NZ school’s removal of soap from children’s toilets labeled ‘appalling’

Whenever someone tells me of an outbreak at a school, day care, university residence, whatever, the first place I go, or someone more geographically-centered should go, is check out the bathrooms.

It’s easy to preach proper handwashing as a way to reduce the spread of infectious disease.

But proper handwashing requires access to proper tools.

So I check out the bathroom and usually find the tools, uh, missing.

Proper handwashing requires vigorous water flow (temperature doesn’t matter), a vigorous rub with soap, and drying with paper towel.

Garth Bray of TVNZ reports an Auckland primary school has dumped a policy that saw soap and hand towels removed from all children’s toilets.

The school felt the children were wasting those basic items, but failed to follow some of the most basic health advice with its policy.

“I think it’s appalling”, said Dr Michael Baker, who is the University of Otago Professor of Public Health.

“We’ve got good evidence in big trials showing that having handwashing can actually reduce risk of gut infections by about 30 per cent and respiratory infections by about 20 per cent so I think all of our schools need to be part of this,” Dr Baker told Fair Go.

Fair Go was contacted by four parents of children at the school who objected to the school withdrawing soap but had been told by teachers this was the policy.

Some had simply accepted this and started sending their children to school with little bottles of liquid hand soap to use.

However, one took her concerns to the principal and to a school board member.

Fair Go has seen written messages between the board member and the parent which say: “There are no legal requirements from the Ministry of Health and the students were wasting the soap and hand towels so they were taken out but every class has hand sanitiser that they encourage their kids to use regularly.”

That’ll work until the kids start drinking the stuff.

Fair Go spoke with the principal, who disclosed that classrooms were sometimes locked at lunchtimes, meaning children had no access to anything but water for washing before meals and after using toilets.

The principal told Fair Go that the same week our programme had made contact, the school board had decided to reverse the policy and will now stock toilets with soap and hand towels again.

On that basis, Fair Go has decided for now not to name the school publicly as it takes steps to make good its commitment to provide hygienic hand washing facilities for children.

“New Zealand’s got an appalling record of having very high rates of a lot of major childhood diseases – respiratory infections, skin infections and gut infections and these are exactly the things that hand washing can protect our children against,” Dr Baker said.

Fair Go’s advice is for parents to take a look at their own school’s facilities and reassure themselves their children have the essentials on hand at school.

I do.

And the school knows I check.

Soap porn: Soap bar sales plunge as young people opt for hand wash

Richard Gray of the Daily Mail reports a fear of germs may be dooming the humble bar of soap as young, hygiene obsessed members of millennials turn to hand wash instead.

doolNew figures have revealed that young people aged between 18 and 24 are choosing liquid soap over the old fashioned bars.

Sales of soap bars in the US fell by 2.2 per cent between 2014 and 2015 even though the overall market for bath and shower products increased by 2.7 per cent, Mintel has found.

Most of this decline in the use of soap bars has been driven by younger consumers and women.

But it appears traditional bars of soap are still popular with older members of society, particularly men who are over the age of 60, perhaps adding to its old fashioned image.

The figures fit within a growing trend that shows consumers are turning their back on traditional soap bars – since 2010 the number of households using bar soap has dropped by five per cent.

While some of this may be partly driven by the growing range of soap products now available, Mintel found that nearly half of all US consumers believe soap bars are covered in germs after use.

This was most strong in those aged between 18 and 24-years-old – the cohort often identified as Generation Z, or more widely as millennials.

A generation so much dumber than its parents

Came crashing through the window.

They said loads: Handwashing and glove use both necessary

Handwashing and glove use are the main methods for reducing bacterial cross-contamination from hands to ready-to-eat food in a food service setting.

amy.sorenne.handwashingHowever, bacterial transfer from hands to gloves is poorly understood, as is the effect of different durations of soap rubbing on bacterial reduction. To assess bacterial transfer from hands to gloves and to compare bacterial transfer rates to food after different soap washing times and glove use, participants’ hands were artificially contaminated with Enterobacter aerogenes B199A at ∼9 log CFU. Different soap rubbing times (0, 3, and 20 s), glove use, and tomato dicing activities followed. The bacterial counts in diced tomatoes and on participants’ hands and gloves were then analyzed. Different soap rubbing times did not significantly change the amount of bacteria recovered from participants’ hands.

Dicing tomatoes with bare hands after 20 s of soap rubbing transferred significantly less bacteria (P < 0.01) to tomatoes than did dicing with bare hands after 0 s of soap rubbing. Wearing gloves while dicing greatly reduced the incidence of contaminated tomato samples compared with dicing with bare hands. Increasing soap washing time decreased the incidence of bacteria recovered from outside glove surfaces (P < 0.05).

These results highlight that both glove use and adequate hand washing are necessary to reduce bacterial cross-contamination in food service environments.

Adequate hand washing and glove use are necessary to reduce cross-contamination from hands with high bacterial loads.

J Food Prot. 2016 Feb; 79(2):304-8. doi: 10.4315/0362-028X.JFP-15-342.

Robinson AL, Lee HJ, Kwon J, Todd E, Rodriguez FP, Ryu D

http://www.ncbi.nlm.nih.gov/pubmed/26818993

FDA CDER wants to know if antimicrobial soaps are effective: Schaffner responds

Friend of the barfblog.com Don Schaffner of Rutgers University writes in this guest post:

The FDA might not be sure if antimicrobial soaps do anything, but I am. My colleague R. Montville[1] and I published a meta-analysis on the topic in 2011. As we noted in our manuscript, although differences in efficacy between antimicrobial and nonantimicrobial soap were small (∼0.5-log CFU reduction difference), antimicrobial soap produced consistently statistically significantly greater reductions when compared to plain soap. This difference was true for any of the antimicrobial compounds investigated (chlorhexidine gluconate, iodophor, triclosan, or povidone) where we had more than 20 observations to analyze.24673_1363044526205_4550195_n

But the story doesn’t end there. The American Cleaning Institute who funded[2] the meta-analysis study wanted to dig a bit further. A second article has been accepted for publication in the Journal of Food Protection, and is in the galley proof stage. That article, entitled “Quantitative Microbial Risk Assessment of Antibacterial Hand Hygiene Products on Risk of Shigellosis” used previously unpublished laboratory data, together with simulation techniques, to compare the ability of nonantibacterial and antibacterial products to reduce shigellosis risk. Our simulation assumed 1 million Shigella bacteria on the hands of a food handler who washed their hands and then handled melon balls, which were then eaten. When a plain soap hand treatment was simulated, we predicted that 50 to 60 cases of shigellosis would result (of 100 exposed). Conversely, each of the antibacterial treatments (0.46% triclosan, 4% chlorhexidine gluconate, or 62% ethyl alcohol) was predicted to result in an appreciable number of simulations for which the number of illness cases would be 0, with the most common number of illness cases being 5 (of 100 exposed). These effects maintained statistical significance down to as low as 100 Shigella per hand, with some evidence to support lower levels. Like I said, I think anti-microbial soaps work. If you think they don’t, show me the data.

[1]: No, not that Montville, his daughter.
[2]: Does that make me an industry shill? Please. Like anyone can tell me what to say.

No soap at school, kids sick

Go evidence or go home.

Children are, according to The New Zealand Herald, becoming sick at one of the country’s most modern new schools, parents say, because for three years the board banned soap and hand towels, fearing that they harmed the environment.

The school, which has Greenstar accreditation for environmentally friendly design, has a healthy attendance rate of 93.4 per cent, the board says, handwash_south_park(2)with no unusual illnesses.

But some parents say their children are suffering due to the school founders’ green philosophy and have complained to the board about their children’s repeated bouts of illness.

Stonefields has stocked only hand sanitiser in bathrooms since it opened in February 2011.

After an approach from the Herald on Sunday this month, board chairman Israel Vaeliki said the school would install hand driers and soap dispensers.

One mum, who asked not to be named, said she, her husband and their child had suffered gastro-intestinal illnesses this year. “The hand sanitiser’s not effective.”

The woman had raised the issue with the school but had been assured handwashing, with soap, was available in the children’s learning hubs.

Another parent said her daughter and classmates had suffered several bouts of gastroenteritis, due to the lack of soap and hand driers. Instead, the children would wipe their wet and dirty hands on their clothes. But a third Stonefields parent, Camille Harvey, believed sanitiser was more effective as children tended to do a poor job with soap and water.

The original sanitiser solution was decided by the establishment board in consultation with the Ministry of Education before the school opened, Vaeliki said. “Having no paper towels was in line with the school’s environmental sustainability philosophy. Recently, the school has received one complaint about the solution but otherwise there have been no issues for three years.”

A ministry spokesman said schools were required to provide a cleaning agent and warm water so the potential spread of germs was kept to a minimum.

As hospitals in the U.S. began to realize several years ago, sanitizer does not replace proper handwashing with soap and drying with paper towel.

Water temperature does not matter, but a vigorous water flow does, as does the vigor of drying with paper. Hand driers don’t cut it.

A google search would have revealed handwashing basics for the environmental educationalists.

handwash.infosht-2-7-08 copy

You can hold my koala but not wash your hands

Sunday in Brisbane (that’s in Australia) was a perfect chance to discover the local wildlife: kangaroos and koalas at the Lone Pine Koala Sanctuary. Emma and Sorenne were overly excited by the opportunity. When it was their turn to get their photo taken with the koala, however, I noticed the sign on the hand sanitizer station saying, “Out of Order. Sorry for any inconvenience.” As we exited the area into the food court, Emma grabbed some sanitizing wipes that were available (but unmarked and almost not noticeable) on a table and cleaned up Sorenne’s hands the best she could.

After our afternoon “tea” (that’s Australian for “snack”), we headed into the Kangaroo Rescue area. For $2 I bought a rather large bag of kangaroo feed, and we proceeded to shove our hands into the faces of every kangaroo who passed by. Emma was brave and lay down on the ground to pose with one of the big boys. For me the highlight was either seeing a pregnant mommy ‘roo whose joey was wiggling about in her pouch or watching Sorenne’s face light up when the baby kangaroos ate from her hands (right exactly as shown).

Upon exiting the area (which was filled with scrub turkeys, ducks, wombats, emus and feces in addition to the kangaroos), there was a handwashing station with ample running cold water and soap but no paper towel to dry hands. The park prides itself on reusing water, and there was clear signage indicating that all water in use was recycled except for handwashing, food preparation, and drinking water. I didn’t feel confident that they were able to separate distribution so well after realizing that handwashing wasn’t possible in the koala cuddling zone.

Handwashing really isn’t simple, especially when the proper tools are not available.
 

You can hold my koala but not wash your hands

Sunday in Brisbane (that’s in Australia) was a perfect chance to discover the local wildlife: kangaroos and koalas at the Lone Pine Koala Sanctuary. Emma and Sorenne were overly excited by the opportunity. When it was their turn to get their photo taken with the koala, however, I noticed the sign on the hand sanitizer station saying, “Out of Order. Sorry for any inconvenience.” As we exited the area into the food court, Emma grabbed some sanitizing wipes that were available (but unmarked and almost not noticeable) on a table and cleaned up Sorenne’s hands the best she could.

After our afternoon “tea” (that’s Australian for “snack”), we headed into the Kangaroo Rescue area. For $2 I bought a rather large bag of kangaroo feed, and we proceeded to shove our hands into the faces of every kangaroo who passed by. Emma was brave and lay down on the ground to pose with one of the big boys. For me the highlight was either seeing a pregnant mommy ‘roo whose joey was wiggling about in her pouch or watching Sorenne’s face light up when the baby kangaroos ate from her hands (right exactly as shown).

Upon exiting the area (which was filled with scrub turkeys, ducks, wombats, emus and feces in addition to the kangaroos), there was a handwashing station with ample running cold water and soap but no paper towel to dry hands. The park prides itself on reusing water, and there was clear signage indicating that all water in use was recycled except for handwashing, food preparation, and drinking water. I didn’t feel confident that they were able to separate distribution so well after realizing that handwashing wasn’t possible in the koala cuddling zone.

Handwashing really isn’t simple, especially when the proper tools are not available.
 

Sanitizers suck for petting zoos, hospitals?

What’s better, washing with soap and water and drying with paper towel, or using a sanitizer?

About 10 years ago the consensus was leaning toward sanitizers because of convenience and mobility. But new studies questioning the effectiveness of various sanitizers means handwashing has become fashionable yet again.

Are sanitizers better than nothing? Probably, in places like hospitals, but not so much on farms where organic matter – dirt and poop – rapidly reduce the effectiveness of sanitizers.

In the wake of an outbreak of cryptosporidium linked to a live lambing event in Wales that has sickened at least 13, the U.K. Health Protection Agency (HPA) has warned anyone who is visiting an open farm over the Easter weekend not to rely on sanitizing hand gels or wipes to protect themselves or their children against germs that may be present in animal dirt around the farm.

Although the risk of becoming unwell is very low in light of the millions of farm visits every year there are, on average, around three outbreaks of gastrointestinal disease which are linked to visits to petting farms. The route of infection in these outbreaks is generally through contact with germs from animal droppings. These germs can be ingested when people, especially children, put their fingers in their mouths.

To reduce the risk of illness, both adults and children should thoroughly wash their hands using soap and water after they have handled animals or touched surfaces at the farm and always before eating or drinking. Hand gels can’t remove contamination in the manner that soap and water can.

Research published by the HPA of a review of 55 outbreaks of intestinal disease linked to petting farms between 1992 and 2009 showed that one of the risk factors associated with illness was the reliance on hand gels instead of handwashing. Over the 17 year period of the study, 1,328 people were reported to have fallen ill following a farm visit, of whom 113 were hospitalised. Illness ranged from mild through to severe diarrhoea and occasionally more serious conditions.

Over half of the 55 outbreaks in the study, 30 (55 per cent) were caused by E. coli O157 (VTEC O157) and a further 23 (42 per cent) were caused by cryptosporidium. The remaining two (three per cent) outbreaks were caused by a type of salmonella.
Other risk factors noted in the research are which have been linked to outbreaks include bottle feeding lambs and thumb sucking by children. The full research paper can be found in Emerging Infectious Diseases 2010 Gormley et al. ‘Transmission of Cryptosporidium spp. at petting farms, England and Wales’ http://www.cdc.gov/ncidod/eid/

Hand gels have their use in areas which are generally clean, for example offices or hospitals, but are not effective in killing bugs such as E. coli or cryptosporidium which can be found in animal droppings and on contaminated surfaces around farms.

Except there may be some BS in the cleanest offices.

The U.S. Food and Drug Administration (FDA) reported yesterday that some hand sanitizers and antiseptic products come with claims that they can prevent MRSA (methicillin-resistant Staphylococcus aureus) infections.

Don’t believe them. These statements are unproven, says FDA.

“Staphylococcus aureus itself is a very aggressive organism,” says Edward Cox, M.D., M.P.H., director of FDA’s Office of Antimicrobial Products. “It’s often associated with patients in hospitals who have weakened immune systems, but the bacterium can also cause significant skin infections and abscesses in a normal, healthy person. And it can get into the bloodstream and, less frequently, may involve the heart valve, which is very difficult to treat.”

But this antibiotic-resistant strain is even more difficult to treat. “With MRSA, a number of the antibiotic drugs we typically used often don’t work, so we lose treatment options we used to rely upon,” says Cox.

FDA is cracking down on companies that break federal law by promoting their products as preventing MRSA infections and other diseases without agency review and approval.

“Consumers are being misled if they think these products you can buy in a drug store or from other places will protect them from a potentially deadly infection,” says Deborah Autor, compliance director at FDA’s Center for Drug Evaluation and Research.

FDA wants consumers to watch out for unproven product claims, too—whether they buy a product from a retail store or through the Internet.

Examples of unproven claims found on product labels are
* kills over 99.9% of MRSA
* helps prevent skin infections caused by MRSA and other germs
* is effective against a broad spectrum of pathogens, including MRSA

One company claims that its hand sanitizing lotion prevents infection from the bacterium E. coli and the H1N1 flu virus. And another firm claims its “patented formulation of essential plant oils” kills the bacterium Salmonella. These claims are also unproven and, therefore, illegal.

“FDA has not approved any products claiming to prevent infection from MRSA, E. coli, Salmonella, or H1N1 flu, which a consumer can just walk into a store and buy” says Autor. “These products give consumers a false sense of protection.”

Research shows how easily bacteria can thrive and spread within family kitchens

Colgate Palmolive and Don Schaffner (right, pretty much as shown) have hooked up to help spread awareness about safe kitchen practices.

Schaffner did a lit review, and I like that the press release has references – so many don’t; I don’t like that it repeatedly says food safety is simple and easy – it isn’t.

Research shows that E. coli, Salmonella and Staph can thrive on dishes and other kitchen surfaces.1 Whether putting away groceries or rinsing fresh vegetables, even the most careful cook can pass bacteria to new kitchen surfaces through the simple process of preparing a dish.

To help spread awareness about safe kitchen practices, the Palmolive® brand partnered with Donald W. Schaffner, Ph.D., renowned microbiologist and professor at Rutgers University. As an author of nearly 100 food microbiology studies, Dr. Schaffner was among the first to quantify how bacteria transfer during common kitchen tasks.

To demonstrate how easily cross-contamination can occur, Dr. Schaffner conducted a comprehensive review of his bacterial studies and those of leading universities and institutions worldwide that specialize in food safety research. Key research findings from this analysis include:

Bacterial Build-Up on Cutting Boards: Bacteria on a cutting board can double after 10 minutes of use, whether cutting raw meat or vegetables.2
Cutting Board Cross-Contamination: Ten percent of bacteria on a cutting board can transfer to lettuce while chopping.3
Survival of E. coli on Dishes: E. coli that remains on washed and dried dishes can survive up to three days.4

"Studies consistently demonstrate how easily bacteria spread throughout a kitchen – both bacteria-contaminated foods and hands can pass bacteria to dishes, cooking utensils and other ingredients," said Dr. Schaffner. "Yet, according to the research, even when cooks understand the ways bacteria can spread, they often fail to follow the simple precautions that can help reduce the risk of bacterial cross-contamination in the kitchen."

Consumers generally understand the causes of cross-contamination, such as not washing or changing the cutting board and other utensils between the preparation of meat and ready-to-eat foods.5 Despite this knowledge, many do not practice these safety measures while preparing meals. A recent study revealed that two-thirds of consumers failed to adequately wash hands after handling raw chicken, nearly 30 percent failed to wash or change the cutting board after cutting raw chicken and one-third failed to wash or change a knife used to cut raw chicken before cutting raw vegetables.6

"We know that consumers want to do everything they can to keep their kitchens clean and their families safe," said Dave Wilcox, Vice President, Product Safety, Regulatory & Quality, Colgate-Palmolive. "Using Ultra Palmolive® Antibacterial Dish Liquid to clean knife blades, dishes and other hard, nonporous kitchen surfaces throughout your cooking prep and clean-up process is a simple step that can help put your cooks’ minds at ease."

References?

1"The importance of hygiene in the domestic kitchen: Implications for preparation and storage of food and infant formula." 2009. Perspectives in Public Health, March. Vol. 129 No. 2 l. http://rsh.sagepub.com/content/129/2/69.refs.html

?2 "Use of Microbial Modeling and Monte Carlo Simulation to Determine Microbial Performance Criteria on Plastic Cutting Boards in Use in Foodservice Kitchens." 2004. Food Protection Trends, Vol. 24, No. 1: 14-19.

3 "Quantification and Variability analysis of Bacterial Cross-Contamination Rates in Common Food Service Tasks." 2001. Journal of Food Protection, Vol. 64, No. 1: 72-80.

4 "The survival of foodborne pathogens during domestic washing-up and subsequesnt transfer onto washing-up sponges, kitchen surfaces and food." 2002. International Journal of Food Microbiology, Vol. 85 (2003): 213- 226.

5 "Bacterial Contamination of Hands Increases Risk of Cross-contamination among Low-income Puerto Rican Meal Preparers." 2009. Journal of Nutritional Educational Behavior, Vol. 41:389-397?

6"Cooking Practices in the Kitchen-Observed Versus Predicted Behavior." 2009. Risk Analysis, Vol. 29, No. 4. DOI: 10.1111/j.1539-6924.2008.01189.x

Failure to make councils check school toilets ‘risks poisoning’

Whenever there’s an outbreak of norovirus or some other tummy upset that forces large numbers of students to call in sick, check the bathrooms.

Are the tools for proper handwashing – running water, soap and paper towel – actually available?

And while a report titled, A Response to School Toilets: Best Practice Guidance for Primary and Secondary Schools in Wales, may not make exciting bathroom reading, continual attention to hygiene basics consistently reduces the numbers of people barfing.

Consumer Focus Wales (CFW) made the same point today, arguing that children face an increased risk of contracting and spreading deadly bugs because councils will not be forced to check school toilet hygiene.

As part of the South Wales E.coli public inquiry, Professor Hugh Pennington recommended that every council should have a program of audits to ensure all schools have adequate toilet and handwashing facilities.

Jennie Bibbings, CFW’s senior policy advocate, said: “In the current financial climate school toilets might be a low priority but hygiene standards could suffer and the risk of illness among school children increases.

The public inquiry into the 2005 E. coli O157 outbreak in South Wales heard shocking evidence about the state of school toilets. In some of the schools in the outbreak area there was no running hot water or even soap for children to wash their hands.

Peter Clarke, Wales’ first Children’s Commissioner, had highlighted concerns about the lack of soap and toilet paper in some schools in 2004 – a year before butcher William Tudor caused the E.coli O157 outbreak.

And his successor Mr Towler again highlighted the sub-standard facilities in his third annual report last year.

“Currently I’m seeing inequality across the country with some schools having made considerable improvement while other pupils feel so strongly about it they refuse to use the toilet during the school day.”

Consumer Focus Wales said it should also include standards for staff facilities because successive food hygiene inspection reports have revealed variable performance among school canteens in the provision of hand washing facilities.”