Home hygiene: a risk approach

doi:10.1078/1438-4639-00193

International Journal of Hygiene and Environmental Health

Volume 206, Issue 1, 2003, Pages 1-8

https://doi.org/10.1078/1438-4639-00193 Get rights and content

Abstract

The need to place “prevention through hygiene” at the core of strategies for infection prevention has been emphasised by recent events. Indications are that re-evaluation of current practice and the promotion of improved hygiene in the domestic setting could have a significant impact in reducing infectious disease. If the public are to play a part however they must be properly informed. Encouraging the concept of the home as a setting in which the whole range of activities occur, including food hygiene, personal hygiene and hygiene related to medical care, provides the opportunity for a rational approach to home hygiene based on risk assessment. In the home surfaces (including hand surfaces) and other sites play an important part in the transmission of infection, especially food-borne infections. From an assessment of the frequency of occurrence of pathogens and potential pathogens at reservoirs, disseminators and hand and food contact sites together with the potential for transfer within the home, the risks of exposure can be assessed. This can be used to develop a rational approach in which effective hygiene procedures involving cleaning and disinfection as appropriate are targeted at these sites to reduce risks of cross contamination. This approach is consistent with the view that good home hygiene is not about “getting rid of household germs” but about targeting hygiene measures appropriately to reduce exposure to germs and thereby prevent cross infection. In motivating change, education programmes must take account of concerns related to antimicrobial resistance, the environment and the “health” of the immune system.

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In the case of food, cross-contamination of foodborne pathogens is a major concern as it increases the risk for humans to ingest contaminated food and become ill. Unfortunately, many consumers have little awareness that domestic food contact surfaces and utensils are considered a contributing factor to transmission and the occurrence of sporadic foodborne disease (Bloomfield, 2003; Pérez-Rodríguez et al., 2008). Evidence to support such a role is based on epidemiological data from Europe, North America, Australia, and New Zealand that infers that a substantial proportion of foodborne disease is attributable to improper food preparation practices in consumers' homes (Redmond and Griffith, 2003).
Poor hygiene and improper food preparation practices in consumers' homes have previously been demonstrated as contributing to foodborne diseases. To address potential cross-contamination by kitchen utensils in the home, a series of studies was conducted to determine the extent to which the use of a knife or grater on fresh produce would lead to the utensil's contamination with Escherichia coli O157:H7 or Salmonella enterica. When shredding inoculated carrots (ca. 5.3 log CFU/carrot), all graters became contaminated and the number of E. coli O157:H7 present on the utensil was significantly greater than Salmonella (p < 0.05). Contamination of knives after slicing inoculated produce (4.9–5.4 log CFU/produce item) could only be detected by enrichment culture. After slicing tomatoes, honeydew melons, strawberries, cucumbers, and cantaloupes, the average prevalence of knife contamination by the two pathogens was 43%, 17%, 15%, 7%, and 3%, respectively. No significant increase in the incidence or level of contamination occurred on the utensils when residues were present (p > 0.05); however, subsequent contamination of 7 produce items processed with the contaminated utensils did occur. These results highlight the necessity of proper sanitization of these utensils when used in preparation of raw produce.
Attachment and biofilm formation by foodborne bacteria in meat processing environments: Causes, implications, role of bacterial interactions and control by alternative novel methods
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Interestingly, the UK surveillance system reported that cross-contamination was the main contributing factor (32%) in the outbreaks investigated in the period 1999–2000 (WHO, 2003). To this direction, various authors have also acknowledged that cross-contamination of foods by bacterial pathogens in homes and in food-service establishments is an important cause of transmission of foodborne diseases (Beumer & Kusumaningrum, 2003; Bloomfield, 2003; Chen et al., 2001). Cross-contamination may occur at any stage between the food (meat) processing plant and the final consumer at home (Reij et al., 2004).
Attachment of potential spoilage and pathogenic bacteria to food contact surfaces and the subsequent biofilm formation represent serious challenges to the meat industry, since these may lead to cross-contamination of the products, resulting in lowered-shelf life and transmission of diseases. In meat processing environments, microorganisms are sometimes associated to surfaces in complex multispecies communities, while bacterial interactions have been shown to play a key role in cell attachment and detachment from biofilms, as well as in the resistance of biofilm community members against antimicrobial treatments. Disinfection of food contact surfaces in such environments is a challenging task, aggravated by the great antimicrobial resistance of biofilm associated bacteria. In recent years, several alternative novel methods, such as essential oils and bacteriophages, have been successfully tested as an alternative means for the disinfection of microbial-contaminated food contact surfaces. In this review, all these aspects of biofilm formation in meat processing environments are discussed from a microbial meat-quality and safety perspective.
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Moreover, although most outbreaks result from extensive growth at abusive storage temperatures, insufficient cooking, etc., many are also associated with bacterial cross contamination/recontamination (Notermans, Zwietering, & Mead, 1994; Roberts, 1990). Similarly, various authors have stated that cross contamination of bacterial and viral pathogens in homes and in food-service establishments could well be the major contributing factor to sporadic and epidemic food borne illnesses (Beumer & Kusumaningrum, 2003; Bloomfield, 2003; Chen, Jackson, Chea, & Schaffner, 2001). In the present study, a high proportion of respondents admits a potentially dangerous behaviour on a daily basis, as 56.8% (n = 88) recognise the need to change their clothes but do not admit the importance of changing knives when they end the work at the abattoir and start at the deboning room.
Professional training for meat handlers is an European Community food law requirement in order to apply HACCP principles and achieve food safety goals. A self-administered questionnaire designed to assess “Knowledge” and “Practice” of public hygiene measures was completed by meat handlers (MH) (n = 159) in slaughterhouses in Portugal. A significant proportion of the group (72.7%) has had professional training in two different areas: Good Practice in Food Industry (12.03%) and Work Safety and Hygiene (22.8%); 37.9% of the respondents have had training in both areas. However 24.5% of the subjects have never had training. Meat handlers with professional training in Good Practice in Food Industry (GPFI) and in both areas (BT) have had the highest proportions of correct answers in Knowledge (66.92 ± 16.36 and 67.26 ± 21.05, respectively) and Practice questions (70.53 ± 17.47 and 68.67 ± 22.58, respectively).
The results of this study point to the need to improve training, particularly in Good Practice in Food Industry, thus enabling meat handlers to achieve more correct answers in Knowledge and Practice. The development of evaluation criteria for the effectiveness of professional training is crucial to protect Public Health.
Quantification and variability of Escherichia coli and Staphylococcus aureus cross-contamination during serving and consumption of cooked thick porridge in Lungwena rural households, Malawi
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The study investigated bacterial transfer to cooked thick porridge via ladles and hands during serving in 29 households in Lungwena, rural Malawi. Household stored water used for hand and ladle washing, was contaminated with Escherichia coli and Staphylococcus. aureus from hands of members of the household or from contaminated ladles used in food preparation. The results showed that hands became contaminated with E. coli and S. aureus cells in the range 0.6–3.7 and 2.2–4.3 log₁₀ CFU/cm², respectively, following washing with the contaminated water. Ladles became contaminated with 0.9–3.2 log₁₀ CFU/cm² of E. coli cells whereas contamination with S. aureus on ladles ranged between 1.9 and 4.6 log₁₀ CFU/cm². Bacterial transfer from hands to food ranged from <1 to 3.6 log₁₀ CFU/g for E. coli and 2.1 to 4.2 log₁₀ CFU/g for S. aureus. Ladle surfaces transferred from 1.3 to 3.1 and from 1.2 to 4.3 log₁₀ CFU/g of E. coli and S. aureus, respectively, on to the food. Contamination of food by hands was significantly (p < 0.05) higher than that of ladles and transfer of S. aureus was significantly (p < 0.05) higher than that of E. coli. The amount of bacteria transferred to the recipient depended on the wash water type and bacteria type. The study has demonstrated that although the traditional cooking of thick porridge inactivates S. aureus and E. coli, the porridge can be contaminated with bacteria during consumption using hands and serving on to a plate with wooden ladles.
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Mini-ReviewHome hygiene: a risk approach

Abstract

Lancet

Food Control

Inter. Biodeterior Biodegrad.

J. Hosp. Infect.

Lancet

Immunol. Today

J. Hosp. Infect.

Hygiene of infant feeding utensils: Practices and standards in the home

BMJ

Cholera epidemic traced to risk miscalculation

Nature

Memorandum on the threat posed by infectious diseases. Need for reassessment and a new prevention strategy in Germany

BMA submission to the Lords Select Committee into antimicrobial resistance

Official Journal of the European Communities

Survival of Salmonella in bathrooms and toilets in domestic homes following salmonellosis

J. Appl. Microbiol.

Significance of biocide usage and antimicrobial resistance in domiciliary environments

J. Appl. Microbiol.

Cross-contamination and infection in the domestic environment and the role of chemical disinfectants

J. Appl. Microbiol.

The effectiveness of hygiene procedures for prevention of cross-contamination from chicken carcasses in the domestic kitchen

Lett. Appl. Microbiol.

Achieving hygiene in the domestic kitchen: the effectiveness of commonly used cleaning procedures

J. Appl. Microbiol.

Rhinoviruses

General outbreaks of infectious intestinal disease in England and Wales 1995 and 1996

Comm. Dis. Public Health

Transmission of rhinovirus colds by self inoculation

New. Engl. J. Med.

Mini-Review
Home hygiene: a risk approach