driver of timely corrective actions in a retail foodservice operation by the person in charge (PIC). Building on King’s presentation, Gary Ades, president of G&L Consulting Group LLC and formerly of Wal-Mart and Foster Farms, who presented an insightful lesson on how to sell food safety to senior management. Reports from the Food and Drug Administration, the Occupational Safety and Health Administration and an outbreak panel provided additional illustrations of the rising risks facing the restaurant industry. A team from the Handwashing For Life Institute opened Day 3 with an update about risk factors affecting all foodservice operators, underscoring the need for better process control for hand washing. Conference attendees followed Pamela Ritz, president of Specialty Risk Management Inc., on a tour through the valley of current risk trends. Discussion showed agreement that Quality Assurance, Operations, and Risk Management staff must work together because they are the frontline forces in keeping top management out of jail and companies protected from the threat of high plaintiff awards. Simulated executive committees for chain restaurants delved into the new technologies available to monitor hand-washing compliance, starting with an assessment of the number of hand washes needed per shift to reach their standard of safety. SmartLink (GOJO) soap dispensers aligned with a brand new CloudClean data gathering and reporting system, Tier 1, was demonstrated as one readily available solution. One of its innovations is that it offers restauranteurs a monitoring option that does not require personal identification badges. There was a warm response to the concept of stimulating employee hand washing via reward programs, now that data is easily and cost-effectively available. The session closed with the suggestion foodservice operators follow the hand washing data trail to motivate employee hand washing and change the operational culture. (To sign up for a free subscription to Food Safety News, click here.)

Conquering this enemy is increasingly a matter of choice

Jim Mann — Tue, 20 Sep 2016 05:00:36 +0000

Editor’s note: This is the third in a series of three guest opinion columns by Jim Mann in recognition of September as National Food Safety Month. The more we learn about norovirus, the clearer the choices are in changing current behaviors. Foodservice operators know a lot about norovirus, especially in how to cope with an outbreak. What they are ignoring are the impacts of breakthroughs in the science of norovirus, DNA identification and in norovirus prevention technologies. The first disregarded breakthrough is in the preventive measure of hand-washing, the number one norovirus intervention. Electronic systems are now commercially available and affordable. These innovations automatically track standards, paperlessly log actual hand-washes and motivate new, sustainable behaviors. Whole genome sequencing (WGS) headlines the ignored advancements in microbiology and their impact on risk. Its addition to the Center for Disease Control and Prevention’s PulseNet laboratories is already translating into more precise outbreak sourcing. It is feeding a legal system that uses accurate DNA connections between the sickened and the source to file more lawsuits and ramp up awards and threats of executive jail time. Norovirus thrives, survives, evolves Norovirus is highly contagious. It is a determined survivor, living on inanimate surfaces for weeks, invisibly waiting for transportation to its next host, usually via a human hand. It commonly follows a fecal-hand-oral path of transmission. It is a prolific virus, second only to the common cold. It sickens and kills the young and the old around the world. Freezing doesn’t kill norovirus, nor do many common disinfectants. Norovirus from projectile vomiting and toilet flushing can be aerosolized. It hangs in the air, waiting to be and ingested, and is blown onto surfaces. New strains rapidly evolve. These characteristics have enabled noroviruses to become the leading cause of endemic diarrheal disease across all age groups, the leading cause of foodborne disease, and the cause of half of all gastroenteritis outbreaks worldwide, according to the CDC’s Aron J. Hall, DVM, MSPH at the Division of Viral Diseases and National Center for Immunization and Respiratory Diseases. A vaccine is not available. Workplace exclusion policies for sick employees alone are not effective. A significant percentage of norovirus carriers exhibit no symptoms, leaving hand-washing as the primary intervention. Single-use gloves are not the answer, as industry has not come up with an effective way to motivate and control glove changes. The only people who see gloves as an effective barrier in managing the norovirus risk are the inspectors, following a food code where hand-washing is not based on risk. Tactical hand hygiene Hand-washing is the answer but motivating staff to practice effective hand-washing has been notably unsuccessful for decades, so long that poor hand-washing rates have become the industry norm. The rapidly falling costs of collecting and reporting hand-washing data wirelessly and the rising risks have entered an important zone of intersection. Motivating behavior change with electronic logging of actual hand-washing is proving to be a game changer, often doubling staff hand-washing. Data melds the randomness of current hand-washing practices into a controllable and sustainable process. Hand sanitizers too can be included in an effective norovirus control protocol provided the right product is selected. Even hand sanitizers with less than 99.999% kill of norovirus can lower the viral load and minimize transfer to other surfaces. One product, tested by Emory University, proved that process too has an effect. Foodservice operators and food producers can now more accurately assess their risk of unwashed hands in the context of an available solution. Data is lighting the path to making hand-washing a sustainable process, complete with standards and tracking. (To sign up for a free subscription to Food Safety News, click here.)

The flywheel of conventional hand-washing

Jim Mann — Tue, 13 Sep 2016 05:02:51 +0000

(Editor’s note: This is the second in a series of three guest opinion columns by Jim Mann in recognition of September as National Food Safety Month.)

Hand-wash tracking technologies have arrived on the restaurant scene, exposing the stark reality of compliance and noncompliance. The new tools are being ignored by many, who are serving as guardians of the status quo based on conventional thinking. While the impact of an outbreak is high, the probability is low, proven by our recent history. And we have solid PR and legal help lined up if we suddenly need them. An electronic hand hygiene monitoring (EHHM) solution, as seen in the Atrio Restaurant in Carmel, IN, provides more than management peace of mind. It is a vast improvement in protecting customer wellness. Hand-washing must be risk-based and risk management is advised to help in the risk assessment of unwashed hands. Why? Conventional thinking is inviting the regulatory remedies of high fines and executive jail time. If that isn’t enough, the Centers for Disease Control and Prevention’s PulseNet labs are now equipped with whole genome sequencing. It’s a look-more, find-more technology. Please note that unsolved outbreaks are never closed but rather moved to a cold-case status. Whole genome sequencing can facilitate their reopening. Failure to use readily available control measures is a legal principle that moves a lesser crime to one of negligence. Please check with your legal department for their views on exposure tied to current hand-washing process control, commonly operating neither with standards nor controls. The Food Safety Modernization Act is moving the attention to prevention, and electronic hand hygiene monitoring will move along with it. EHHM offers operators an upgrade for their hazard analysis and control point plans and the conversion to Hazard Analysis and Risk-Based Preventive Controls. Operators might consider installing a new flywheel for hand hygiene by creating a test site or two and let the momentum of value drive a rollout. (To sign up for a free subscription to Food Safety News, click here.)

The outbreak breakthrough of whole genome sequencing

Jim Mann — Tue, 06 Sep 2016 05:00:24 +0000

Editor’s note: This is the first in a series of three guest opinion columns by Jim Mann in recognition of September as Food Safety Month. Whole genome sequencing, WGS, is a new motivator for enhanced hand washing in all locations where people are preparing and/or serving food. More broadly, it is a robust laboratory procedure for the DNA fingerprinting of pathogens. This advancement provides the opportunity to stop outbreaks sooner and avoid additional illnesses by the rapid and accurate identification of the specific strain of a pathogen while lighting the path to its source. The Centers for Disease Control and Prevention uses this analogy to better appreciate the dimension of this scientific breakthrough: “Instead of only having the ability to compare bacterial genomes using 15-30 bands that appear in a PFGE pattern, we now have millions of bases to compare. That is like comparing all of the words in a book (WGS), instead of just the number of chapters (PFGE), to see if the books are the same or different.” CDC’s 83 geographically spread PulseNet laboratories, aligned within seven regions, are now using WGS as they scan their respective territories for outbreaks. This advance gives public health officials the ability to solve outbreaks faster and with more accuracy. It is already helping find and define more outbreaks as it reveals the pathways of the stealthier foodborne pathogens. This new deep-dive into the universe of health-harming organisms carries with it increased risks for the foodservice operator as a new, previously unknown, layer of evidence is penetrated and exposed. The quick and accurate identification will also help plaintiffs in their pursuit of legal resolution. Speed alone helps but courtroom history shows that a direct connection between the infected person and its source, along with a precise naming of the organism, improves the plaintiff’s award levels. Look-more find-more outbreak scanning technology Outbreak is an important word to define for both food producers/food service operators and regulators. A foodborne disease outbreak (FBDO) is classified by the CDC as “an incident in which two or more persons experience a similar illness resulting from the ingestion of a common food.” Might this new WGS tool of accuracy open the door to recognizing and reporting of single incidents of foodborne illness (FBDI)? Whole genome sequencing is already improving food safety but it clearly puts new pressure on the operator’s food safety control system. The now unreported causes of FBDOs will increasingly move to the reported column and provide a basis for potential legal action by the plaintiff. CDC statistics show that majority of hospitalizations and deaths — 71,878 and 1,686, respectively — are caused by “unspecified agents” some of which will now likely be identified by WGS. The strength of the WGS technology will only strengthen traditional epidemiology investigations. Unresolved outbreaks and even random illness clusters are never closed, but rather filed as “cold cases.” Whole genome sequencing can be used to reopen these cases as the combination of PulseNet’s database and the new GenomeTrakr sequence database builds. Hand washing for many food producers and food service operators is either not a process at all or one that is completely out of control. It has no standards, no measurement and no data to alert the Person-In-Charge (PIC) when trend lines slip below the agreed standard. Indicators of danger, never reach the C-Suite executives for their input into sustainable corrective actions. Hand-washing performance remains at the core of CDC’s recommended interventions: “Hand-washing is the single-most important means of preventing the spread of infection.” (To sign up for a free subscription to Food Safety News, click here.)

Follow the money: Reducing risk vs. increasing costs

Jim Mann — Thu, 16 Jun 2016 05:00:07 +0000

Healthcare providers, caregivers, researchers and suppliers gathered at the 43^rd annual meeting of the Association for Professionals in Infection Control & Epidemiology (APIC) in Charlotte, NC, June 11-13. The theme was “Inspiring Innovation in Infection Prevention” and attendees discussed how evidenced-based research can resolve the recurring riddle of risk versus budgets for both foodservice and skilled nursing facilities. Motivating innovations in foodborne outbreak prevention was an unstated goal but an important byproduct of the meeting. All hospitals and nursing homes prepare and serve food for the most vulnerable populations. The CDC attributes Healthcare Associated Infections (HAIs) as the cause of death for 99,000 hospital patients annually and 380,000 in nursing homes. The year-to-date reference point is carried to the state level at this website: http://handwashingforlifehealthcare.org/healthcare-deaths Personnel from the Handwashing For Life Institute were unsuccessful in attempts at APIC to locate peer reviewed estimates on the percentage of these deaths due to the food preparation, delivery and feeding of the patients and residents. Busting myths about gloves, hot water and hand sanitizers Deep dives into measuring new factors in infection transmission exposed flaws in food handling and overall patient protection systems. Sessions challenged such basics as “To Glove or Not To Glove” and busted many a myth. Deborah Burdsall presented findings she has discovered in her doctoral work on this topic at the University of Iowa. Research illustrates that we in the USA are overusing gloves but under-changing them when a clean, gloved-hand is most essential in protecting the at-risk population. Glove use and misuse is deeply psychological and thus very difficult to align behaviors with the science and the guidelines of the FDA or CDC. Caregivers at the annual meeting attended sessions starting as early as 5:30 a.m. where they were challenged to think about the advantages of washing hands with cool water after years of guidance under the Model Food Code to use hot water. Evidenced-based research shattered the myth that alcohol hand sanitizers are drying to the hands, causing Irritant Contact Dermatitis (ICD). Poorly formulated soaps, particularly those which are not easily rinsed, are the culprits. Formulation matters.

On the left, before treatment with ultraviolet light, pathogens are apparent. After UV-C treatment, (right) no pathogens are detected.

Sometimes more money means fewer infections, which means money saved High-tech challenges were also on the menu. Much of the meeting content recognized that the majority of unresolved issues in patient safety required behavior changes and changes of culture, from the boardroom to the caregiver. Most all require significant investment but offer greater savings in lower infection rates. Two specific technologies were well represented and integrated from the show floor through to educational sessions and in an array of poster presentations. Electronic Hand Hygiene Monitoring (EHHM) and ultraviolet (UV-C) surface disinfection are both problem-solving advancements but both require a strong business case to initiate. HAI costs are well documented and their reduction often has a payback within the first year. But getting started is still a hard sell in some corporate settings. The growth of ultraviolet in killing resistant pathogens was summarized by Gunner Lyslo, founder and CEO at Surfacide LLC. He said UV-C is a good example of applied innovation. It is an evidence-based technology that not only is effective in reducing pathogens in patient rooms but more importantly is improving patient outcomes. Documented performance directly connected to lowering HAIs is driving the current surge of usage. The Affordable Care Act incentivizes higher performance with its scale of reimbursements from the punitive to the positive rewards for outstanding outcomes. This innovation is quickly becoming the standard, Lyslo said. According to APIC 2016 keynote speaker Dr. William Rutula from University of North Carolina Health System, “If you don’t have these systems, you should have them in your capital budget.”

High-tech, automated faucets such as ths have been shown to result in better hand washing and faster rinsing.

Overwhelming innovation, underwhelming implementation Innovation can drive behavior change but effective and enduring solutions start with leadership in realistic risk assessment and the early engagement and empowerment of the program creators, implementers and maintainers. Yes, APIC sees the R in ROI as “return” but also as lives saved. The I is for “investment,” but they are looking to “innovation” to accelerate patient safety initiatives. ROII, or I squared, Return On Investments in Innovation, is a call for all to learn business speak when trying to improve care. Business drives the care. Let’s all learn the language. Neither infection prevention nor quality assurance arguments are effective funding factors by themselves. They both require evidence converted to revenue. All foodservice and care providers in general are risky businesses, getting riskier as the government amps up its array of penalties as a more efficient way to “motivate” compliance rather than adding more facility auditors. Scientific advancements, such as Whole Genome Sequencing, contribute to the rising risk as tracking the infection back to its source of infection is getting faster and more accurate. Progress in risk modeling, including quantitative risk assessment, is making it easier to build better business cases to invest in enhanced patient care and foodservice innovations. University of Arizona’s Kelly Reynolds presented one such powerful advancement: “Once we find the pathogens, it is important to quantify the risk and identify the effective interventions. Our team is continuously enhancing these decision support models.” Make your business case:

Measure your risk and opportunity.
Set your standards.
Optimize processes.
Train to the standards.
Motivate with evidence-based outcomes.

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UPDATED: Hand washing goes high tech during Vegas demo

Jim Mann — Thu, 28 Apr 2016 05:00:50 +0000

UPDATED: Coverage of Wednesday activities added The Norovirus Summit III picked up where last week’s Conference For Food Protection left off. Presentations and workshops took on the Norovirus challenge from beating back biofilms to data-driven hand washing systems.

Steve Russak, COO of CloudClean, describes the capabilities of a new hand wash performance system with chefs from a variety of casino kitchens Tuesday. The system converts current handwash rules into a staff reminder and reporting program. The electronic network set up for handwash verification has a secondary use for tracking temperatures during food preparation and storage. (Photo by Jim Mann)

This workshop was part of the second annual combined meeting between the Nevada Foodservice and the Nevada Environmental Health Association. The audience was split evenly between members of the Southern Nevada Health District and representatives from casinos, restaurants and schools. All strongly agreed on the importance of hand washing in foodservice but differed on execution. Inspectors were skeptical about operators’ willingness to invest in hand washing. Operators were concerned about being cited by inspectors when documented compliance was less than perfect. Inspectors expressed a desire that electronic, data-driven solutions be designed to retain the human elements involved in developing and maintaining critical operator-inspector relationships. Demonstrations of new wireless electronic technologies in a working casino kitchen dispelled many preconceptions. Actual hand washing data fills an important gap in Active Managerial Control (AMC). The Handwashing For Life Institute is pursuing a collaboration among Southern Nevada Health, the Nevada Foodservice Task Force and a facility in Las Vegas willing to invest in an “an electronic hand wash coaching/performance system.” This would serve Las Vegas and the country as a hand hygiene innovation center. Discussions are ongoing. Wednesday activities: 5-star Las Vegas norovirus control The final day of the Nevada Food Safety Task Force meeting at the South Point Casino in Las Vegas included a review of the work product from the teams that attempted to specify norovirus-free operations. Teams of seven food safety professionals became mock restaurant entrepreneurs preparing to build and operate a new facility in Las Vegas. These investors had a low tolerance of risk and a high priority of public safety and the protection of their valued brands. Each team first named their restaurant to help get the creative juices flowing. Three of the winners played on pathogen names: “Sam ’n Ella’s,” “No Mo No Ro” and “The Norwalk Cafe.” The teams’ new knowledge about norovirus was translated into aggressive use of technology and measurements to fuel sustainable HACCP plans and Active Management Control. “What gets rewarded gets done” summarized the positive positioning for hand washing verification systems. Teams chose among the four technologies which were presented. Some preferred options which individually identified staff members while others were attracted to the team approach. Time will tell if Wednesday’s buzz about systems that motivate and verify hand washing will convert to investments which will make Las Vegas an even stronger leader in food safety. (To sign up for a free subscription to Food Safety News, click here.)

Food protection group agrees norovirus needs more attention

Jim Mann — Thu, 21 Apr 2016 05:00:32 +0000

Editor’s note: The Conference for Food Protection is managed by an executive board that includes 23 voting members who represent: state food regulatory agencies from each of the FDA regions; local food regulatory agencies from each of the FDA regions; the FDA; USDA/FSIS; the CDC, the food industry; an academic institution; and consumers. BOISE, ID — On Wednesday, state representatives arrived and gathered to vote on the work done in recent days by the three Councils of the Conference for Food Protection. They were disadvantaged by not having had participated in the deep-dive assessments, but were briefed by their regulatory colleagues.

Chairman John Luker addresses the closing session of the bi-annual meeting of the Conference for Food Protection. (Photos by Jim Mann)

The star of the 2016 meeting of the Conference for Food Protection was clearly norovirus. Pre-session chitchat Wednesday continued connecting the many dots between new learning on biofilms and vomit-readiness plans, which should require that a 50-foot diameter area be cordoned off for deep cleaning if norovirus is suspected. This requirement appears quite important, but will be difficult to implement in places like produce aisles of grocery stores or in quick-serve restaurants where closing a 50-foot circle would mean closing the restaurant. Might the incident be a bout of morning sickness, the flu or too much alcohol? Quick action is a critical part of vomit-readiness plans, offering little opportunity to confirm the possibility of norovirus. Norovirus lexicon was enriched at the 2016 CFP when the word “spewnami” was added as a descriptor for scenes of multiple incidents. The source dot that carried conversations though to the sixth and final day of the bi-annual meeting was the August 2015 Simi Valley norovirus outbreak among patrons of a Chipotle Mexican Grill restaurant. Conference attendees commented that known shortcomings in food safety controls now threaten executives with personal penal action. Early last week, just prior to the opening of the 2016 Conference, an exciting norovirus breakthrough was announced by NoroCore. Scientists from Baylor University led a multi-school team to culture human norovirus in the lab, opening the door to many avenues of needed research. This phenomenal advancement is a true display of American scientific prowess. The collaboration adds hope to solving this and many other threats to public health. Other anecdotal facts were shared at the Conference, each adding new support for the importance of the prime norovirus intervention — handwashing. Aircraft carriers are rarely grouped with the cruise ships but yet they do share in the norovirus war. Military vessels must be battle-ready at all times, but they are totally disabled when this microbial menace hits. It is difficult to directly connect a Conference issue with new food safety product developments but easy to connect to its idea-generating sidebars. Thanks to one such exchange, researchers have collaborated to develop a norovirus-effective hand sanitizer, now commonly used on cruise liners. Hopefully it will find its way to defend those defending our country. (To sign up for a free subscription to Food Safety News, click here.)

CFP’s sidebars drive food safety in ‘No Action’ atmosphere

Jim Mann — Wed, 20 Apr 2016 05:01:32 +0000

Editor’s note: The Conference for Food Protection is managed by an executive board that includes 23 voting members who represent: state food regulatory agencies from each of the FDA regions; local food regulatory agencies from each of the FDA regions; the FDA; USDA/FSIS; the CDC, the food industry; an academic institution; and consumers. BOISE, ID — Robert’s Rules drive order in the complex deliberations at the bi-annual meeting of the Conference for Food Protection. They also drive attendees out of the intense sessions to refresh in open spaces where they can share learning in a spirit of open-mindedness. Heading into the final day of the meeting today, some frustration was voiced Tuesday by attendees from academia.

(Photos by Jim Mann)

“We are invited to join committees because of our scientific knowledge and then the science is ignored, in favor of No Action, protecting the status quo,” one academic said. “Insufficient science …” was the verdict to warrant a recommendation of No Action for a proposal seen as very important in solving hand cleanliness issues where ready-to-eat produce is harvested. The proposed protocol — to use hand sanitizers in an unconventional way — was successfully tested by Emory University in a controlled study in produce fields. Dubbed SaniTwice, the method delivered results equal to or better than the soap/water standard. This second day in Council III of the Conference organization was dominated with similar scenarios with brightly colored stickers announcing “No Action” on a string of agenda items — many of them related to hand washing. The most frequent sponsors of the No Action option were members of the regulatory community. Reflections on norovirus precipitated a chorus of disagreement after the Council voted for “No Action” on Issue III-040. ATP (adenosine triphosphate). Using Green Fluorescent Proteins (GFPs), the ATP testing method measures biological cleanliness by showing whether live biological cells are present on surfaces. Live cells are not visible to the human eye and indicate microbial growth. “This term (ATP) is not used in the FC (Food Code),” was the reason given for the No Action vote on the issue. However, the question before the Council was whether to add a definition for ATP. The current standard for high-touch, non-food contact surface cleanliness prevailed: “Clean to sight and touch.” One attendee quipped: “Good news for the covert community of norovirus.” Pondering progress With Council work completed today, a well deserved sense of accomplishment prevailed this afternoon in Boise. Post-Council collaborations are perhaps the strongest element of the Conference for Food Protection. Win or lose, each issue increases awareness and lights a path to future action. The influence of the Conference is undeniable. A lunch break took some attendees to a nearby restaurant. Guests were welcomed by a greeter while she cleaned menus before handing them to the hungry and appreciative food safety professionals. (To sign up for a free subscription to Food Safety News, click here.)

3 steps to cleaner hands, safer food: Learn, develop, implement

Jim Mann — Tue, 19 Apr 2016 05:00:30 +0000

Editor’s note: The outbreak referenced in this meeting coverage was linked to a Chipotle Mexican Grill in Simi Valley, CA, and sickened an estimated 230 to 1,500 people, according to public health officials. Council meetings at the bi-annual Conference for Food Protection meeting turned to hand washing and norovirus this past weekend as a 2015 outbreak became a case in point for discussion purposes.

Attendees at the Council III meeting Sunday at the Conference for Food Protection bi-annual meeting discussed hand washing guidelines and policy. (Photo by Jim Mann)

The Conference for Food Protection brings together representatives from the food industry, government, academia, and consumer organizations to identify and address emerging problems of food safety and to formulate recommendations. Proper hand washing is one of the primary defenses against the spread of foodborne pathogens. Norovirus quickly took center stage as a target pathogen during the council meeting Sunday as participants reflected on the outcomes of the 2015 Simi Valley California outbreak. Restaurants generally have policies in place to restrict ill workers, but the industry and other stakeholders have learned infected customers are a major source of norovirus entry into the dining space. Every day, restaurants are also challenged by the presence of asymptomatic workers, making frequent hand washing a business-critical intervention. Development of hand washing policy and guidance unfortunately suffered a major setback when the Hand Hygiene Committee reported a dead end to their two years of diligent work. The group recommended disbanding the committee while two sub-agencies of the Food and Drug Administration — CFSAN and CDER — work out and send forth a standard of effectiveness for a traditional soap-water hand washing. This pause presented a chilling implementation irony in that all the previous norovirus-related science pointed to raising hand washing standards and suddenly the stakeholders had no base to build on. If this hiatus continues, some attendees at the Conference for Food Protection say it will be a major disincentive for research by academia and industry. Until there is agreement between FDA’s two sub-agencies — the Center for Food Safety and Applied Nutrition (CFSAN) and the Center for Drug Evaluation and Research (CDER) — on what to punish as the new standard of effectiveness for hand washing little movement is expected. The Conference for Food Protection is managed by an executive board that includes 23 voting members who represent: state food regulatory agencies from each of the FDA regions; local food regulatory agencies from each of the FDA regions; the FDA; USDA/FSIS; the CDC, the food industry; an academic institution; and consumers. (To sign up for a free subscription to Food Safety News, click here.)

Tech talk dominates Conference for Food Protection

Jim Mann — Mon, 18 Apr 2016 05:00:43 +0000

The bi-annual Conference for Food Protection includes several opportunities for discussion and comment.

BOISE, ID — Advances in technology were merged into a day which ranged from fear to a science-based confidence at the bi-annual Conference for Food Protection this weekend. Deep dives into the realities of produce farming and the recurring global challenge of bird flu, lighted paths for needed research at the farm level. Risks at the retail level were driven home by an inside look at the formation of biofilms both on food and high-touch nonfood contact surfaces. Speakers empathized the importance of frequent surface cleaning as opposed to a quick pass of sanitizer. Biofilm-forming agents quickly assess the properties of their surface and create a tailored protective matrix, nearly impervious to casual attempts to kill rather than clean. Attention to high-touch surface issues immediately moved the discussion to staff training on hand washing at all points of the supply chain from the farm to the fork. Attendees chimed in pointing out the needed “training” at the C-suite level to change staff behavior in a sustainable way. An application of robotics demonstrated a path where physical food handling was eliminated in transporting food from the kitchen to hospital patient rooms. The thread of whole genome sequencing bridged from the morning’s highly technical workshop to the afternoon’s conference keynote where it became clear that failure to solve known food safety issues is now being defined as a crime, even without criminal intent. Food safety is increasingly a matter being taken up by the FBI. (To sign up for a free subscription to Food Safety News, click here.)

Mission-Critical Hand Hygiene

Jim Mann — Wed, 16 Sep 2009 02:00:00 +0000

A Return To Mom’s Rules

Mom was right for more reasons than she ever realized. Her insistence to “wash your hands” led to good habits, likely lasting 6-7 years. At that point an attack of self-reliance coupled with a touch of a Superman complex changed handwashing behaviors. Kids were exposed to other kids, older kids, and adults demonstrating their daily disregard for handwashing.

Every cold and flu that followed was a lost opportunity to connect handwashing with the spread of disease. This escaped even mom who was likely lulled into the popular belief that colds and flus couldn’t be avoided and had little to do with handwashing. After all, these maladies are respiratory . . . The 2009 H1N1 Swine Flu is the latest example. The flywheel of conventional thinking is all about vaccines. Good handwashing will do more for containing the spread of the flu as summarized in this statement from the Centers for Disease Control and Prevention (CDC): Handwashing is the single most important means of preventing the spread of infection.

Soon the teens were preparing and serving food for others at the nation’s restaurants and cafeterias, immersed again in environments where the need for good handwashing didn’t match up with the behaviors. Fellow workers scoffed at the few diligent handwashers while they witnessed missed handwashes by the very person who trained them.

Raising bacteria and viruses

Handwashing is mission-critical where food is prepared, stored and served. Germs, largely bacteria and viruses, depend on hands for their own survival as they are moved around until they find a safe harbor to multiply. Bacteria love moist heat and can double in numbers in just twenty minutes, raising their potential to inflict suffering and even death. Viruses need a host and don’t multiply until they find one. Both bacteria and viruses share certain key traits. Their survival on inanimate surfaces makes many a foodservice surface a transit station, an intersection for them and the hands of service, foodservice.

Both bacteria and viruses are invisible in two ways. First, they are so small and concealed, not only can’t you see them but you can’t feel them or smell them. Forget the common standard for cleaning surfaces: Clean to sight and touch.

Second, they both use some of the hardier more resistant humans as carriers, a microbial Trojan horse. These folks show no symptoms while they shake your hand, prepare your food, or care for your parent in a nursing home.

Why Wash

Foodborne illness takes its human toll along with a prolonged outflow of cash. Both will vary by pathogenic source. The most common troublemaker, Norovirus, gets our attention initially as our digestive system is a first responder and violently rejects the intruder, hurling everything it can as fast as it can out of its two primary paths. Undigested food takes the high road and partially processed goes for the lower hatch. Continued rounds of diarrhea and vomiting quickly dehydrate the body.

Most healthy people will call this attack the 24-hour flu. Norovirus often goes unreported unless it affects multiple people from more than one family. When an outbreak occurs, health department’s epidemiologists are called in.

Norovirus is best known for its power to send massive cruise ships back to port ahead of schedule. It’s not normally a killer.

E. coli represents the killer-class of pathogens. Survivors of this kidney-destroying bacterium can face a lifetime of pain and suffering, usually a shortened life. A survivor of the watershed Foodmaker outbreak in 1993 faces a shortened life and will be unable to bear children.

When to Wash

We are frequently asked for a standard regarding frequency of handwashing. How many times per day? This depends primarily on five variables:

Your own personal health
The health, the immune systems of the people with whom you are in contact
The number of people you will contact, directly or indirectly
Your “caring for others” factor, the moral standard
The tolerance of risk and poor handwashing by your employer

For some restaurants, largely quick-serve establishments with minimal raw food handling, minimums may be as low as one hand wash per employee hour. For the more discerning risk-adverse casual dining operator, three hand washes per hour is a good standard.

Handwashing frequency should not be established purely by the clock. Food workers must understand and connect their own behaviors as the triggers to handwashing. The need to wash is driven by specific tasks, task changes and personal behaviors.

Where to Wash

Restrooms are important handwashing stations but they are also a troubling source of cross-contamination. The most common route of foodborne outbreaks starts with invisible fecal matter, fecal-hand-oral.

Ill people are heavy users of washrooms, endangering all who follow. Should those accidental encounters reach the food flow, one unwashed hand can affect many. This restroom handwash is at the top of the priority list.

Kitchen handwashing is an obvious must, starting with the return of each employee regardless of his or her reason for leaving. For those returning from the restroom, this means an immediate second wash. This is a matter of monitoring and control.

How to Wash

Everyone knows how to wash their hands. Everyone has been doing this for years by the time they enter a professional kitchen. This level of experience actually becomes a barrier to understanding the difference required in professional handwashing. The splash-n-dash handwash is often seen as sufficient until we visually and personally experience the difference, aided by using tracer lotion and a UV light.

The steps of a professional handwash are:

Wet/Pre-rinse with warm water
Take liquid or foam soap
Lather aggressively for 15-20 seconds
Rinse thoroughly (to avoid drying of the skin)
Dry with a single-use paper towel

If faucets are manual, it is recommended to turn off the water with the paper towel. A much better solution is the use of electronic faucets for their hygiene advantage but also the labor saving speed factor and water savings. Nearly one gallon of heated water is saved for each handwash.

Fused-bristle nailbrushes speed effective washing and should be used for all handwashes done on returning to the kitchen.

Adding the application of hand sanitizer is another performance booster to consider, particularly when serving the immune compromised. Children, the elderly, pregnant women and those taking medicines for ongoing conditions lead this group, estimated as 20% of the general population.

No-Water Hand Sanitizing & Cleansing

The Blackberry/cell phone/multi-tasking/grazing public increasingly demands foodservice that fits smoothly into their away-from-home trail. Foodservice situations develop far from a water supply and a handsink. While alcohol hand sanitizers are proven resources at these locations, those people preparing and serving food and beverage need to add a cleaning step by using the SaniTwice® technique. Hand sanitizer is applied in a heavier dose and scrubbing for 15-20 seconds follows, with plenty of friction to loosen contaminants. While the hands are still wet, this first application is wiped off with a paper towel, sending all the suspended soil and germs into the waste receptacle. A sec ond application of hand sanitizer follows, killing any residual pathogens.

This SaniTwice intervention is particularly important for Norovirus and H1N1 virus control as these troublemakers come in the front door of an establishment via ill customers. New hand sanitizers are now available, developed specifically for these front-door pathogens.

Conclusion

Remember Mom … and the CDC: Handwashing is the single most important means of preventing the spread of infection.

Hand hygiene’s best practices pay food safety dividends, protecting your health and the health of your business.