Prevention of food worker transmission of foodborne pathogens: risk assessment and evaluation of effective hygiene intervention strategies

Abstract

The infected food handler can be responsible for the transmission of infectious intestinal diseases (IID) caused by foodborne pathogens. It is believed that personal hygiene practices with varying levels of complexity can help prevent foodborne pathogens from entering the food chain. Overall, it has been difficult to reach a consensus among stakeholders on precisely which intervention measures should be employed in food handling environments to effectively reduce IID rates. Through a study of over 300 reports of outbreaks attributed to ill or asymptomatic food handlers, hazards and contributory factors responsible for foodborne illness outbreaks were identified. With the use of the risk analysis software platforms of Analytica®, @Risk, and GoldSim®, models were created to explore measures of hygiene effectiveness. Through the use of appropriate models, results of various personal hygiene intervention measures were explored for the development of preventive management strategies, designed to improve food‐handling practices at various levels of the food chain. These included exclusion of ill food handlers, vaccination for hepatitis A virus, handwashing combined with drying, wearing of gloves, and use of instant hand sanitizers and fingernail brushes. This was accomplished by modeling pathogen transfer and transmission routes from food handler via foods, beverages and common contact surfaces using GoldSim® and Monte Carlo simulations. A lottery model was also created to understand risk as an interrelated overlapping extremes driven system, comprised of the three components of hygiene frequency, efficacy and cross‐contamination. Data gaps were identified with respect to areas where considerable variability and uncertainty exists in order to establish research priorities.

Contamination of Fresh Produce by Microbial Indicators on Farms and in Packing Facilities: Elucidation of Environmental Routes

“…Though no other studies to date that we know of have quantified the relationships of microbes between hands and produce in the agricultural environment, this implication is consistent with those of other studies suggesting that hands are an important vehicle of contamination of produce (13,(33)(34)(35)(36). We hypothesize that microorganisms measured in our study could have been transferred either from hands to produce or produce to hands, as has been demonstrated to occur (33,(37)(38)(39). These findings and our hypothesis led to testing the effectiveness of hand hygiene interventions (soap, hand sanitizer) to improve the microbial quality of hands and produce (33,34).…”

The Level of Compliance of Food Handlers with National Regulations on Food Hygiene and Safety Practices: A Case of Selected Fast Food Outlets in Thohoyandou, South Africa

“…Food workers may transmit pathogens to food coming from a contaminated surface of another food, or from hands contaminated with organisms from their gastrointestinal tract. This is also supported by report in which about 89% of outbreaks caused by food contamination by food workers, pathogens were transferred to food by workers' hands (Michaels et al, 2004).…”

Social Influence in Child Care Centers: A Test of the Theory of Normative Social Behavior

“…In terms of message development, the findings of this study suggest that interventions might focus on developing messages to strengthen injunctive norms at a given center. Similar to the situation in hospitals and food preparation contexts (Creedon, 2005;Michaels et al, 2004;Pittet, 2001), hand hygiene policies and enforcement in child care centers did not explain significant variance in reported handwashing. Thus, this study focused on the influence of social norms on reported handwashing, and found significant effects.…”