The tweeting, texting, multitasking public increasingly expects food and beverage service in nontraditional locations — many of them without hand sinks and running water. Clearly, hand-hygiene technology has lagged well behind the pace of expanding mobile foodservice.
In the past, operators have often sought to comply with health regulations that insist they have water available for handwashing by supplying a mostly inconvenient, ineffective trickle of water dispensed from coffee urns and the like.
Even that is not an option in many military situations, as was the case several years ago, when the new Iraqi police force was being trained at a temporary location where its foodservice tent had no running water. Its food safety advisors were led to test some alternate methods that would provide staff with an option that would be more effective than the use of standard alcohol hand sanitizers. And that in turn led the Handwashing for Life Institute to a no-water hand-cleansing and -sanitizing protocol dubbed SaniTwice.
Mobile hand hygiene
We tested a procedure in which a foodservice worker applied an excess of food code-compliant alcohol hand sanitizer and vigorously scrubbed for 20 seconds, just as he would do with handwashing when water is available, so that its emulsifiers and emollients might have the time (and temperature) to loosen soils. Then the hands, still wet, were wiped clean with a pattern-embossed paper towel (for increased friction) to pull away the soil. This was followed by a second application of hand sanitizer, this time used according to label instructions, allowing the hands to air dry.
In that case, there was neither time nor budget for laboratory confirmation. The solution made sense and the physical demonstrations were convincing: SaniTwice became a reality in the Iraqi desert.
From one desert to another
Two years later, Handwashing For Life was approached by a major Las Vegas hotel that wanted to improve handwashing effectiveness at its catered events. The SaniTwice protocol was presented as a possible solution. It offered some clear advantages, but both the operator and the health department would not proceed based only on field research that had come from the military experience. They insisted on documented effectiveness data. The SaniTwice protocol was tested with resoundingly positive results from food and beverage managers, bartenders and health department inspectors.
Health inspectors saw other applications for their clients, and operators are now looking at SaniTwice in other contexts, such as a way to improve glove changing in remote service areas and by dishroom workers in between the handling of soiled and clean dishes.
An interest in SaniTwice among regulatory groups has been enhanced by the arrival of two new wrinkles: the advent of reliable, touch-free dispensers and the development of a new breed of synergized alcohol hand sanitizers that retain their Model Food Code compliance while eliminating concerns regarding effectiveness on norovirus, the number one foodborne pathogen in foodservice.
The cruise industry and health authorities have completed studies that indicate norovirus is primarily introduced onto ships via ill passengers (one of the same problems that can plague special events.) Such “front-door pathogens” need special attention as they are less likely to be contained by traditional temperature control and other food safety interventions. Any norovirus penetration of a facility has a strong person-to-person element as well as high potential for surface cross-contaminations. And the current concerns over H1N1 flu may provide even more impetus to such strategies, as hand sanitizing remains one of the best forms of defense.
When running water is not available or is very inconvenient to use, the SaniTwice protocol can be an effective alternative as long as its implementation is approved by the local health department.