Hand Washing Compliance among Retail Food Establishment Workers in Cartagena de Indias, Colombia
Keywords:
Hand Washing, Retail Food Establishment, ColombiaAbstract
Inadequate hand washing by food workers is an important contributing factor to foodborne disease outbreaks in retail food establishments (RFEs). We conducted a survey of RFEs to investigate the effect of hand washing training, availability of hand washing facilities, and the ability of the person in charge (PIC) to describe hand washing according to the Ministry of Health and Social Protection on workers’ ability to demonstrate food code–compliant hand washing. Only 52% of the PICs could describe the hand washing procedure outlined in the food code, and only 48% of workers could demonstrate code-compliant hand washing. The most common problems observed were failure to wash for 20 s and failure to use a fingernail brush. There was a strong positive association between the PIC being a certified food manager and being able to describe the food code hand washing procedure (odds ratio [OR], 5.5; 95% confidence interval [CI], 2.2 to 13.7), and there was an even stronger association between the PIC being able to describe hand washing and workers being able to demonstrate code-compliant hand washing (OR, 15; 95% CI, 6 to 37). Significant associations were detected among correct hand washing demonstration, physical infrastructure for hand washing, and the hand washing training methods used by the establishment. However, the principal determinant of successful hand washing demonstration was the PIC’s ability to describe proper hand washing procedure. These results suggest that improving hand washing practices among food workers will require interventions that address PIC knowledge of hand washing requirement and procedure and the development and implementation of effective hand washing training methods.
References
Bean, N. H., J. S. Goulding, C. Lao, and F. J. Angulo. 1996. Surveillance for foodborne-disease outbreaks—United States, 1988–1992. MMWR CDC Surveill. Summ. 45:1–66.
Campbell, M. E., C. E. Gardner, J. J. Dwyer, S. M. Isaacs, P. D. Krueger, and J. Y. Ying. 1998. Effectiveness of public health interventions in food safety: a systematic review. Can. J. Public Health 89:197–202.
Clayton, D. A., C. J. Griffith, P. Price, and A. C. Peters. 2002. Food handlers’ beliefs and self-reported practices. Int. J. Environ. Health Res. 12:25–39.
Cotterchio, M., J. Gunn, T. Coffill, P. Tormey, and M. A. Barry. 1998. Effect of a manager training program on sanitary conditions in restaurants. Public Health Rep. 113:353–358.
Curtis, V., and S. Cairncross. 2003. Effect of washing hands with soap on diarrhoea risk in the community: a systematic review. Lancet Infect. Dis. 3:275–281.
Drankiewicz, D., and L. Dundes. 2003. Hand washing among female college students. Am. J. Infect. Control 31:67–71.
Duse, A. G., M. P. da Silva, and I. Zietsman. 2003. Coping with hygiene in South Africa, a water scarce country. Int. J. Environ. Health Res. 13(Suppl. 1):S95–105.
Ebel, B. E., T. D. Koepsell, E. E. Bennett, and F. P. Rivara. 2003. Use of child booster seats in motor vehicles following a community campaign: a controlled trial. JAMA 289:879–884.
Guinan, M. E., M. McGuckin-Guinan, and A. Sevareid. 1997. Who washes hands after using the bathroom? Am. J. Infect. Control 25: 424–425.
Hoque, B. A., D. Mahalanabis, M. J. Alam, and M. S. Islam. 1995. Post-defecation hand washing in Bangladesh: practice and efficiency perspectives. Public Health 109:15–24.
Jones, T. F., B. I. Pavlin, B. J. LaFleur, L. A. Ingram, and D. W. Schaffner. 2004. Restaurant inspection scores and foodborne disease. Available at: http://www.cdc.gov/ncidod/EID/vol10no4/03-0343. htm. Accessed March 2004.
Mathias, R. G., R. Sizto, A. Hazlewood, and W. Cocksedge. 1995. The effects of inspection frequency and food handler education on restaurant inspection violations. Can. J. Public Health 86:46–50.
Mead, P. S., L. Slutsker, V. Dietz, L. F. McCaig, J. S. Bresee, C. Shapiro, P. M. Griffin, and R. V. Tauxe. 1999. Food-related illness and death in the United States. Emerg. Infect. Dis. 5:607–625.
Oteri, T., and E. E. Ekanem. 1989. Food hygiene behaviour among hospital food handlers. Public Health 103:153–159.
Sattar, S. A., V. S. Springthorpe, J. Tetro, R. Vashon, and B. Keswick. 2002. Hygienic hand antiseptics: should they not have activity and label claims against viruses? Am. J. Infect. Control. 30:355–372.
Sharek, P. J., W. E. Benitz, N. J. Abel, M. J. Freeburn, M. L. Mayer, and D. A. Bergman. 2002. Effect of an evidence-based hand washing policy on hand washing rates and false-positive coagulase negative Staphylococcus blood and cerebrospinal fluid culture rates in a level III NICU. J. Perinatol. 22:137–143.
Sobel, J., B. Mahon, C. E. Mendoza, D. Passaro, F. Cano, K. Baier, F. Racioppi, L. Hutwagner, and E. Mintz. 1998. Reduction of fecal contamination of street-vended beverages in Guatemala by a simple system for water purification and storage, hand washing, and beverage storage. Am. J. Trop. Med. Hyg. 59:380–387.
SECTORIAL COLOMBIANA 007. NORMA TÉCNICA NTS-USNA. NORMA SANITARIA DE MANIPULACIÓN DE ALIMENTOS. SANITARY STANDARD FOR FOOD HANDLING.
U.S. Food and Drug Administration. 2000. Report of the FDA retail food program database of foodborne illness risk factors. Available at: http://www.cfsan.fda.gov. Accessed January 2004.
U.S. Public Health Service. 2001. FDA food code. Food and Drug Administration, Washington, D.C.
Weinstein, J., T. Oteri, and E. E. Ekanem. 1991. The clean restaurant, II: employee hygiene. Restaurants Inst. 101:138–139, 142, 144 passim.
