It may, at first, appear from Figure 15 that employee hygiene is not that important since only 4% responded that they had had an incident related to lack of handwashing or shoe/bootwashing. However, when this is compared with Figure 4 (page 3), it is seen that the percentage of respondents who had not had incidents (81%) roughly correlates with a calculation of the average of those who see all the listed factors of employee hygiene as being very important (78%).

This correlation of those seeing importance in employee hygiene and not having incidents would appear to support the regulations and standards requiring that food facilities take reasonable measures and precautions related to personal hygiene — and the requirements for employee training in the importance of employee health and hygiene (as discussed in the article on page 3). This is further reinforced by the survey responses on corrective action taken following an incident, with the most common action being that of increased training or retraining of employees (88%) (Figure 16).

Of the eight facilities that did have a related incident, none resulted in a recall, but all the facilities made improvements following the incident.

Second to the most common response of training/retraining was that of increased environmental testing (63%). The importance of this practice relates to both hand and foot cleanliness, as an employee who does not wash their hands prior to entering a food area can contaminate the food or a food-contact surface that they touch, which can be detected through environmental testing. To help reduce the potential of this, 38% of respondents added or increased their handwashing supervision or automation.

Additionally, because unclean footwear can track pathogens into food production zones, the environmental testing can help detect contamination before it impacts a food product. As such, it does appear that incidents caused respondents to realize the need for footwear sanitation, as more than half (63%) of those who had had a related incident made changes to their footwear policies — adding or increasing shoe/bootwashing (50%) or adding a captive-boot program (13%).

Protecting food from hand, foot, and ill-worker contamination is a regulatory requirement for the food industry, but with no two food facilities being exactly the same and options existing for this protection, no two company policies and practices will be exactly the same either. This appears to be particularly true in footwear sanitation, as it was the only hygiene factor of the survey which was not rated as important or very important for at least 94% of respondents.

However, the fact that 63% of those who had had related incidents implemented corrective action for footwear likely shows an increasing awareness of — and preventive controls for — the potential for footwear-related contamination. ?

Shoes and boots can be a significant source of contamination in a food facility. As was stated in a 2008 University of Arizona study, and has been recently reinforced by coronavirus transmission research (such as that explained in a Penn State Extension article), bacteria can be carried into food facilities on the surfaces and soles of workers’, visitors’, and customers’ shoes.

In the University of Arizona research, coliform and E. coli bacteria were found on 96% of the outside of shoes studied, indicating frequent contact with fecal material. The study also indicated that bacteria can be tracked by shoes over a long distance.

Despite these findings, 34% of food facilities have no footwear hygiene system (Figure 13) and 57% do not provide boots or shoe coverings for employees or visitors (Figure 14). There may be some overlap between these — with those not providing boots or shoe covers instead having a footwear hygiene system. However, with Figure 3 (page 2) showing that 13% of respondents saw shoe/boot sanitation as having little or no importance, we can likely assume that at least 13% have no procedures in place for reducing bacterial contamination of foot traffic.

It is also feasible that at least some of the 34% (in Figure 14) who have no footwear hygiene system are among the 34% (in Figure 15) who provide boots or shoe covers for the purpose of further preventing contamination. However, having no footwear hygiene system — such as the footbath/boot dip and floor foamer used by 25% and 21%, respectively — provides for no control of the contamination that could be carried into a food area on the wheels of equipment and tools. ?

In addition to food facilities having requirements for handwashing, 78% of respondents stated that they require the use of gloves. However, those requirements for who must wear gloves and where and when they must be worn vary between businesses (Figure 11). The most common requirement is that any employees who contact the food itself are required to wear gloves (85%), and close to half of those who require gloves mandate them of all employees in the processing area (41%).

In some cases, visitors also must don gloves, particularly those who have polished nails or do not remove rings (30%); and about a fifth (17%) require that all visitors in the processing area wear gloves.

While it may seem duplicative to wash hands if gloves are to be worn, it is in fact a regulation that this be done. As stated in the Code of Federal Regulations Title 21, Part 112, hygienic practices of personnel who handle (contact) covered produce or food contact surfaces include “washing hands thoroughly…before putting on gloves.” Not only do 93% of respondents follow that practice, but 31% of those also require that hands be washed after the wearing of gloves as well (Figure 12).

However, the Conference for Food Protection has clarified that this does not mean hands must be washed every time gloves are changed even when performing the same task. Rather, employees should be allowed to change gloves without having to wash their hands when they are performing the same task without increased risk of cross-contamination and when handling raw food and not increasing the risk of cross-contamination with RTE foods or clean food contact surfaces. ?

To determine their extent of knowledge, survey participants were asked about proper handwashing procedures. While only 84% knew that handwashing should take at least 20 seconds (Figure 7), this closely corresponds with the total percentage of respondents (83%) in roles (food safety, quality control/assurance, plant managers and sanitarians) most likely to be responsible for training and working with employees on hygiene (Figure 2, page 2).

That training is being conducted, as 93% of respondents said their employees are trained on handwashing, with the highest numbers being trained upon hire (89%), through signs at handwashing sinks (85%) and during regular food safety training (75%) (Figure 8). With the exception of signage, training is infrequently conducted as the majority (52%) repeated handwashing training only annually (Figure 9). However, 53% supervise handwashing (Figure 10), so further training could be conducted at that time, if needed.

There has been a continually repeated emphasis on 20-second handwashing as a preventive measure during the COVID-19 pandemic. This, too, is an area in which we are likely to see a focus retained well into the “new normal” of the post-pandemic era. ?