Breaking the Fecal-Hand-Oral Chain with "The Doubler"
The best implement to wash a hand is the other hand. (See the Core Handwash.) Brushless hand washing is the standard. However, there are limitations. In the case of handwashing, the use of a nail brush in select situations is often essential for effective cleaning.
Proper use of a Best Practice nailbrush can double the cleaning power. Friction is an important factor in hand cleansing. It helps penetrate and remove biofilms. It is better to use a good nailbrush in high soil situations rather than selecting an aggressive handsoap.
Oral care offers useful comparisons. A mouthwash can be effective in removing loosely attached foods. Brushing with toothpaste removes more. However, without flossing, organic plaque will flourish between teeth and below the gum line. The same can happen when pathogens hide under and around finger nails.
Norovirus & The Restroom
The Centers For Disease Control has now confirmed that the number one pathogen group responsible for foodborne illness is the norovirus. This virus generally originates in the restroom. The route of food contamination is fecal-hand-oral. Fecal deposits, usually not visible to the naked eye, are commonly trapped beneath nails and around cuticle tissue. Properly used, the nail brush breaks this chain of contamination and sends these dangerous pathogens down the drain.
Selecting a nail brush requires an understanding of brush construction. Bristles must first be made of materials, which are non-absorbent. They must also offer flexibility to reach beneath the nail and strength to provide effective cleaning. Using the right nail brush, one that is not too aggressive, stimulates strong healthy cuticles much like tooth brushing does for the gums.
The Best Practice Nailbrush
The ideal nail brush has bristles that are fused rather than stapled. Most nail brushes use the stapling method, which creates potentially germ laden pockets at the base of the bristles. Fused bristles are easy to clean, virtually self cleaning with each use. To be certain, Handwashingforlife recommends running nail brushes through your dishwasher at the end of every shift or periodically throughout the day.
Tethering the nail brush to the hand washing sink ... Does the tethering raise cleanliness standards or just raise more hygiene questions? In our observational studies we continue to find that tehering cuts use. Staff concerns regarding the chemicals deter use. Tethered brushes appear to be more concerning than easily rinsed and recycled brushes which have likely been used previously by a team colleague.
Considering the value of the nail brush versus the cost, perhaps a frequent recycling of a fused-bristle brush is a better option.
A Comparison of Hand Washing Techniques To Remove Escherichia coli and Caliciviruses under Natural or Artificial Fingernails
CHIA-MIN LIN,a FONE-MAO WU,a HOI-KYUNG KIM,a MICHAEL P. DOYLE,a BARRY S. MICHAELS,b and L. KEOKI WILLIAMSc
(a) Center for Food Safety, University of Georgia, 1109 Experiment Street, Griffin, Georgia 30223-1797
(b) Georgia-Pacific Corporation, Palatka, Florida 32178-0919
(c) Department of Human Resources, Division of Public Health, Atlanta, Georgia 30303-3186, USA
Compared with other parts of the hand, the area beneath fingernails harbors the most microorganisms and is most difficult to clean. Artificial fingernails, which are usually long and polished, reportedly harbor higher microbial populations than natural nails. Hence, the efficacy of different hand washing methods for removing microbes from natural and artificial fingernails was evaluated. Strains of nonpathogenic Escherichia coli JM109 and feline calicivirus (FCV) strain F9 were used as bacterial and viral indicators, respectively. Volunteers with artificial or natural nails were artificially contaminated with ground beef containing E. coli JM109 or artificial feces containing FCV. Volunteers washed their hands with tap water, regular liquid soap, antibacterial liquid soap, alcohol-based hand sanitizer gel, regular liquid soap followed by alcohol gel, or regular liquid soap plus a nailbrush. The greatest reduction of inoculated microbial populations was obtained by washing with liquid soap plus a nailbrush, and the least reduction was obtained by rubbing hands with alcohol gel. Lower but not significantly different (P > 0.05) reductions of E. coli and FCV counts were obtained from beneath artificial than from natural fingernails. However, significantly (P 0.05) higher E. coli and FCV counts were recovered from hands with artificial nails than from natural nails before and after hand washing. In addition, microbial cell numbers were correlated with fingernail length, with greater numbers beneath fingernails with longer nails. These results indicate that best practices for fingernail sanitation of food handlers are to maintain short fingernails and scrub fingernails with soap and a nailbrush when washing hands.
© Copyright by International Association for Food Protection
Nail Brush Selection Checklist:
Eliminate existing brushes where risk of contamination is higher than added cleansing benefit. These include brushes that:
- Have non-plastic or non-fused bristles
- Have wooden base
- Have staples holding bristles in place
- Are tethered to station with dirty chain, rope or plastic.
Be cautious if you are currently following FDA guidlines and immersing your brush in a sanitizing solution:
- Handwashing For Life Institute has found that immersed brushes in santizing solution are often avoided by employees.
- Sanitizing solutions are difficult to maintain in the proper range of efficacy (ie. they are often too strong, over diluted or contaminated).
Select brushes that:
- Have soft/medium bristles with tested efficacy
(test yourself using GlitterBug® and black light)
- Have fused bristle technology
- Are self-cleaning, dish washer durable and microwavable.
- Purchase in bulk for best price and ready availability.