Hand Hygiene

Hand Hygiene

This post was initially drafted last year, when hand hygiene was not a pandemic issue. The reason I started this post was that The Guardian (April 2019) printed a long article on the issues of hand washing, and the politics of drying hands that intrigued me, and brought up issues I had not considered before.

I was intrigued because it has always been a general and consistent issue with health workers, and people who work anywhere in the food system (from farms, to restaurants, to home cooks). Properly washing and drying hands have a certain complexity most of us would have never considered in times before the pandemic. Now however, our “normal” has changed and how to correctly wash-n-dry hands is a legitimate conversation topic.

Proper Hand Washing

Kaiser indicates that proper hand washing involves these steps:

• Wetting your hands and applying soap
• Rubbing your hands together and scrubbing them, front and back, including wrists and under fingernails
• Scrub for 20 seconds, about the time it takes to sing “Happy Birthday” twice through
• Rinsing hands well under running water
• Drying hands using a paper towel or air dryer.
• If you’re drying with a paper towel, use it to turn off the faucet

Drying Hands Is Also Important

Due to the Pandemic, folks have focused on washing hands; however, the overall process to keep your hands clean is not limited to washing, it also must include drying.

• BusinessInsider writes, washing your hands frequently and thoroughly is one of the most important ways to protect yourself and others from the novel coronavirus. But drying your hands properly is just as important since wet or moist hands can breed germs.  Different drying methods have different levels of effectiveness…. 

Did You Wash Your Hands?

With cooking and working in a cooking school, this question is always asked of students: did you wash your hands? It is asked after handling meat (especially chicken), after putting something in your mouth or scratching your nose, and after going to the bathroom. Did you wash your hands? During these pandemic times, that question is not just cropping up in the kitchens, but in households generally as washing hands is the primary way to limit the spread of COVID-19.

Gender Differences

According to Verge, a study in the UK found that while 99% of people said they washed their hands after visiting the restroom, recording devices showed that only 32% men and 64% women actually had. These percentages have been proven over and over again — men tend not to wash their hands after a restroom visit, more so than women. All of us know we should wash our hands after using the restroom, but many tend to skip that part.

Hand Adornments

Policies on wearing jewellery in kitchen prepping and cooking areas can differ from business-to-business and from country-to-country.

The reason to not wear jewelry, is that effective hand washing is limited by jewelry, such as rings. Jewelry may accidentally drop into food (just like uncovered hair) causing a foreign matter contamination issue. Touching jewelry –such as earrings in ears, noses, tongues and other facial areas — can result in inadvertent hand contact with bacteria filled bodily fluids. And finally there is a general safety concept, that there is an increased risk of personal injury when jewellery can get caught in moving machinery parts or equipment.

If you wear jewelry, you may be asked to wear gloves when handling food, the same with false nails or if you have any injuries to the hands.

In the health industry they are also suggesting that the removal of false nails (1), and the use of waterless, alcohol-based skin sanitizer can help lower risk. InfectionControlToday writes that studies show that the time it takes to effectively degerm your hands with soap and water is between 10 and 60 seconds. It takes the active antimicrobial ingredients in soaps up to 60 seconds to destroy most organisms.

However, in the food industry nothing beats actual hand washing. First, cooks‘ hands are often wet and contaminated with fatty or high protein material. Alcohol-based sanitizers cannot remove all these materials and have a reduced efficacy in the presence of these materials. Second, while norovirus is the leading cause of foodborne outbreaks, sanitizers do not kill the norovirus.

Toilet Differences

One of the issues has to do with the toilets and the facilities we use. Two items specifically come to my mind. I am not sure if these two items were reviewed in the studies I cite above, or would change the outcomes.

• First, is that work toilets tend to not have lids, while home toilets do. In the first case it means when flushing, the particulate cannot help but be thrown in the air. In the second case, there can be some limiting qualities of a lid, and perhaps it can keep more of the sprayed particulates in the toilet.
• Second, is that at public places toilets in the USA have minimal barriers between them, in other words the stalls have large openings on the top and bottom of of the panels which allows particulates to travel further. If we had enclosed toilets, as used in non-gendered restrooms, it might limit the particulate spread to the room in which the toilet sits.

Another study tested the dispersal of bacteria in restrooms. The study says most of us do not wash our hands adequately (if we do), so there is a high percentage of fecal and other matter that can remain on our hands when we start to dry. The study concluded: The choice of hand‐drying device should be considered carefully in areas where infection prevention concerns are paramount, such as healthcare settings and the food industry. Obviously the air drying method disbursed bacteria further and wider than paper towels.

In real life, ScienceAlrt tells us, we have lived with toilets and sinks, paper towels and air blowers, and most of us have not come down with a disease. While a bit of this hypersensitivity of drying seems overblown, with a high “yuck” factor, the issue really is this: if you are in the medical or food industries, after using the restroom, you need to properly wash your hands and dry them before returning to work.

Best Way to Dry Hands

These days, in many (but not all) places of the world, washing hands can happen, but how do you dry them? Do you use the air-dryer, paper towels, or cloth towels?

Originally, cloth towels were used everywhere, but quickly were converted to brown or white paper towels (except in expensive spa areas). Now paper towels seem to be old technology and air blowers are the high tech answer to this activity.

But which is cleaner?

A Mayo Clinic research study reports: The transmission of bacteria is more likely to occur from wet skin than from dry skin; therefore, the proper drying of hands after washing should be an integral part of the hand hygiene process in health care. A literature search was conducted in April 2011, [and] this review found little agreement regarding the relative effectiveness of electric air dryers. However, most studies suggest that paper towels can dry hands efficiently, remove bacteria effectively, and cause less contamination of the washroom environment. From a hygiene viewpoint, paper towels are superior to electric air dryers. Paper towels should be recommended in locations where hygiene is paramount [snip].

One of the Chefs I work with does not like air dryers. His argument? When you are in a bathroom, and flush, the particulates get into the air. So if using an air dryer guess what is blowing all over your hands? (This is also why you take off your apron and leave it in the kitchen before using the bathroom.) His opinion is backed up by studies showing: when someone flushes an open toilet, little bits of poop and bacteria can be thrown as high as 15 feet (4.5 metres) into the air. Gross, right?

My Work Cleaning Techniques

At the kitchen school, we follow California food handling regulations.

• I wash my hands first thing when I come into the kitchen to start, and anytime I touch my body or handle meat. (I find I tend to touch my face a lot; a scratch here, an itch there, or my hair as it has a mind of its own sometimes)
• I always use paper towels to dry my hands after washing up
• We have blue damp cloths for use that day to wipe up debris on the table and knives
• The Chefs have white dry cloths for an every day use to wipe hands on in between cooking activities, unless meat is involved
• All cloth towels are washed daily

My Home Cleaning Techniques

At home, as I stated before, we have less regulations to follow.

• I wash my hands to start the cooking process, and anytime I touch meat
  • I wash with a mild soap unless my hands are oily, then I go for dishwashing liquid (Dawn)
• To dry I have paper towels and kitchen (microfiber and cotton) towels
  • I generally dry on a kitchen towel when cooking vegetarian or vegan, but if I am handing meat, fish or fowl I always use paper towels
• Most often I use the kitchen towels to: hold my hot tea kettle while I pour; wipe veggie, herbs, and spice debris off my hands; pull hot food out of the microwave; and and to soak up water or tea spills on the counter
  • I will toss the kitchen towel in the laundry after a day of cooking and prepping as it is fairly dirty by then and needs cleaning; otherwise at least once a week
  • When contaminated by sauces, oil, or meat drippings, or if used on the floor as an emergency spill picker-upper, I change the kitchen towel immediately
• If I cut myself, and yes it does happen, I grab a paper towel and not the kitchen towel
• Scientific studies suggest a daily hot-water washing of kitchen towels, with heat drying (and no fabric softener) is best (1)
• I hang my towels up properly to dry in between use and never leave them in a bundle or knot, so they dry thoroughly
• My kitchen is not damp which lessens bacteria breeding

Historically, we have done all this to assure no one becomes sick due to our cooking efforts. Now, given the pandemic, proper hand washing and drying is a way to assure we are not personally passing on the COVID-19, or any other virus.

Safety Requires Clean Water

A note about “everyone having clean water” with which to wash hands and to keep conditions sanitary.

• CDC reports that an estimated 790 million people (11% of the world’s population) [are] without access to an improved water supply. An estimated 1.8 billion people (25% of the world’spopulation) [are] without access to adequate sanitation.
• WHO: 2 billion people worldwide use a drinking-water source contaminated with feces, so washing hands to help limit the spread of a virus is not feasible. Only 71% of the worlds population has access to managed, clean water.

YES, as a world we are all in the middle of a pandemic and are subject to its impacts. But NO, we do not experience this pandemic similarly. I recognize, and publicly admit, how damn lucky I am. A graphic I saw recently, sums it up best.

• There are a variety of ships and boats in a storm, the storm is the pandemic, and from row boat to yacht to battle ship is each of us. We are in the storm together, but our vehicles are widely different.

–Patty

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TIP: If you have a jar of jam and cannot get it all out, add oil and vinegar to the jar, shake, and make a fruit flavored salad dressing.

NEWS: Delish reports that during the Pandemic stores are banning reusable bags, just as Starbucks and Peets are banning reusable coffee cups. These are temporary bans, and in place with the intent to keep everyone safe. Meanwhile, FoodandWine reports that San Francisco has temporary rescinded the plastic bag ban, again in concerns of the Pandemic. The question is, what will returning to normal be? With or without disposable bags, cups, etc.?

TIP: I find raw or cooked kale too bitter. So, in my house kale is chopped (stem and all) into smallish ribbons, put into a colander and massaged roughly under running cold water. I saw this on a cooking show, tried it, and was surprised because it worked.

Running out of TP? Try online ordering from Restaurant Supply houses. The TP may not fit on your rollers, I find that the usual commercial size is ~1” too wide, but they have them available because all the businesses are closed and are not ordering refills.