It's a debate that has raged in foodservice circles for years and centers on the question of whether hand washing alone is effective in preventing foodborne illness. One side believes that hand washing is sufficient. The other side believes that proper hand washing is not being enforced and that a barrier, such as single-use gloves or utensils, is required to protect the food. Unfortunately, it's a circular argument.

Barriers would not be needed if proper hand washing took place, yet that's not the case. However, one common issue remains on both sides: training. With a combination of training on proper hand washing techniques and training on the proper use of disposable gloves and other barriers, the goal of preventing foodborne illness can be more easily reached.

The Food and Drug Administration (FDA) takes this approach a step further in its 2009 FDA Food Code, which states that employees may not contact ready-to-eat foods with bare hands, except when washing fruits and vegetables and when otherwise approved. The purpose of this rule is to prevent restroom germs, referred to by the FDA as fecal-oral pathogens, from getting into food. These restroom germs include E. coli, Staphylococcus, Hepatitis A, Norovirus, Giardia and Shigella and can be carried to food by hands that are not properly washed after using the restroom. The FDA believes that a combination of three factors will give the best result in stopping this transmission: proper hand washing, a barrier to bare-hand contact with ready-to-eat foods, and exclusion of ill employees from food preparation areas.

Hand washing is not enough

Two major pieces of evidence led the FDA to its cautious approach to hand sanitation. First, the Centers for Disease Control (CDC) reports that hands are the most common way that germs, or "restroom pathogens" are spread. Second, illness can occur by passing on a very small number of germs, which hand washing alone does not remove from hands. Scientific tests have shown that residual bacteria exists on hands after routine hand washing that may be enough to cause illness if then transferred to foods or food contact surfaces. To combat this limitation with hand washing, the FDA encourages the use of a barrier to direct hand contact with foods. Utensils, such as spoons, scoops and tongs, are a common and convenient barrier to use. In some instances, deli tissues can be used. Perhaps the most controversial barrier is a single-use, disposable glove. As a last precaution, ill employees should not be allowed to work with foods and, ideally, should be sent home to recover from their illness.

The FDA recognizes that situations exist where a barrier is not practical and has outlined guidelines for this. In many jurisdictions, if allowed, the operator may be granted a variance and adopt a "no bare contact policy" by demonstrating how food will be kept safe, and by providing a written plan to his health inspector. The plan must outline the critical tasks where food contamination is most likely and provide procedures for each of these tasks to limit contamination from bare hands, such as double hand washing, using nail brushes and using an FDA-approved hand sanitizer. Documentation must also show that all employees have been trained in these methods and that monitoring and verification of these procedures occurs. Lastly, the FDA lists other acceptable methods for preventing the spread of foodborne illness that should be considered. These factors include vaccinations and motivation for ill employees not to work such as offering paid sick time.