Verification of cleaning efficiency and its possible role in programmed hygiene inspections of food businesses undertaken by local authority officers

AIM: The aim of this study was to determine whether or not the assessment of surface cleanliness could make a contribution to visual inspections of food premises. METHODS AND RESULTS: Forty-five premises were studied with both rapid (ATP) and traditional microbiological swabbing being used to test surfaces that either come into direct contact with prepared foods or were likely to be touched by hands during food preparation. A significant link was found between aerobic colony counts and ATP measurements. In most cases, the visual appearance of surfaces could not be used to accurately predict either microbial or ATP results. CONCLUSION: This study suggests that ATP testing is a useful indicator of surface cleanliness and could be helpful to local authority officers as part of risk assessment inspections. SIGNIFICANCE AND IMPACT OF THE STUDY: This study provides further evidence that visual inspection alone may not always be adequate to assess surface cleanliness. In high-risk premises, ATP could, if appropriately targeted, help identify potential problem areas. The results are available at the time of the inspection and can be used as an on-the-spot teaching aid.     

Application of HACCP to identify hygiene risks in the home

Hygiene related health hazards in the home include ingestion of microorganisms or toxins, inhalation of toxins, allergens or microorganisms and infections through the skin. Bacteria, fungi and viruses may all be involved. For any particular family these hazards translate into different risks ranging from mild irritations to serious health threats. These will require different responses in terms of hygiene practice and hygiene product use. The consumer needs help to identify which hazards in his/her home pose a high risk and which are insignificant. Risk analysis techniques especially HACCP (Hazard analysis—critical control point) have been proven as effective tools in controlling hazards in the food industry. We have applied HACCP principles to a risk analysis of a typical home. We conclude that further studies are warranted and to focus on particular groups (e.g. families with infants, pensioners). Such information could be valuable in drawing up hygiene codes of practice and for forming the basis of educational material aimed at different target groups.     

Evaluation of three indices for biofilm accumulation on complete dentures

doi:10.1111/j.1741‐2358.2009.00285.x
Evaluation of three indices for biofilm accumulation on complete dentures Objectives: The objective of this study was to evaluate the accuracy and reproducibility of three complete denture biofilm indices (Prosthesis Hygiene Index; Jeganathan et al. Index; Budtz‐Jørgensen Index) by means of a computerised comparison method. Background: Clinical studies into denture hygiene have employed a large number of biofilm indices among their outcome variables. However, the knowledge about the validity of these indices is still scarce. Materials and methods: Sixty‐two complete denture wearers were selected. The internal surfaces of the upper complete dentures were stained (5% erythrosine) and photographed. The slides were projected on paper, and the biofilm indices were applied over the photos by means of a scoring method. For the computerised method, the areas (total and biofilm‐covered) were measured by dedicated software (Image Tool). In addition, to compare the results of the computerised method and Prosthetic Hygiene Index, a new scoring scale (including four and five graded) was introduced. For the Jeganathan et al. and Budtz‐Jørgensen indices, the original scales were used. Values for each index were compared with the computerised method by the Friedman test. Their reproducibility was measured by means of weighed κ. Significance for both tests was set at 0.05. Results: The indices tested provided similar mean measures but they tended to overestimate biofilm coverage when compared with the computerised method (p < 0.001). Agreement between the Prosthesis Hygiene Index and the computerised method was not significant, regardless of the scale used. Jeghanathan et al. Index showed weak agreement, and consistent results were found for Budtz‐Jorgensen Index (κ = 0.19 and 0.39 respectively). Conclusion: Assessment of accuracy for the biofilm indices showed instrument bias that was similar among the tested methods. Weak inter‐instrument reproducibility was found for the indices, except for the Budtz‐Jørgensen Index. This should be the method of choice for clinical studies when more sophisticated approaches are not possible.     

Comparative evaluation of the hygienic efficacy of an ultra-rapid hand dryer vs conventional warm air hand dryers

Aims: To compare an ultra‐rapid hand dryer against warm air dryers, with regard to: (A) bacterial transfer after drying and (B) the impact on bacterial numbers of rubbing hands during dryer use. Methods and Results: The Airblade? dryer (Dyson Ltd) uses two air ‘knives’ to strip water from still hands, whereas conventional dryers use warm air to evaporate moisture whilst hands are rubbed together. These approaches were compared using 14 volunteers; the Airblade? and two types of warm air dryer. In study (A), hands were contaminated by handling meat and then washed in a standardized manner. After dryer use, fingers were pressed onto foil and transfer of residual bacteria enumerated. Transfers of 0–10⁷ CFU per five fingers were observed. For a drying time of 10 s, the Airblade? led to significantly less bacterial transfer than the other dryers (P < 0·05; range 0·0003–0·0015). When the latter were used for 30–35 s, the trend was for the Airblade to still perform better, but differences were not significant (P > 0·05, range 0·1317–0·4099). In study (B), drying was performed ± hand rubbing. Contact plates enumerated bacteria transferred from palms, fingers and fingertips before and after drying. When keeping hands still, there was no statistical difference between dryers, and reduction in the numbers released was almost as high as with paper towels. Rubbing when using the warm air dryers inhibited an overall reduction in bacterial numbers on the skin (P < 0·05). Conclusions: Effective hand drying is important for reducing transfer of commensals or remaining contaminants to surfaces. Rubbing hands during warm air drying can counteract the reduction in bacterial numbers accrued during handwashing. Significance and Impact of the Study: The Airblade? was superior to the warm air dryers for reducing bacterial transfer. Its short, 10 s drying time should encourage greater compliance with hand drying and thus help reduce the spread of infectious agents via hands.     

Self-reported oral hygiene habits among institutionalised elderly and their relationship to the condition of oral tissues in Taubaté, Brazil

Objectives: To record self‐reported hygiene habits, examine the oral conditions of a sample group of institutionalised elderly, and examine possible relationships between these habits and conditions. Design: Cross‐sectional. Setting: All the institutions for the elderly in Taubaté, Brazil. Subjects: The entire population of these institutionalised elderly people (n = 553). Intervention: The subjects were interviewed and underwent an oral examination. Main outcome measures: Oral hygiene habits, oral conditions and statistical relationships between habits and oral conditions were recorded. Results: The average age of the subjects who knew their age (n = 364) was 74.9 years (±12.9), and 64.7% of the sample group were females. Denture‐related stomatitis was found in 19.5%, impaired manual dexterity in 40%, dry mouth sensation in 36.3%, difficulty in performing oral hygiene in 20%, no oral hygiene‐related orientation in 54.1%, no periodic oral examinations in 59.5%, and no tongue cleaning in 68.3% was declared. Among dentate subjects, 73.3% had periodontal disease, 54.7% had caries, 26% reported no toothbrushing, and 7.3% reported flossing. Of the denture wearers, 7% did not brush their dentures. Denture‐related stomatitis showed a statistical relationship with impaired manual dexterity (p = 0.012) and an inverse statistical relationship with denture brushing frequency (p = 0.006). Periodontal disease showed an inverse relationship to flossing (p < 0.001) and tongue cleaning (p = 0.0026). Caries showed an inverse relationship with tooth‐brushing (p = 0.043), flossing (0.022), proper oral hygiene orientation (p = 0.041) and periodical check‐ups (p = 0.007). Conclusion: Oral hygiene practices in this sample group were found to be inadequate, and statistically significant relationships were verified between the lack of good oral hygiene practices and the deleterious oral conditions.     

Sensory detection of food odour in relation to dental status,gender and age

The aim of this study was to investigate to what extent declining odour perception can be ascribed to dental status and oral hygiene habits, taking into account gender and age. Apparently healthy adults (n=182), ranging from 53 to 93 years (mean age=68.4) were tested. Information about oral hygiene habits (brushing teeth and cleaning dentures) and dental status was obtained by questionnaires. A validated objective procedure was used to measure sensory detection thresholds for isoamylacetate by an ascending method of limits. A significant negative correlation of odour perception with age was shown by the edentulous subjects which might reflect their wider age spread with many subjects over age 75. The evaluation of odour perception as a function of dental status shows no significant difference in odour perception between persons partial denture wearers, with natural teeth only or complete dentures. However, a tendency for lower odour perception was observed among male partial denture wearers, especially those reporting less frequent oral hygiene, which justifies further more detailed study.     

Denture contamination by yeasts in the elderly

Objectives: The aim of this study was to investigate yeast carriage in healthy denture wearers by swabbing and to evaluate the effect of denture hygiene habits. Materials and methods: Denture wearers (n = 87) without evidence of denture stomatitis or any other oral disease were investigated by separately swabbing the fitting surface of the upper denture and the corresponding palatal mucosa in contact with the appliance. In a group of volunteers, a gel without any active compound was spread on the palatal side of the denture once in every morning for 2 weeks. Results: Screening showed Candida colonisation of upper prosthesis in 75.9% of individuals. The most frequent species isolated were Candida albicans (77.9% of the positive cultures), Candida glabrata (44.1%) and Candida tropicalis (19.1%). Carriage of more than one yeast species was found in 48.5% of the contaminated dentures. There was a statistically significant association between denture contamination and palatal mucosa colonisation (chi‐squared test: p < 0.0001). Repeated swabbings after 1 week as well as during a weekly follow‐up for 1 month confirmed the denture contamination and its degree of severity. A daily gel application produced a yeast‐count decrease to 10% of the initial value after 2 weeks (chi‐squared test: p = 0.0134 and p = 0.2841 for prosthesis and palatal mucosa, respectively). Conclusion: This study documented the reliability of oral swabbing when investigating yeast carriage in healthy denture wearers. Moreover, just a diagnostic tool, sampling upper dentures for Candida could be the opportunity to verify the patient’s compliance to hygiene advice.     

The benefits of silver in hygiene, personal care and healthcare

Silver has been used for centuries as an antimicrobial agent to reduce bioburden and prevent infection. Its usage diminished when antibiotics were introduced but remained one of the most popular agents for wound infections, especially in burned patients. Incorporation of silver into a range of hygiene and healthcare applications has increased, and this has raised concerns over the development of silver resistance, toxicity, methods of testing products and evidence of efficacy. The published evidence for resistance and toxicity is limited and associated with frequent and high levels of silver used. Increasing evidence of improved antimicrobial activity of nanoparticles of silver and possible dual immunomodulatory effects are exciting. This may lead to further product development as potential alternative preservatives as some currently available preservatives have an increasing incidence of allergic reactions. Acknowledging the role of the carrier is important, and as silver is active when in solution, opens a window of opportunity in personal hygiene area. This is important in an age when multiple antibiotic–resistant bacteria are becoming prevalent.     

The effectiveness of oral hygiene programmes for elderly people - a review

Comprehensive oral health care is an essential feature of quality of life. In the near future, a greater number of elderly people will retain more natural teeth, whether or not supplemented by prosthetic provisions, and/or may be provided with implants. As a consequence, oral self-care will be much more demanding. Prevention must reduce the greater risk of oral disease for elderly people. Effective early intervention strategies are: promotion of over-all general health, obviation of stereotypes, education by dental hygienists, instruction and demonstration combined with systematic evaluation, use of a fluoride containing dentifrice, and regular professional support and use of chlorhexidine rinses for less well and confused elderly.     

Virus transfer between fingerpads and fomites

Aims: Virus transfer between individuals and fomites is an important route of transmission for both gastrointestinal and respiratory illness. The present study examines how direction of transfer, virus species, time since last handwashing, gender, and titre affect viral transfer between fingerpads and glass. Methods and Results: Six hundred fifty‐six total transfer events, performed by 20 volunteers using MS2, ?X174, and fr indicated 0·23 ± 0·22 (mean and standard deviation) of virus is readily transferred on contact. Virus transfer is significantly influenced by virus species and time since last handwashing. Transfer of fr bacteriophage is significantly higher than both MS2 and ?X174. Virus transfer between surfaces is reduced for recently washed hands. Conclusions: Viruses are readily transferred between skin and surfaces on contact. The fraction of virus transferred is dependent on multiple factors including virus species, recently washing hands, and direction of transfer likely because of surface physicochemical interactions. Significance and Impact of the Study: The study is the first to provide a large data set of virus transfer events describing the central tendency and distribution of fraction virus transferred between fingers and glass. The data set from the study, along with the quantified effect sizes of the factors explored, inform studies examining role of fomites in disease transmission.     

Effects of housing and management conditions on teat cleanliness of dairy cows in cubicle systems taking into account body dimensions of the cows

Dirty udders and teats result in a higher workload in terms of cleaning before milking and may constitute a risk for udder health. The aim of this prevalence study on 23 farms with very low within-farm variation in cubicle measures and other cubicle characteristics was to identify potentially influencing housing and management factors concerning teat and teat tip soiling. Information about udder soiling, housing and management was collected through direct recording and farmers’ interviews. Height at withers, shoulder width and diagonal body length were measured in 79% to 100% of the cows in each herd. On the basis of the 25% largest animals, compliance with recommendations for cubicle measures was calculated, which was generally rather low. Stepwise regression was used to find predictors for the percentage of dirty teats and of dirty teat tips. The final model on dirty teats explained 58.5% of the variance and contained four factors (F = 6.34, P = 0.0023). Less soiled teats were found on farms that conducted teat dipping after milking (t = −3.21, P = 0.0048), had increased daily cubicle maintenance time (t = −2.58, P = 0.0187), deep-bedded cubicles (t = −2.42, P = 0.0265) and decreasing compliance concerning cubicle length (t = 2.33, P = 0.0317). The final model on teat tip soiling explained 46.0% of the variance and contained three factors (F = 5.39, P = 0.0075). Less soiled teat tips were associated with increasing height of bedding material (t = −2.89, P = 0.0094) and decreasing compliance concerning resting length (t = 2.12, P = 0.0470). Difficult to explain was the association found between increased passage soiling and decreased teat tip dirtiness (t = −1.86, P = 0.0790). Thus, even under relatively restrictive cubicle conditions, a certain increase in teat and teat tip soiling was found with increasing cubicle length. However, at the same time, measures relating to good management may positively affect teat and teat tip cleanliness. In addition, deep-bedded cubicles yielded advantages in this regard. Both regression models for teat and teat tip cleanliness contained similar but not identical predictive variables. This indicates that dirtiness of each particular area may originate from slightly different though related causes. The low correlations found between udder, teat and teat tip cleanliness should be considered in future studies.     

Adding denture cleanser to microwave disinfection regimen to reduce the irradiation time and the exposure of dentures to high temperatures

Background: The microwave energy is an efficient disinfection method; however, it can generate high temperatures that can result in distortion of the dentures. objectives: To evaluate whether the addition of an enzymatic cleanser to microwave disinfection regimen would disinfect dentures with shorter irradiation time. Materials and methods: Seven resin discs colonized with Candida albicans biofilm were placed on the palatal surface of sterile dentures to be randomly assigned to the following treatments: immersion in distilled water for 3 min with 0 (DW), 1 (DW + M1), 2 (DW + M2), or 3 min (DW + M3) of microwave irradiation; or immersion in denture cleanser for 3 min with 0 (DC), 1 (DC + M1), 2 (DC + M2) or 3 min (DC + M3) of irradiation. After the treatments, the viable cells were counted by a blinded examiner. The temperature was measured immediately after irradiation. The data were analyzed by ANOVA and Tukey post hoc tests (α = 0.05). Results: No viable cells were found after DC + M2, DC + M3, and DW + M3 treatments, of which DC + M2 achieved the lowest temperature. No significant difference was found between the effectiveness of DW, DW + M1 and DC treatments (p > 0.05). Conclusion: Within the limits of this study, the association of a denture cleanser and microwave energy is efficient to disinfect dentures in lower irradiation time and temperature.     

Denture disinfection by microwave energy: influence of Candida albicans biofilm

doi: 10.1111/j.1741‐2358.2010.00439.x Denture disinfection by microwave energy: influence of Candida albicans biofilm Objective: This study evaluated the influence of the area of Candida albicans biofilm on denture disinfection by microwave energy. Materials and methods: Candida albicans biofilm was allowed to form for 72 h on resin discs, and three small coverage or seven large coverage discs were placed onto the palatal surface of sterile maxillary dentures. Each denture was immersed in 200 ml distilled water and individually irradiated at a power of 450, 630 or 900 W for different time intervals (1, 2 or 3 min) (n = 6). The effectiveness of disinfection was evaluated by counting the residual cells. The data were analysed by anova and Tukey’s HSD test (α = 0.05). Pearson’s correlation test was performed to determine the correlation between effectiveness of sterilisation and temperature. Results: Dentures with a larger area of biofilm demanded a longer irradiation exposure to achieve disinfection (p < 0.001), irrespective of power setting, and in this time no yeast growth was detected. Dentures with small areas of biofilm were disinfected after 1 min at 900 W and 2 min at 450 or 630 W. A positive correlation was found between water temperature and effectiveness of disinfection (r = 0.6170; p < 0.001). Conclusion: The C. albicans biofilm area influenced disinfection by microwave energy; therefore dentures with larger biofilm areas required longer irradiation exposure to be disinfected.     

Candida albicans biofilm formation on soft denture liners and efficacy of cleaning protocols

doi: 10.1111/j.1741‐2358.2011.00485.x
Candida albicans biofilm formation on soft denture liners and efficacy of cleaning protocols Objective: The aim of this study was to investigate Candida albicans biofilm formation on denture liners and to analyse the efficacy of cleaning protocols. Material and methods: Specimens were prepared from four silicone‐based soft denture liners. After artificial ageing and surface free energy determination, specimens were incubated with saliva (2 h) and Candida albicans ATCC 10231 for either short‐ (2.5 h) or long‐term (24 h) biofilm formation. Adherent cells were determined either after incubation of specimens with Candida albicans or after treatment with different denture cleaning protocols. Statistical analysis was performed using one‐way anova and the Games–Howell test (α = 0.05). Results: For both short‐ and long‐term biofilm formation, similar amounts of Candida albicans cells were found on the surface of the different liners (p = 0.295 and 0.178, respectively). For both short‐ and long‐term biofilm formation, the highest cleaning efficacy was observed for sodium hypochlorite (NaOCl; p < 0.01). The efficacy of the chemical denture cleaner in removing long‐term Candida albicans biofilms was significantly lower than the efficacy of removal by brushing (p < 0.001). Conclusion: Different silicone‐based soft denture liners yield similar Candida albicans biofilm formation on their surface. The highest efficacy for the removal of Candida albicans biofilms was identified for NaOCl. Chemical denture cleaners appear to have rather low efficacy to remove mature Candida albicans biofilms.     

水土保持植物--蔓荆功能产品的开发研究

蔓荆籽丰富的营养成分赋予其极大的开发利用潜力。本文介绍了蔓荆口服液功能产品的生产工艺 ,同时对该产品开展了相应的毒理学和卫生学检测     

Quantification of the ease of removal of bacteria from surfaces

This paper describes a technique which reproducibly quantifies the ease of removal of microorganisms from surfaces. Tiles (22 mm×22 mm) of various materials were colonised withStaphylococcus epidermidis NCTC 11047,Escherichia coli K12 HB101 orPseudomonas aeruginosa PaWH, by submersion, for various times (2 min–48 h), in inoculated Tryptone Soya broth (37°C). Colonised tiles were blotted onto a Tryptone Soya agar plate for 1 min and the process was repeated through a succession of agar plates. The final plate contained tetrazolium salts (0.05% w/v) and was incubatedin situ with the tile. Tetrazolium plates indicated that very few organisms remained on the tiles after 15 successive blots. In all instances, the number of recovered colonies per plate decreased exponentially with plate succession number, according to the relationship, CFU-A.10^–kN, where CFU is the number of colonies transferred,k is the removal exponent, A is the intercept and N is the plate succession number. Removal exponents differed significantly between organisms (P>0.95), depended on the nature of the test surface, and decreased as the inital attachment and colonisation time was increased from 2 min–48 h. Intercept values (A) but not the gradients were dependent upon the initial numbers of bacteria in suspension. These data indicate that the gradients derived from counting recoverable viable cells from successive blots of test tiles onto agar is a measure of the strength of attachment of the organisms to the surface.