Dirty restrooms don’t correlate to foodborne illness outbreaks

While making a recent pilgrimage from Raleigh to Southern Ontario (and back) via minivan I saw a bunch of dirty restrooms. One was so bad (right, exactly as shown) that Dani made us go to the next exit; things almost got messy in the car.

DSC05623A dirty restroom is gross, and might be a good source of a pathogen like norovirus from a previous, uh, user, but do dirty bathrooms say anything about the food handling practices in the kitchen? Or does a clean bathroom mean that the cooks know their stuff and are reducing cross-contamination? Some argue that a dirty restroom is an indicator of poor sanitation throughout the system (maybe), but analysis of inspection results seem to disagree that dirty bathrooms are correlated with outbreaks. We talked about this a bit in a paper published earlier this year (D.A. Powell, S. Erdozain, C. Dodd, R. Costa, K. Morley, B.J. Chapman. 2013. Audits and inspections are never enough: A critique to enhance food safety. Food Control).

Some good stuff that friend of barfblog Ruth Petran published last year also showed that for certain pathogens there was little correlation between inspection factors related to sanitation and outbreaks. Sanitation of facilities and non-food contact surfaces only came up in noro outbreaks with a relative risk of less than the lack of single use/service articles and weirdly proper cooling and date marking. Dirty facilities wasn’t seen as a risk factor popping up in Salmonella or C. perfringens outbreaks at all. What matters are things like keeping ill employees out of the kitchen and controlling temperatures.

Evidence often isn’t enough to sway public opinion though. UPI reports that in a survey funded by restroom hygiene equipment that cleanliness matters to patrons.

Almost 30 percent of U.S.adults say they will never return to a restaurant with a dirty bathroom, a survey indicates.

Elliott Greenberg, owner of www.TouchFreeConcepts.com said a recent survey conducted by Harris Interactive for SCA Tissue North America found 50 percent of restaurant patrons who have a negative experience with the restroom — bad odors, grimy soap dispensers, dirty toilets and other cleanliness problems — will discuss it to friends and family.”

“We live in a world that is consumed with hand sanitizers and green living. The consumer is acutely aware of those things that cause the spread of germs and bacteria,” said Donna Santoro, senior product manager of the washroom solutions global business team for Rubbermaid Commercial Products. “And it is all about touching.”

Killer dishcloths cycling through media spin

Press release before publication. Again.

And it seems to plague stories about dishrags or dishcloths or sponges or whatever they’re called; those things used to wipe up stuff in the kitchen.

In 1995, the front-page of Toronto’s Globe and Mail screeched, “Warning: your kitchen dishrag is a killer. … you probably handle an unimaginably dangerous collection of harmful bacteria" while going about your kitchenly chores, and that "90 per cent of food-related illness in the home could be prevented by using paper towels when preparing foods, especially meats."

That was Dec. 1995. The paper describing the research was eventually published in 1997.

Today, Safefood Ireland sent out a strinkingly similar press release with strikingly similar flaws.

And the Irish Examiner went with a similar lede.

A total of 27% of household dishcloths were found to contain the raw meat bacterium E. Coli, in a recent study.

According to research from Safefood, listeria was also present on 14% of cloths analyzed by scientists.

The research shows that although one-third of consumers who re-use dishcloths clean them in bleach and almost one in four wash them by hand, neither method is effective at removing the germs that cause food poisoning.

Safefood is reminding people that cloths must be cleaned in a washing machine on a temperature of least 30 degrees or else boiled for 15 minutes to effectively kill germs.

I’m not sure of the validity of those statements: Safefood cites some research, but it doesn’t appear to have been published anywhere; and if it has, PR 101 would be to include the reference on the press release.

Instead the PR contained this:

1. ‘Assessment of the ability of dishcloths to spread harmful bacteria to other kitchen surfaces and determination of the effectiveness of various dishcloth cleaning regimes’. safefood/Prof David McDowell; University of Ulster; Jordanstown
2. ‘The microbiological status or household dishcloths and associated consumer hygiene practices’. safefood/ Eolas International, 2011

There’s lots of research out there, but the information presented in this press release is difficult to assess. What is the quantitative difference between rinsing a cloth or sponge before use, and the dishwasher? Were the numbers derived from self-reported responses or actual observation (people lie)? Can the actual risk of cross-contamination from such cloths be modeled in a risk assessment?

When I use a sponge or dishcloth, I habitually rinse it first, which does not eliminate but may reduce bacterial loads. Dish clothes and towels get swapped out 1-2 times a day, and sponges go in the dishwasher about every third day. When dealing with raw meat, the sponges or clothes are swapped out immediately. Pete Snyder makes similar recommendations.

The 1995 killer-dishrag story met the primary goal of its creators: to sell more sponges. Specifically, anti-bacterial sponges manufactured by 3M Co. of Minneapolis, Minn.

Dr. Charles P. Gerba, an environmental microbiologist at the University of Arizona in Tucson, was contracted by 3M to perform tests of household dishrags and sponges in five U.S. cities and compare the results to the 3M sponge. Dr. Gerba found about 100 times more bacteria in dishrags retrieved from households.

Then the public relations firm hired by 3M peddled the results, taking Dr. Gerba on a five-city tour to release the results. That was in Aug. 1995. Several stories appeared on the U.S. wire services. Why the Globe decided to run the story at the end of Dec. 1995 remains a mystery.

Some may argue the end justifies the means, that any message promoting the safe handling of food in the kitchen is good. Except that stories which overstate a risk have been shown to do more harm than good. It’s called the boomerang effect. If a message is oversold or overstated, people stop believing. With killer sponges, the message is more harmful than the bacteria; unless properly validated.

Is qwerty tummy real?

It’s called “qwerty tummy,” the idea that office workers or people like me who do everything around the notebook keyboard are spilling food crumbs that attract mice that then leave their droppings and disease and make people barf.

Qwerty being the first six letters on a keyboard. Get it?

A N.Y. Times word blogger wrote it up today, based on a story that appeared May 12, 2010 in the Daily Mail.

The Royal Society of Chemistry says mice are leaving droppings in computer keyboards as they search for food crumbs in empty offices at night. Their claims come amid a rise in anecdotal evidence suggesting mice are becoming an increasing problem.

One London cleaning firm told them: ‘A woman worker wondered why ‘seeds’ were coming out of her computer keyboard when she typed. She was mystified because she did not eat food at her desk. An investigation showed them to be mice droppings.’

I get asked about these pop safety surveys all the time – someone wants to sample keyboards (left, photo from Daily Mail), or door handles, or money, or lemon wedges or iced tea dispensers and yes, there are bacteria present, but where are the bodies? Where are the sick people from these practices?

I should have taken a picture this morning of the nightly offering held forth by our cats – a dead mouse on the front porch. The cats need to do a much better job scaring off the rabbits from our lettuce patch.

CHUCK DODD: Eating dirt can be bad for you

New York Times journalist Jane Brody suggests that eating dirt is an instinctive behavior in humans. In her article, Eating dirt can be good for you – just ask babies, she interviewed researchers who think people should eat dirt in order to stimulate their immune system.  Brody says that immune system disorders such as asthma and allergies have risen significantly in the United States. 

Although allergies do appear to be on the rise, the awareness of allergies, the ability to diagnose allergies, and the number of people at risk (the U.S. population) have also risen significantly. 

The director of gastroenterology and hepatology at Tufts Medical Center in Boston, Dr. Joel Weinstock, said in the interview,

"There are very few diseases that people get from worms. Humans have adapted to the presence of most of them. … Children should be allowed to go barefoot in the dirt, play in the dirt, and not have to wash their hands when they come in to eat…let kids have two dogs and a cat, which will expose them to intestinal worms that can promote a healthy immune system.”

Dr. Weinstock, I’m sure glad you aren’t my doctor. 

I agree that immune systems are naturally stimulated by various exposures to the environment, and that Americans use too many antibacterial products, but I question Dr. Weinstock’s knowledge of zoonotic diseases.  Intestinal parasites from animals that infect humans, since many are not adapted to humans, often leave the intestines and migrate through the body.  There are approximately 10,000 human cases of larva migrans in the U.S. each year.  Unfortunately, most of these cases are in children, and a few of these kids die.

Eating dirt is an instinct?  Not for me.  Babies eat dirt because they don’t know better.  Some may think that bad behavior is an instinct, but calling bad behavior an instinct doesn’t excuse it.  Bad advice shouldn’t be excused either. 

Dirt may have poop in it, so don’t eat it.


Restaurant sinks are not bathtubs

An Ohio man is in hot water for taking a hot bath in a Burger King bathtub. The video shows a man sitting in the sink, while other employees look on laughing. At one point the employee with the camera goes to ask the manager if she wants to come watch. The manager declines, but also fails to take any action. The video was then posted on Myspace. The fast food restaurant has fired all employees involved. They added that the sink was sanitized twice and all utensils were thrown out. Health officials are working with prosecutors to see if charges will be filed. However the health department has declined to issue any fines. If bathing in a kitchen sink isn’t worth a fine, what is?

The video contains some not safe for work language.

Burger King Employee Takes Bath In Sink – Watch more free videos

America’s worst bathroom contest

Received an email from a company running a contest for the Scott Paper and White Cloud toilet paper today asking about a previous barfblog post on dirty bathrooms:

We are running an online contest for Scott Paper and White Cloud toiler paper in an effort to find America’s Worst Bathroom.  We have been notified by several entrants about an entry with a photo that appeared on your blog.  The link to the entry is here. Could you please contact me either via e-mail or; better yet, by phone as soon as possible?  I am trying to find out who owns the copyright for the image in question.  Did you take the photo?  If so, I have to remove this entry and replace it with another.  If not, the entry stays in the contest and I don’t have to make any changes.

Sounds like a serious contest.  I didn’t take the original picture, found it somewhere on the interwebs using Google Image Search (like a lot of the barfblog photos).  Go check out the contest and vote for the dirtiest bathroom.

Dirty drinking glasses in hotel rooms

HealthInspections.com has uncovered yet another television story that has found that the glasses don’t get washed.
WCPO in Cincinnati borrowed an idea that was first tried by a Fox television station in Atlanta. They placed hidden cameras into hotel rooms to watch housekeepers in action. 

WCPO found that instead of washing the drinking glasses in guest rooms, they’re just wiping them off and reusing them. And it’s happening at big name hotels such as the Hilton.

In one case, it shows a housekeeper wiping the bathroom floor with a towel then using the same towel to wipe off drinking glasses.

WCPO found glasses being reused at hotel rooms in Ohio, Kentucky, Kansas City, Phoenix, and Baltimore.

Are bathrooms a good indicator for food safety practices?

I don’t believe they are.  I think there are lots of food businesses that have spotless toilets and bad food safety practices.  Ron Pelger of the Produce News suggests they are a good indicator:

The next time you go into a restaurant, I highly recommend that you visit the restroom first to check out the sanitation conditions of the establishment before ordering and eating your meal. Give it the old once-, twice- and three-times-over inspection. If it passes your examination, the restaurant must have high cleanliness standards.

Really? Pelger sounds pretty trusting. There is some great literature that suggests that inspection scores are not a good indicator of whether a restaurant is going to make someone ill. Should consumers also ask to see the conditions of the bathrooms and port-a-potties on farms and make decisions based on that? I don’t think so. I think we should be basing our decisions on what a produce distributor (grower/packer/shipper) can prove about the food safety practices on the farm, not what is possible to clean-up in preparation for a planned audit.

Pelger also writes:

There are many scenarios in the produce industry that can lead to product contamination. Through a sophisticated trace-back process, product can be traced to its original source. In the recent past, foodborne illness outbreaks were linked to spinach, lettuce and tomatoes. These cases have been traced back to their sources and the problems corrected. But what about areas other than farms? Could contamination be happening in other links of the food chain as well?

Pelger is right that food safety is a farm-to-fork, food system issue — but he unfortunately comes across as whining about how it’s not always farms (true) without suggesting how the entire supply chain should get together and address it. If an industry truly believes in the everyone-has-a-role-to-play mantra, they should help their partners (upstream and downstream) in producing safe food. And tell everyone about it.

New iFSN infosheet — Dirty Finger Al

One of the best ever monikers in any food safety story came out courtesy of our friends at healthinspection.com.  Dirty Finger Al inspired today’s infosheet which can be found here.

Dirty Finger Al got his name because he is allegedly “grotesque in his hygiene because of filthy hands and fingers and open, oozing sores while cooking.”   And he’s a chef. Yum.