Purpose: The purpose of this study was to evaluate the produce handlers’ handwashing behaviors in secondary school cafeterias through systematic observations.
Methods: The literature and expert advice guided development of the data collection instrument. Included was time and occasion of each observation when hands should have been washed, duration, areas of hands washed, and if recontamination occurred. The instrument was pilot-tested and revised before data collection by trained researchers at 14 secondary school cafeterias where fresh produce was served. The compute function was used to evaluate handwashing adequacy, and descriptive statistics were calculated to summarize the data.
Results: At 14 school cafeterias, 425 occasions where handwashing was necessary were observed. The most frequent occasions were “between changing tasks” (n=177) followed by “after touching equipment doors” (n=72), “before handling different food” (n=44), “before starting food preparation” (n=38), and “after cleaning equipment and utensils” (n=12). Of 425 occasions, employees washed hands on 128 occasions only (30.1%). Hand soap was used less often (n=95, 22.4%). In 44 cases, hands were recontaminated by touching faucets, clothes, and other equipment. Of those who used soap, the mean length of time for lathering was 4.3 seconds (max=16). In the majority of cases (n=60), participants only washed their palms and tops of their hands. Washing between fingers was observed only on 22 occasions.
Significance: Systematic observations revealed inadequate handwashing by produce handlers in school cafeterias. Given that no further heating will occur to kill pathogens and hands being the most frequent point of contamination, training on proper handwashing and motivation to comply may be necessary to ensure food safety.