Efficacy of EPA-registered disinfectants against two human norovirus surrogates and Clostridioides difficile endospores.

AIMS: To determine the efficacy of a panel of nine EPA-registered disinfectants against two human norovirus (HuNoV) surrogates (feline calicivirus [FCV] and Tulane virus [TuV]) and Clostridioides difficile endospores. METHODS AND RESULTS: Nine EPA-registered products, five of which contained H2 O2 as active ingredient, were tested against infectious FCV, TuV and C. difficile endospores using two ASTM methods, a suspension and carrier test. Efficacy claims against FCV were confirmed for 8 of 9 products. The most efficacious product containing H2 O2 as ingredient achieved a >5.1 log reduction of FCV and >3.1 log reduction of TuV after 5 min, and >6.0 log reduction of C. difficile endospores after 10 min. Of the five products containing H2 O2 , no strong correlation (R2  = 0.25, p = 0.03) was observed between disinfection efficacy and H2 O2 concentration. Addition of 0.025% ferrous sulphate to 1% H2 O2 solution improved efficacy against FCV, TuV and C. difficile. CONCLUSION: Disinfectants containing H2 O2 are the most efficacious disinfection products against FCV, TuV and C. difficile endospores. Product formulation, rather than the concentration of H2 O2 in a product, impacts the efficacy of a disinfection product. SIGNIFICANCE AND IMPACT OF STUDY: H2 O2 -based disinfectants are efficacious against surrogate viruses for HuNoV and C. difficile endospores.

Perceived challenges in implementing halal standards by halal certifying bodies in the United States.

Islamic dietary laws inform halal standards, defining which foods are halal (lawful and permissible). Many halal foods are produced in non-Muslim majority countries increasing the likelihood they might be haram (prohibited). Halal certification is one way to operationalize halal standards, hence protecting Muslim consumers. At present there is no unified halal standard guiding halal certification. The aim of this study was to determine the perceived challenges in implementing halal standards in the United States. Semi-structured in-depth interviews were done with a representative from 6 of the 11 halal certifying bodies (HCBs) in the United States. All reported their role was to verify food safety records for compliance with government regulations but not to monitor food safety practices. Two main issues-forged halal certificates and expired halal logos were identified as significant issues. Three HCBs stated there is no problem with having multiple halal standards, but all believed it is necessary to have one universal halal standard with minimum standards followed by everyone. The findings of this study can be beneficial to the U.S. halal industry as it highlights the challenges and issues they face.

Molecular Detection of Salmonella spp. and E. coli non-O157:H7 in Two Halal Beef Slaughterhouses in the United States.

The aim of this study was to estimate the prevalence of pathogenic bacteria on halal beef carcasses and environmental surfaces in two halal beef slaughterhouses in the United States. To evaluate halal beef slaughter operations, 144 beef carcass samples (pre- and post-evisceration), and 24 environmental site samples (slaughter hall floor, brisket saw, and offal's table) were collected in two halal beef slaughterhouses during June to September 2017. All carcass and environmental samples were analyzed for the presence of Salmonella spp., Escherichia coli O157:H7, and shiga toxin-producing E. coli (non-O157 STEC). Results revealed that Salmonella spp. was isolated and confirmed for the presence of invA gene in 5/36 samples (13.8%) and 5/36 samples (13.8%) at pre-evisceration in plants A and B, respectively. Salmonella spp. was isolated in 2/9 samples (5.6%) of plants A and was not detected in any sample at post-evisceration process. E. coli O157:H7 was not detected in any sample collected from plant A and B. E. coli non-O157 was isolated and confirmed for the presence of virulence genes in 4/36 samples (11.1%) and 2/36 samples (5.5%) at post-evisceration in plants A and B, respectively. Salmonella spp. was detected based on the presence of the Salmonella invA gene in the slaughter hall floor (4/4) and the offal's table (2/4) samples using multiplex polymerase chain reaction (mPCR). In plant B, Salmonella spp. was also confirmed in the slaughter hall floor (2/4) and brisket saw (2/4) samples. On the other hand, one isolate of E. coli O157:H7 and one non-O157 STEC were obtained from the slaughter hall floor of plant A. The E. coli O157:H7 isolate was positive for stx1, stx2, eaeA, and EHEC-hly genes. Two isolates of non-O157 STEC (2/4) were detected in the environmental site samples, one from the slaughter hall floor, and one from an offal's table sample of plant B. These data can be used to inform food safety interventions targeting halal meat operations in the southeastern United States.

Evaluating the Alignment and Quality of Microgreens Training Materials Available on the Internet: A Content Analysis.

Interest in microgreens, young, edible seedlings of a variety of vegetables, spices, and herbs, is growing worldwide. A recent national survey of the U.S. microgreen industry reported 48% of 176 growers learned to grow microgreens by viewing websites and videos on the internet. However, it is unknown if the content related to growing microgreens is aligned with regulations and clearly presented. The aim of this research was to conduct a content analysis to determine alignment with the Food Safety and Modernization Act Produce Safety Rule (PSR)and the presentation quality of existing microgreen training materials available on the internet. Microgreen training materials were collected using two search engines - Google and YouTube. A deductive approach was used to inform the development of three coding manuals to evaluate the training materials meeting the eligibility criteria. One was used to determine the alignment of the content and was based on the PSR. The other two manuals were used to determine the presentation quality of Google and YouTube training materials according to CDC's Quality E-learning Checklist. A total of 223 training materials (86 Google and 137 YouTube), which fulfilled the inclusion criteria, were selected for the analysis. The results of the alignment with the PSR revealed that both sources minimally covered food safety principles with several areas minimally or not addressing specific information (e.g., water testing, worker training, environmental monitoring, and record keeping). In addition, some food safety information was unclear or presented conflicting information (e.g., requirement of washing microgreens, cleaning and sanitization methods, seed treatment methods, and waste management). The Google and YouTube quality scoring systems resulted in a mean quality score of 15.81 and 22 of a maximum score of 28, respectively. These findings indicate the quality and alignment with the PSR of microgreen training materials need to be improved.

Relationship between ATP Bioluminescence Measurements and Microbial Assessments in Studies Conducted in Food Establishments: A Systematic Literature Review and Meta-Analysis.

ABSTRACT: Adherence to proper environmental cleaning practices is critical in food establishments. To validate cleanliness, cleaning practices should be routinely monitored, preferably by a rapid, reliable, and cost-effective method. The aim of this study was to determine whether a correlation exists between ATP bioluminescence measurements and selected microbial assessments in studies conducted in food establishments. A systematic literature review and meta-analysis was conducted using the principles of preferred reporting items for systematic reviews and meta-analyses. Twelve online databases and search engines were selected for the review. Peer-reviewed articles published in English between January 2000 and July 2020 were included in the search. From a total of 19 eligible studies, 3 that included Pearson correlation coefficients (r) between ATP bioluminescence measurements and microbial assessments were used for the meta-analysis calculations. Only the fixed-effect model produced a strong correlation because one value dominated the estimates: r = 0.9339 (0.9278, 0.9399). In contrast, both the random effects model, 0.2978 (0.24, 0.3471), and the mixed effects model, r = 0.3162 (-0.0387, 0.6711), indicated a weak relationship between ATP bioluminescence and microbial assessments, with no evidence of a strong correlation. The meta-analysis results indicated no sufficient evidence of a strong correlation between ATP bioluminescence measurements and microbial assessments when applied within food establishments. This lack of evidence for a strong correlation between the results of these two monitoring tools suggests that food establishments cannot depend on only one method. Yet, with immediate feedback and quantification of organic soiling, ATP bioluminescence could be an effective monitoring tool to use in food establishments.

Hygienic monitoring in long-term care facilities using ATP, crAssphage, and human noroviruses to direct environmental surface cleaning.

BACKGROUND: Norovirus and C. difficile are associated with diarrheal illnesses and deaths in long-term care (LTC) facilities and can be transmitted by contaminated environmental surfaces. Hygienic monitoring tools such as adenosine triphosphate (ATP) bioluminescence and indicators of fecal contamination can help to identify LTC facility surfaces with cleaning deficiencies. METHODS: High-touch surfaces in 11 LTC facilities were swabbed and tested for contamination by norovirus, a fecal indicator virus, crAssphage, and ATP which detects organic debris. High levels of contamination were defined as log ATP relative light unit values or crAssphage log genomic copy values in the 75th percentile of values obtained from each facility. RESULTS: Over 90% of surfaces tested positive for crAssphage or gave failing ATP scores. Norovirus contamination was not detected. Handrails, equipment controls, and patient beds were 4 times more likely than other surfaces or locations to have high levels of crAssphage. Patient bed handrails and tables and chairs in patient lounges had high levels of both ATP and crAssphage. CONCLUSIONS: Surfaces with high levels of ATP and crAssphage were identified. Quantifying levels of contamination longitudinally and before and after cleaning might enhance infection prevention and control procedures for reducing diarrheal illnesses in LTC facilities.

New Approach to Food Safety Training: A Review of a Six-Step Knowledge-Sharing Model.

Significant resources, including both human and financial capital, have been dedicated to developing and delivering food handler training programs to meet government and organizational mandates. Even with the plethora of food safety-oriented training programs, there is scant empirical evidence documenting effectiveness, suggesting the need to rethink the design and delivery of food safety training for food handlers. One underlying assumption of most training programs is that food handlers engage in unsafe practices because of lack of knowledge. As a result, many training curricula are designed to improve knowledge, assuming behavior will change as knowledge increases. However, food handlers often return to the work environment and try to implement the new knowledge with minimal success. One explanation for this is that the training context and the implementation context often differ, making it difficult for the food handler to transfer what they learned into practice. Understanding the connection between knowledge, the organization, and its environment is critical to knowledge implementation. The focus of this review is to describe a six-step knowledge-sharing model. Here, knowledge sharing is broadly defined as the process of creating and then using knowledge to change a practice or behavior. Our proposed knowledge-sharing model includes six steps: generation, adaptation, dissemination, reception, adoption, and implementation. We have organized this model into two dyads: (i) transfer between researcher (i.e., knowledge generators) and educator and (ii) transfer between educator and food handler (i.e., knowledge implementers). To put into practice this proposed model for developing and delivering effective food safety training for food handlers, we have provided suggested actions that can be performed within each step of the knowledge-sharing process.

Factors associated with environmental service worker cleaning practices in health care settings: A systematic review of the literature.

INTRODUCTION: Health care-associated infections can be reduced through better environmental disinfection practices. Central to effective disinfection is the environmental service worker (ESW). The aim of this systematic literature review was to identify factors associated with the disinfection practices of ESWs in health care settings. METHODS: A systematic literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses principles. Ten online databases and search engines were selected for the review of English-language studies published between 2000 and 2019. RESULTS: Thirty-one (31) eligible studies were identified. Environmental disinfection was associated with many factors (eg, knowledge, perceptions) as well as ESW exposure to education/training sessions. When education/training was combined with performance evaluation/feedback, significant improvement in ESW disinfection practices was reported. CONCLUSIONS: To sustain improvements in disinfection practices, education/training sessions need to be continuous. The long-term commitment of an organization is also essential for continuous improvement in disinfection outcomes. While knowledge transfer is critical for behavior change, education/training also needs to focus on the skills and perceptions of ESWs. Future studies need to use a randomized controlled design with larger sample sizes to determine a true effect.

Surveying the food safety training needs of environmental health specialists in the U.S.

As part of a U.S. Department of Agriculture Cooperative State Research, Education, and Extension Service grant, six focus group sessions on the topic of food safety education and training were held June 24, 2008, at NEHA's Annual Educational Conference & Exhibition in Tucson, Arizona. A total of 30 participants attended one of the six 50-minute sessions. Participants were NEHA conference attendees and nearly all stated they had a food safety training and education role in their job. A series of questions related to food safety at retail and food service levels was asked. This report summarizes some of the opinions provided by focus group participants.

A Review of State Licensing Regulations to Determine Alignment with Best Practices to Prevent Human Norovirus Infections in Child-Care Centers.

OBJECTIVES: Close, frequent contact between children and care providers in child-care centers presents many opportunities to spread human noroviruses. We compared state licensing regulations for child-care centers with national guidelines written to prevent human noroviruses. METHODS: We reviewed child-care licensing regulations for all 50 U.S. states and the District of Columbia in effect in June 2015 to determine if these regulations fully, partially, or did not address 14 prevention practices in four topic areas: (1) hand hygiene, (2) exclusion of ill people, (3) environmental sanitation, and (4) diapering. RESULTS: Approximately two-thirds (8.9) of the 14 practices across all state regulations were partially or fully addressed, with few (2.6) fully addressed. Practices related to exclusion of ill people and diapering were fully addressed most often, while practices related to hand hygiene and environmental sanitation were fully addressed least often. CONCLUSION: Regulations based on guidelines for best practices are one way to prevent the spread of human noroviruses in child-care facilities, if the regulations are enforced. Our findings show that, in mid-2015, many state child-care regulations did not fully address these guidelines, suggesting the need to review these regulations to be sure they are based on best practices.

Content Analysis of Vomit and Diarrhea Cleanup Procedures To Prevent Norovirus Infections in Retail and Food Service Operations.

Human noroviruses are the leading cause of foodborne disease in the United States, sickening 19 to 21 million Americans each year. Vomit and diarrhea are both highly concentrated sources of norovirus particles. For this reason, establishing appropriate cleanup procedures for these two substances is critical. Food service establishments in states that have adopted the 2009 or 2013 U.S. Food and Drug Administration Food Code are required to have a program detailing specific cleanup procedures. The aim of our study was to determine the alignment of existing vomit and diarrhea cleanup procedures with the 11 elements recommended in Annex 3 of the 2011 Supplement to the 2009 Food Code and to determine their readability and clarity of presentation. In July 2015, we located vomit and diarrhea cleanup procedures by asking Norovirus Collaborative for Outreach, Research, and Education stakeholders for procedures used by their constituency groups and by conducting a Google Advanced Search of the World Wide Web. We performed content analysis to determine alignment with the recommendations in Annex 3. Readability and clarity of presentation were also assessed. A total of 38 artifacts were analyzed. The mean alignment score was 7.0 ± 1.7 of 11 points; the mean clarity score was 6.7 ± 2.5 of 17 points. Only nine artifacts were classified as high clarity, high alignment. Vomit and diarrhea cleanup procedures should align with Annex 3 in the Food Code and should, as well, be clearly presented; yet, none of the artifacts completely met both conditions. To reduce the spread of norovirus infections in food service establishments, editable guidelines are needed that are aligned with Annex 3 and are clearly written, into which authors could insert their facility-specific information.

Hygienic conditions in child-care facilities in North Carolina and South Carolina: an integrated microbial and observational study.

BACKGROUND: In the United States almost one-quarter (23%) of children younger than age 5 years participate in some form of out-of-home child care; these children are 2.3-3.5 times more likely to contract acute gastrointestinal illness. METHODS: Observational investigations were done to understand the hygienic conditions and practices of 40 child-care facilities in North Carolina and South Carolina. These data were compared with microbiological indicator data (aerobic plate counts and coliform counts) collected from selected surfaces in each facility. Results from the two data sets were analyzed using nonparametric statistical methods to reveal potential risk factors for enteric disease transmission. RESULTS: Statistically significant differences (P ≤ .05) in surface microbial counts were observed when comparing family child-care homes versus centers and between facilities participating in the Child and Adult Care Food Program and those that do not participate. Facilities without written surface cleaning or food preparation policies had statistically significantly higher microbial counts on surfaces. CONCLUSIONS: Our unique study, which combined observational and microbiological data, provided revealing information about the relationship between hygiene indicators and sanitary practices in child-care facilities in the southeastern United States.

Preventing food-borne illness in food service establishments: Broadening the framework for intervention and research on safe food handling behaviors.

Unsafe food handling practices in food service establishments are a major contributor to the transmission of food-borne illness. However, current worker education and training interventions demonstrate only modest success in changing food service worker behavior. We argue for more ecologically-oriented interventions that address both individual and contextual factors that influence safe food handling behaviors. We describe potential predisposing influences (e.g. knowledge, beliefs concerning risk of food-borne illness, perceived control, self-efficacy), enabling influences (e.g. intensity and quality of training, work pressure and pace, safety procedures and protocols, appropriate equipment) and reinforcing influences (e.g. management enforcement of policies, incentives for safe food handling, job stress and organizational justice) on worker behavior. Efforts to change food service workers' behaviors are more likely to be effective if they pay greater attention to the ecological context, address multiple influences on worker behavior, and view workers as partners in preventing food-borne illness in food service establishments.

Effectiveness of Cold-serving Units Using Two Cold-holding Methods in Foodservice Operations 1.

Effectiveness of two cold-holding methods commonly used to maintain temperatures of products held on cold-serving units (CSU) was determined by time-temperature and bacterial growth patterns of three products. Products used were bulk (2.27 kg) and portioned (100 g) cottage cheese, portioned (100 g) tuna salad, and deviled eggs halves (100 ± 10 g). All products were held on a cold-serving unit using the mechanical/ice cold-holding method (mechanical cooling used in combination with 3 to 10 cm ice) for 24 h (control; laboratory setting), as well as on three separate cold-serving units using the mechanical cold-holding method (at three university residence hall field sites under actual operating conditions) for 4 h (maximum length of service). Temperatures of all bulk and portioned products held on CSUs using the mechanical/ice cold-holding method (initial temperatures of food were 4 to 8.2°C) were >7.2°C after 2 h with a 50% load factor. When the mechanical cold-holding method was used, all portioned products (initial temperatures were 8.2 to 11°C) were <7.2°C after 2 h with a 75% load factor. Temperature differences between the mechanical and mechanical/ice cold-holding methods were attributed to ice on the cold-serving unit. The ice insulated the products from the mechanically cooled basin and allowed internal temperatures of the products to increase. Statistical significance for bacterial growth patterns was reported only for products held on cold-serving units using the mechanical/ice cold-holding method: mesophilic growth in deviled eggs (p<0.05) and psychrotrophic growth in tuna salad (p<0.001). As expected, bulk cottage cheese had a significantly higher temperature over time (p<0.05) than did portioned cottage cheese for both methods of cold-holding. Based on results of this study, portioned foods on cold-serving units should be held less than 2 h when the mechanical/ice cold-holding method is used, or up to 4 h when the mechanical cold-holding method is available.