Quantifying the Effects of Water Temperature, Soap Volume, Lather Time, and Antimicrobial Soap as Variables in the Removal of Escherichia coli ATCC 11229 from Hands.

The literature on hand washing, while extensive, often contains conflicting data, and key variables are only superficially studied or not studied at all. Some hand washing recommendations are made without scientific support, and agreement between recommendations is limited. The influence of key variables such as soap volume, lather time, water temperature, and product formulation on hand washing efficacy was investigated in the present study. Baseline conditions were 1 mL of a bland (nonantimicrobial) soap, a 5-s lather time, and 38°C (100°F) water temperature. A nonpathogenic strain of Escherichia coli (ATCC 11229) was the challenge microorganism. Twenty volunteers (10 men and 10 women) participated in the study, and each test condition had 20 replicates. An antimicrobial soap formulation (1% chloroxylenol) was not significantly more effective than the bland soap for removing E. coli under a variety of test conditions. Overall, the mean reduction was 1.94 log CFU (range, 1.83 to 2.10 log CFU) with the antimicrobial soap and 2.22 log CFU (range, 1.91 to 2.54 log CFU) with the bland soap. Overall, lather time significantly influenced efficacy in one scenario, in which a 0.5-log greater reduction was observed after 20 s with bland soap compared with the baseline wash (P = 0.020). Water temperature as high as 38°C (100°F) and as low as 15°C (60°F) did not have a significant effect on the reduction of bacteria during hand washing; however, the energy usage differed between these temperatures. No significant differences were observed in mean log reductions experienced by men and women (both 2.08 log CFU; P = 0.988). A large part of the variability in the data was associated with the behaviors of the volunteers. Understanding what behaviors and human factors most influence hand washing may help researchers find techniques to optimize the effectiveness of hand washing.

Quantifying Bacterial Cross-Contamination Rates between Fresh-Cut Produce and Hands.

This study quantifies the cross-contamination rates between fresh-cut produce and hands using a nalidixic acid-resistant nonpathogenic Enterobacter aerogenes and cocktails of rifampin-resistant Salmonella or Escherichia coli O157:H7 strains. Volunteers performed the E. aerogenes experiments (n = 20), and one of the authors performed the Salmonella and E. coli O157:H7 experiments multiple times (n =15 and n =10, respectively). Each participant handled 25 g of fresh-cut carrots, celery, or cantaloupe in two different scenarios. In the first scenario, gloved hands were inoculated with 6 log CFU per hand of the bacteria, and in the second scenario, five 25-g pieces of fresh produce were inoculated to a concentration of 6 log CFU/25 g. The glove juice method was used to quantify the bacterial concentration on the gloved hands. About 30% of E. aerogenes on gloved hands was transferred to the carrots and celery, and 18% of E. aerogenes on gloved hands was transferred to the cantaloupe. When carrots or cantaloupe was inoculated with E. aerogenes , 1% was transferred to gloved hands; from inoculated celery, about 0.3% of E. aerogenes was transferred to gloved hands. There was not a significant difference between E. aerogenes and Salmonella cross-contamination rates (P > 0.05). When gloved hands were contaminated with E. coli O157:H7, about 30% was transferred to carrots, about 10% to celery, and about 3% to cantaloupe. When carrots and celery were inoculated with E. coli O157:H7, about 1% was transferred to gloved hands, but from inoculated cantaloupe only about 0.3% was transferred. Direction of transfer (to versus from produce), difference in type of produce, and differences among the bacterial species all had significant effects on the transfer rate. Understanding transfer rates to and from fresh-cut produce will allow for better risk assessment and management of microbial food safety risk related to fresh-cut produce.

Quantifying the effect of hand wash duration, soap use, ground beef debris, and drying methods on the removal of Enterobacter aerogenes on hands.

Hand washing is recognized as a crucial step in preventing foodborne disease transmission by mitigating crosscontamination among hands, surfaces, and foods. This research was undertaken to establish the importance of several keys factors (soap, soil, time, and drying method) in reducing microorganisms during hand washing. A nonpathogenic nalidixic acid-resistant Enterobacter aerogenes surrogate for Salmonella was used to assess the efficacy of using soap or no soap for 5 or 20 s on hands with or without ground beef debris and drying with paper towel or air. Each experiment consisted of 20 replicates, each from a different individual with ∼ 6 log CFU/ml E. aerogenes on their hands. A reduction of 1.0 ± 0.4 and 1.7 ± 0.8 log CFU of E. aerogenes was observed for a 5-s wash with no soap and a 20-s wash with soap, respectively. When there was no debris on the hands, there was no significant difference between washing with and without soap for 20 s (P > 0.05). Likewise, there was no significant difference in the reductions achieved when washing without soap, whether or not debris was on the hands (P > 0.05). A significantly greater reduction (P < 0.05) in E. aerogenes (0.5 log CFU greater reduction) was observed with soap when there was ground beef debris on the hands. The greatest difference (1.1 log CFU greater average reduction) in effectiveness occurred when ground beef debris was on the hands and a 20-s wash with water was compared with a 20-s wash with soap. Significantly greater (P < 0.05) reductions were observed with paper towel drying compared with air (0.5 log CFU greater reductions). Used paper towels may contain high bacterial levels (>4.0 log CFU per towel) when hands are highly contaminated. Our results support future quantitative microbial risk assessments needed to effectively manage risks of foodborne illness in which food workers' hands are a primary cause.

Cross contamination of Escherichia coli O157:H7 between lettuce and wash water during home-scale washing.

Lettuce and leafy greens have been implicated in multiple foodborne disease outbreaks. This study quantifies cross contamination between lettuce pieces in a small-scale home environment. A five-strain cocktail of relevant Escherichia coli O157:H7 strains was used. Bacterial transfer between single inoculated lettuce leaf pieces to 10 non-inoculated lettuce leaf pieces that were washed in a stainless steel bowl of water for 30 s, 1 min, 2 min, and 5 min was quantified. Regardless of washing time, the wash water became contaminated with 90-99% of bacteria originally present on the inoculated lettuce leaf piece. The E. coli O157:H7 concentration on initially inoculated leaf pieces was reduced ∼ 2 log CFU. Each initially uncontaminated lettuce leaf piece had ∼ 1% of the E. coli O157:H7 from the inoculated lettuce piece transferred to it after washing, with more transfer occurring during the shortest (30 s) and longest (5 min) wash times. In all cases the log percent transfer rates were essentially normally distributed. In all scenarios, most of the E. coli O157:H7 (90-99%) transferred from the inoculated lettuce pieces to the wash water. Washing with plain tap water reduces levels of E. coli O157:H7 on the inoculated lettuce leaf pieces, but also spreads contamination to previously uncontaminated leaf pieces.

Quantifying transfer rates of Salmonella and Escherichia coli O157:H7 between fresh-cut produce and common kitchen surfaces.

Cross-contamination between foods and surfaces in food processing environments and home kitchens may play a significant role in foodborne disease transmission. This study quantifies the cross-contamination rates between a variety of fresh-cut produce and common kitchen surfaces (ceramic, stainless steel, glass, and plastic) using scenarios that differ by cross-contamination direction, surface type, produce type, and drying time/moisture level. A five-strain cocktail of rifampin-resistant Salmonella was used in transfer scenarios involving celery, carrot, and watermelon, and a five-strain cocktail of rifampin-resistant Escherichia coli O157:H7 was used in transfer scenarios involving lettuce. Produce or surface coupons were placed in buffer-filled filter bags and homogenized or massaged, respectively, to recover cells. The resulting solutions were serially diluted in 0.1% peptone and surface plated onto tryptic soy agar with 80 µg/ml rifampin and bismuth sulfite agar with 80 µg/ml rifampin for Salmonella or sorbitol MacConkey agar with 80 µg/ml rifampin for E. coli O157:H7. When the food contact surface was freshly inoculated, a high amount (>90%) of the inoculum was almost always transferred to the cut produce item. If the inoculated food contact surfaces were allowed to dry for 1 h, median transfer was generally >90% for carrots and watermelon but ranged from <1 to ∼70% for celery and lettuce. Freshly inoculated celery or lettuce transferred more bacteria (<2 to ∼25% of the inoculum) compared with freshly inoculated carrots or watermelon (approximately <1 to 8%). After 1 h of drying, the rate of transfer from inoculated celery, carrot, and lettuce was <0.01 to ∼5% and <1 to ∼5% for watermelon. Surface moisture and direction of transfer have the greatest influence on microbial transfer rates.