How best to protect deli and other prepared foods from unintentional contamination is a source of much hand-wringing for food safety advocates.
While hand washing and glove wearing have always been an integral part of food-handling guidelines, it's not a given that associates follow proper protocols day in and day out. Furthermore, many observers argue that although glove use can be effective, it can also promote poor hand-washing practices.
“I know supermarkets understand that you should have clean hands when you touch food, whether it's ready-to-eat or any kind of food,” said Shirley Bohm, consumer food safety officer of the retail food program at the U.S. Food and Drug Administration, Washington. “But often, they overestimate the effectiveness of using gloves. When you think that you've solved your problem when the employee uses gloves, and that's not really true, then they may not have the protection that they're hoping for.”
Industry experts agree glove wearing should not replace hand washing. Too often, they said, proper hand washing and glove use are not followed on a regular basis in deli and food-service departments.
“Proper glove use is a problem,” said John Luposello, certified food safety manager for the Orangeburg, N.Y.-based Nice-Pak's food-service division. Nice-Pak manufactures branded and private-label premoistened wipes for infection control and prevention.
“The use of gloves is intended to be a barrier so that if after you wash your hands, and they become contaminated, you put the gloves on and it's another level of protection,” he said. “Too often, people put the gloves on and it just becomes a second skin. They handle money, they handle other things that contaminate the glove and then they go and handle food, and that defeats the purpose.”
Lakeland, Fla.-based Publix Super Markets adopted the Food Marketing Institute's Super Safe Mark program, which was introduced to the industry in 2003. Prior to that, Publix used the ServSafe food safety training and certification program from the National Restaurant Association.
“ServSafe was more of a restaurant-industry-type course, but it was the closest thing that we had in our industry to be able to provide our managers with the proper training that we needed,” said Maria Brous, spokeswoman for Publix. The Super Safe Mark program emphasizes that glove wearing is not meant to replace hand washing.
“They are two separate things,” Brous said. “Associates should be wearing gloves when appropriate and should change gloves when the task changes. They shouldn't keep the gloves on for an extended period of time. Those are the common practices in the industry.”
Buehler Food Markets teaches ServSafe because it was the program the retailer initially started with, and the chain operates restaurants in many of its stores, said Cheryl Cohen, certified food safety specialist for the Wooster, Ohio-based chain of 11 stores. After the initial rollout, the retailer decided to implement ServSafe training throughout store departments. Cohen tailors the instruction for the retail environment.
All managers and full-time employees, and some part-timers, are required to go through the program. Cohen said she has trained about 200 people over the past four years.
“Employees are trained to wash their hands every time they put a new pair of gloves on, and to change gloves every time they change a job and anytime the gloves become soiled or dirty,” Cohen told SN. “If they're working on the same job, they're allowed to wear them for up to four hours, but very rarely is somebody working the same job for four hours, so they are to change them when necessary. I would say that on average, an employee should go through at least three pairs of gloves in four hours, but again, it depends on their job and what they're doing.”
The latest FDA Food Code provides a list of situations in which hands should be washed, such as before food preparation and after handling dirty equipment. It also indicates that hand washing should take at least 20 seconds and should include running warm water, using soap, friction between hands for 10 to 15 seconds, rinsing and drying with paper towels or hot air.
Because hand washing does not remove all pathogens, the food code also specifies that bare-hand contact should be avoided when handling ready-to-eat foods, and kept to a minimum for non-ready-to-eat foods. The code noted “barriers” such as gloves, deli tissue and utensils may be used when handling both types of foods. Taking precautions is especially important with ready-to-eat foods, since there's no second chance to kill pathogens on items that don't require additional cooking, said Bohm.
Industry experts and retailers agree that hand washing, glove wearing and the use of hand wipes work together and that one does not replace another.
“Hand washing is an integral part of using gloves, and that's almost always omitted,” said Bohm. “Another thing: You wouldn't think so, but people tend to reuse gloves. Once you've used them and take them off, they're dirty inside and out. People don't always wash hands between gloves if they change, so there are a lot of downsides to using gloves, because people think that once you have them on, everything is OK, and that's not necessarily true.”
According to an observation study conducted by the Environmental Health Specialists Network, some workers believe that glove use eliminates the need for hand washing. EHS-Net, a network of environmental health specialists focused on the investigation of contributing factors to foodborne illnesses, including food-preparation and hand-washing practices, is a collaborative project of the Centers for Disease Control and Prevention, the FDA and the U.S. Department of Agriculture.
“I think people need to be educated and aware of proper gloving and proper hand washing and hand sanitizing,” said Luposello. “People use our product as an adjunct to hand washing to further ensure that if there are any germs that are potentially infectious — such as E. coli, salmonella, the leading causes of foodborne illnesses — that their hands are sanitized so they do not spread those germs to any other surface that anybody could ingest to get sick.”
Managers and employees at Buehler's are required to participate in a ServSafe training program every five years, according to Cohen.
“They recommend five years because there are always changes,” she said. “The Food Code's always updated, so if there are any major changes, managers and employees are notified.”
At least 10% to 15% of the 15-hour course is dedicated to hand washing and glove usage, Cohen said. “Hand-washing and glove-wearing training and education can vary anywhere between one to two hours,” she said. “Sometimes it comes up throughout the whole program, not just one straight hour of it.”
Indeed, education is crucial in order to have workers understand the importance of appropriate glove use, said Melvin Kramer, president of Baltimore-based EHA Consulting Group, which focuses on public health, epidemiology and food safety matters.
“Hand washing is primary, and the fallback is going to be the appropriate utilization of gloves — it's a one-two step,” Kramer said. “There's no question that unclean gloves can contaminate and cross-contaminate as easily as dirty hands. I've seen people washing gloves and in rest rooms with gloves — that shouldn't be done. The key element is you've got to start off with education, and you have to keep hand washing as something that is very, very vital throughout. You've got to educate, re-educate, enforce and reinforce the importance of clean hands and the proper utilization of gloves.”
Responsibility for safe food handling should be equally shared among the ranks, Bohm said. Managers should make sure that training is directed to specific jobs so workers will know what to do in particular situations. Hand washing and glove use should be monitored, and managers should make sure employees on the floor have the necessary facilities, such as sinks with hot and cold running water and paper towels at hand.
“Those are all management responsibilities that sound simple and straightforward, but are also the ones that sometimes people slip up on,” Bohm said.
Back to Basics
Retail establishments must have a strategy to resolve or minimize risk factors. That was the consensus reached last year at a satellite broadcast on reducing risk factors at the retail and food-service levels, conducted by the U.S. Food and Drug Administration. About 30 industry experts, officials from food retailing and food-service companies, and county health departments participated.
“We came up with several that seemed to be themes across the industry,” said Shirley Bohm, consumer food safety officer of the retail food program at the FDA.
Bohm's strategies include the following:
Offer positive reinforcement. Managers should catch associates doing the right thing, and compliment them.
Model the behavior. If the manager is going to work in the kitchen, he should wash his hands. That carries a lot of weight with employees when they see the boss using soap and water on his own hands.
Repeat the message. Keep up the training and remind associates frequently that they need to wash their hands. Managers also should point out the activities that require hand washing.
Make it fun. Hand-washing contests, a buddy system and automatic towel dispensers can make a mundane activity enjoyable for employees.
Make it personal. Relate the behavior to something in their home or personal life. Make sure workers understand that if they wash their hands, they're going to keep themselves, their kids or other family members from catching a cold or a foodborne illness. Remind associates that hand washing is essential not only at work but at home as well.