Purpose: The purpose of this study was to identify environmental factors associated with transmission of NoV in food preparation areas of LTCF in South Carolina (SC).
Methods: As part of a larger study, all LTCF in SC that met inclusion criteria (163) were contacted and those that agreed to participate (26) were visited during July - November 2013. Two trained observers assessed sanitary conditions in food preparation areas using a checklist. Equipment cleanliness and condition, three-compartment sink set-up, type of sanitizer used, handwashing sinks, and worker hygiene were evaluated. Answers were hand-recorded as “yes” or “no” and comments noted. Categorical responses (yes/no) were digitized and comments categorized into themes. Relative frequencies were calculated.
Results: All work tables, cutting boards, and preparation and three-compartment sinks were clean and in good repair. A total of 23 LTCF used quaternary ammonia as a sanitizer; only 3 used chlorine bleach. All handwash sinks had warm water, soap, and an appropriate drying device. Most (18) used antimicrobial soap; 7 used plain soap. Most (24) had paper towels for drying and handwashing signage (22). Food workers appeared to be healthy and wearing clean clothes (26), hair restraints (25), gloves (21), and had no jewelry on hands or forearms (23).
Significance: Most LTCF adhered to recommended environmental sanitation practices in food preparation areas. However, SC state regulations require LTCF to use quaternary ammonia and not chlorine bleach to sanitize/disinfect surfaces. Quaternary ammonia is not effective against NoV even at disinfection concentrations. Therefore, regulations concerning sanitizing/disinfecting must be changed to better control the spread of NoV in food preparation areas in LTCF.