In the world of food safety, 14 is the unluckiest number.That's how many people the Centers for Disease Control and Prevention estimate die each day from any of the more than 250 foodborne illnesses currently catalogued. The agents range from the natural, like bacteria and viruses, to man-made heavy metals.And like a human chain, almost all of them can be transmitted by the hand, according to the

In the world of food safety, 14 is the unluckiest number.

That's how many people the Centers for Disease Control and Prevention estimate die each day from any of the more than 250 foodborne illnesses currently catalogued. The agents range from the natural, like bacteria and viruses, to man-made heavy metals.

And like a human chain, almost all of them can be transmitted by the hand, according to the CDC. Long aware of the personal connection, food retailers have been constantly searching for new and improved ways to protect their customers.

"We focus everything we do in regards to food safety around what we call the 'Big Three,"' said Michael Eardley, vice president of fresh foods for D&W Food Centers, Grand Rapids, Mich. "No. 1 is handwashing."

Most of the strategies employed by operators start with those who touch food. And though progress has been made promoting the personal hygiene practices of store-level associates, certain ever-present challenges continue to dog even the most comprehensive food-safety programs. The hurdles range from high turnover to finding time for instruction. But, regardless of the cause, retailers know even the most legitimate reasons do not reduce their responsibility.

"Supermarket fresh foods is a growing business, and it's important they make it a priority to protect their profits," said Jim Mann, executive director of the Handwashing Leadership Forum, a Libertyville, Ill.-based organization of manufacturers who banded together to promote best practices in sanitation. Inaugural members of the group include NSF International, Ann Arbor, Mich.; Cini Little, Rockville, Md.; Advance Tabco, Edgewood, N.Y.; GOJO Industries, Akron, Ohio; Tucel Industries, Forestdale, Vt.; Georgia Pacific, Atlanta; Glo Germ, Moab, Utah; and FoodHandler, Westbury, N.Y.

Retailers themselves are devoting more internal resources to food safety as the level of public awareness grows. New partnerships with food manufacturers include strict processing guidelines; commodities like produce are subject to third-party audits; brochures, signage and public events remind consumers to do their share in protecting the foods they eat; and retailers are placing more responsibility directly on store employees.

"Our department managers are accountable for food safety in their departments, and food safety is part of every associate's job description," said Eardley.

Developing an effective training program goes a long way toward minimizing the impact of store-level factors like employee turnover and training time. John Schulz, director of quality assurance for hotel giant Marriott International, Washington, said simplicity is best. That is, associates don't have to be taught microbiology.

"If we ever have a foodborne illness outbreak, I doubt my hourly cook is going to have to figure out what the incubation time of that organism was," he said. "Time is better spent on teaching them the fundamentals of safe food handling, rather than frustrating them with names and statistics."

Schulz, who spoke at the annual Food Safety Summit this spring in Washington, said a potent training program focuses on practice, not process.

"This means concentrating on duties elemental to their positions, things they're going to use on a daily basis so it's reinforced by themselves, and not by the manager," he said.

Dion Lerman, a Philadelphia-based Certified Food Service Professional specializing in food safety, believes that too many programs have relied on huge charts "naming all these organisms with their Latin names and onset symptoms, duration and treatment. All that doesn't matter. Food handlers are not going to be diagnosing people."

What matters is what they can do to prevent illness, he said. To that end, Lerman uses a direct approach to drive home the idea of individual responsibility. His lesson plans force trainees to look at the consequences of their behavior, and to eliminate those actions that make people sick.

"Make it real for people," he said. "For example, if I'm talking about cooking hamburgers to the proper temperature, I don't talk about E.coli 0157:H7, or hemolytic uremic syndrome. I tell them the burgers they undercooked just killed four kids. I ask them how they would feel knowing they were the ones responsible for that."

There is general industry agreement that personal hygiene -- centered around the practice of consistent handwashing -- is the first and most critical step in safe food handling.

"It impressed us how much the industry is investing in temperature control, yet there continues to be more scattered investment in handwashing, even though the CDC says it plays a bigger part in foodborne illness," Mann said.

One of the problems with handwashing is that it's not measurable, like temperature control, where there are exact measurements to the degree, he noted. That's why effective training is all the more important.

Marriott faced particular difficulties, as an operator of more than 2,000 properties in 53 countries. The company's food-safety training program had to cut through differing levels of education, various cultures and assorted languages -- and be cost effective.

The three-year development process resulted in a highly symbolic and visual video that is wordless and culture-less.

"We found that using very simplified ideas was best. We stayed away from complex scenarios requiring a lot of discussion. It's very in-your-face and very elemental in design," Schulz said.

The Handwashing Leadership Forum has also produced a video series of three installments. And, like Marriott's approach, these nonverbal videos are simple and short. Each lasts only 90 seconds.

"Nobody has the time to sit associates in the back room for an hour," Mann said. "They can be used for initial training, but they're also short enough to use as a reminder or refresher from time to time."

The videos are based on why, when and how one should wash their hands, and each installment is named after that particular directive.

"What we've felt is missing is a need for the worker to understand their responsibility, and part of being a food-service professional is realizing their obligations beyond the customer," said Mann. "One of the people they need to protect is themselves, and another their families. That type of approach can make them think more about consequences of not washing."

At D&W, all management is certified under the National Restaurant Association's ServSafe food-safety training program. Select management, in turn, trains associates on a regular basis. And independent sanitarians regularly visit stores for spot checks and to help associates refresh skills, including handwashing.

"We bring that set of eyes from outside the store," he said. "They are actually checking for performance based on our sanitation standards. They're there to reinforce correct behaviors and correct ones not up to our standards."

Teaching employees about personal hygiene is only one aspect of a comprehensive food-safety program, industry experts told SN. Retailers must strive to create a culture of caring, a process that starts with a strong support strategy.

"You can spend a lot of time and money running these great training workshops and buying videos and showing people things, but if they go to the handsink and there's no soap or paper towels, all that training is undone," said Lerman, the consultant.

"If a manager walks by the handsink and takes a piece of cheese off the table without washing their hands, associates see that," he added. "We call it 'untraining."'

One common breakdown in any food-safety program is this failure to appoint someone to police sanitary fixtures like the soap and towel dispensers, and refill them when required. Building in convenience is also critical, and often overlooked.

"If the handsink is in the back in some prep area, and the associate is up at the counter serving someone, are they going to go wash their hands?" asked Lerman. "The sinks have to be convenient, accessible and supplied."

A lot of innovative products entering the market may facilitate handwashing for employees in food areas. Already, there are updated, more reliable versions of hands-free, sensor-operated sinks, towel dispensers and soap dispensers. All are designed to knock down the barriers keeping retailers from changing the way their employees work around fresh foods.

Quoting a colleague in Chicago, Lerman said that even without these advances, management cannot complain that issues like employee turnover are preventing them from teaching food-safety.

"What happens if you don't train them, and they stay?"

The Glove Question

There's little argument that gloves can play a critical safety role in any food retailing environment. In fact, gloves are used by a lot of companies as a demonstration to their customers that they care about protection.

The danger lies in operators who use them as a cure-all -- and not in addition to -- food-safety practices like handwashing, say experts.

"Gloves are only an additional barrier, after you've washed your hands," said Dion Lerman, Certified Food Service Professional. "Because if you don't wash your hands first, whatever you've got on your hands is going to get all over the gloves."

Government regulations talk about "bare-hand" contact. But the real issue is simply hand contact, whether it's bare or gloved, observers note.

"Customers have responded quite warmly to gloves, so it's become an incentive for workers to wear them, regardless of whether they wash their hands," said Jim Mann, executive director of the Handwashing Leadership Forum. "Management wants it, customers like it, so why should they take them off?"

The problem is that hands enclosed in gloves get sweaty and hot -- a perfect medium for pathogens, which thrive in warm, moist environments. The danger level is magnified if workers fail to change gloves, because breakage can "deliver a 'slug' of germ-laden sweat directly into food," said Lerman.

"You don't put gloves on and leave them on all day long," he said. "You wash your hands first, you wash your hands after, and you change gloves when you change your task."

Manufacturers are working to make it easier for food handlers to follow proper sanitation guidelines, including glove changes. Some companies have developed dispensing fixtures that make it more convenient for workers to change gloves. These dispensers position gloves on a tear strip like produce bags, allowing a person to put their clean hand inside, lift and tear it away from the rest of the pack.