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Alimentarius, national and international legislation, and sectoral guidelines governed by the principles of HACCP. QMS always include requirements regarding personal hygiene, including hand hygiene. While BRC and IFS contain specific work instructions (Table 6), ISO 22000 requires implementation of the so-called prerequisite programmes (PRPs). These are standard operating procedures that contain the basic conditions and activities that are necessary to maintain a hygienic environment throughout the food chain. The organization defines PRPs according to the Codex Alimentarius, national and international law, and sectoral guidelines. Examples of equivalent terms are: Good Agricultural Practice (GAP), Good Veterinarian Practice (GVP), Good Manufacturing Practice (GMP), Good Hygienic Practice (GHP), Good Production Practice (GPP), Good Distribution Practice (GDP) and Good Trading Practice (GTP). One such PRP defines the regulations concerning hygiene of employees. ISO 22000 requests the organization to validate and monitor HACCP and the defined PRPs. The organization has to verify and demonstrate compliance with the regulations defined in the PRPs. COMPLIANCE WITH HAND HyGIENE REGULATIONS Food operators play a key role in food safety by using safe and hygienic practices during all stages of food production. Good hand hygiene is critical in reducing food contamination (45). However, hand hygiene techniques are effective only if the appropriate procedures are carried out correctly. This is certainly the case with handwashing. For instance, a procedure prescribes that hands be rubbed together thoroughly with water and soap for at least 15 seconds, but, in reality a general lack of compliance has been noted (39, 81, 97). Several medical studies show that improvement of compliance with hand hygiene guidelines coincides with a significant decrease in nosocomial infections and MRSA (Methicillin-resistant Staphylococcus aureus) transmission, emphasizing the importance of good compliance (94). Ease of use and comfort appear to be major factors that determine whether or not hand hygiene procedures are followed correctly. For instance, skin irritation and “being too busy” are regularly reported reasons for not washing hands. However, several other factors also influence the levels of compliance with hand hygiene procedures. The infrastructure necessary to maintain good hand hygiene should be sufficiently available and should be nearby. Social factors, such as gender, cultural factors, education, and religious background, also play a role in the levels of compliance. For instance, it is not recommended that Muslim employees be forced to disinfect hands using hand alcohols, because they often refuse to use alcohol for religious reasons (39, 46). Demanding full compliance with guidelines is often unrealistic and can even negatively influence compliance (94). Monitoring compliance with procedures is not straightforward. For instance, it is not easy to verify that the prescribed amount of soap or alcohol is used or to monitor whether sufficient time is taken to wash or disinfect hands (17, 39, 46). In the medical sector, it has been suggested that the monitoring of hand hygiene compliance be carried out electronically. This can be achieved by installing electronic readers that can scan employee badges at sinks or dispensers. In this way, the organization can monitor how often a certain employee washes or disinfects his or her hands (17, 48). In a more advanced system, electronic readers may even measure how much soap or alcohol is used and how much time was taken to carry out the hand hygiene procedure. Such a recording device provides feedback about soap or alcohol use for hand hygiene quality improvement, and may improve compliance with hand hygiene procedures (48). In fact, a system for monitoring hygiene appliances was recently patented (60). In order to obtain better compliance with hand hygiene procedures, management must provide adequate quantities of washing facilities, sinks, alcohol dispensers, and/or gloves. The operators are often not fully aware of the importance of good hand hygiene and as a consequence may be careless in complying with these rules. Therefore, employees should be better trained in proper handwashing techniques. In addition, information campaigns can make employees more conscious of good hygiene. For instance, posters that are displayed in working areas remind employees to carry out the prescribed procedures correctly (71). Compliance is especially enhanced when both employees and management are actively involved in these information campaigns (93, 94). Routine observation and feedback are most effective measures in improving compliance (25). Rewards, sanctions and active participation in the design of hand hygiene programs may contribute to a positive culture for hand hygiene and result indirectly in an improvement in compliance levels (39, 46). CONCLUSIONS Exposure to microbial pathogens via food is increasing because of changing consumption and social habits, resulting in an increase in foodborne illnesses (6, 68). Good hand hygiene during all stages of food production is extremely important to minimize the risk of foodborne illnesses, especially with ready-to-eat foods or fresh cut produce, which require no further cooking or heating steps. Moreover, in a globalized world, foodstuffs travel longer distances between production and consumption, giving microorganisms the opportunity to proliferate in contaminated foodstuffs. Choosing the optimal hand hygiene technique is not an easy task, as the scientific literature is not unequivocal on this topic; hands hygiene involves complex interactions between several parameters. Neither washing hands nor disinfection nor wearing gloves can completely abolish the risk of cross contamination. A specific hand hygiene technique should be selected based on its inherent advantages and disadvantages, taking into account the specific circumstances and needs of the working environment. Food companies often have to compromise between the desired reduction in the number of microorganisms and the implementation of a hand hygiene technique that is achievable in the specific working environment. Regardless of the hand hygiene technique chosen, it is of the utmost importance that the basic principles of hand hygiene are strictly adhered to. A very simple and effective technique to remove microorganisms is washing hands with soap. The described washing procedure must be executed correctly, complying with the correct time (at least 15 s) necessary to allow for the effective physical removal of pathogens. Hand drying is another basic component 580 FOOD PROTECTION TRENDS | AUGUST 2008

Food Protection Trends - August 2008

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