Factors related to food worker hand hygiene practices.

To identify factors related to food worker hand hygiene practices, we collected (i) observational data on food worker (n = 321) hand hygiene practices (hand washing and glove use) and (ii) observational and interview data on factors related to hygiene behavior, such as worker activity, restaurant characteristics, worker food safety training, and the physical and social environment. Results indicated that hand washing and glove use were more likely to occur in conjunction with food preparation than with other activities (e.g., handling dirty equipment) and when workers were not busy. Hand washing was more likely to occur in restaurants whose food workers received food safety training, with more than one hand sink, and with a hand sink in the observed worker's sight. Glove use was more likely to occur in chain restaurants and in restaurants with glove supplies in food preparation areas. Hand washing and glove use were also related to each other--hand washing was less likely to occur with activities in which gloves were worn. These findings indicate that a number of factors are related to hand hygiene practices and support suggestions that food worker hand hygiene improvement requires more than food safety education. Instead, improvement programs must be multidimensional and address factors such as those examined in this study.

Food worker hand washing practices: an observation study.

Improvement of food worker hand washing practices is critical to the reduction of foodborne illness and is dependent upon a clear understanding of current hand washing practices. To that end, this study collected detailed observational data on food worker hand washing practices. Food workers (n = 321) were observed preparing food, and data were recorded on specific work activities for which hand washing is recommended (e.g., food preparation, handling dirty equipment). Data were also recorded on hand washing behaviors that occurred in conjunction with these work activities. Results indicated that workers engaged in approximately 8.6 work activities per hour for which hand washing is recommended. However, workers made hand washing attempts (i.e., removed gloves, if worn, and placed hands in running water) in only 32% of these activities and washed their hands appropriately (i.e., removed gloves, if worn, placed hands in running water, used soap, and dried hands) in only 27% of these work activities. Attempted and appropriate hand washing rates varied by work activity--they were significantly higher in conjunction with food preparation than other work activities (46 versus < or = 37% for attempted hand washing; 41 versus < or = 30% for appropriate hand washing) and were significantly lower in conjunction with touching the body than other work activities (13 versus > or = 27% for attempted hand washing; 10 versus > or = 23% for appropriate hand washing). Attempted and appropriate hand washing rates were significantly lower when gloves were worn (18 and 16%) than when gloves were not worn (37 and 30%). These findings suggest that the hand washing practices of food workers need to be improved, glove use may reduce hand washing, and restaurants should consider reorganizing their food preparation activities to reduce the frequency with which hand washing is needed.