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No-Water Hand Cleansing Grows

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SaniTwice® out-performs soap & water handwash ... again

These three recent quotes from an operator, an industry leading food safety auditor and a passionate advocate serve as a SaniTwice update following presentations at recent meetings:

"As foodservice moves closer to the action and further from the kitchen, SaniTwice is the answer." Food & Beverage Manager

"Regulators must change their paradigm that water is available if there is a plumbing fixture somewhere in the building." Food safety auditor and former state health department executive.

"Log two pathogen reduction is easily achieved in many different combinations of chemical action, pyhsical action (friction), time and temperature." Jim Mann, Chemist & Executive Director, Handwashing For Life.

SaniTwice is now being used or considered for use at catered events, outdoor events, petting zoos, schools (during water outages), gourmet food trucks, airlines, bars, first responder situations in healthcare, cruise lines and airlines.

SaniTwice is the hand cleansing protocol for use where water is not readily available or in too small a quantity to yield a good handwash, log 2 pathogen reduction. Two rounds of research at BioScience Laboratories in 2008/9 demonstrated positive results in light to moderate soil situations (beef broth).

Three Times a Charm

A third evaluation was conducted following discussions with regulatory representatives. Their advice was to check performance on heavy soil (ground beef), providing an even greater margin of safety for this new intervention. This has now been completed and the results are reported in the following bar graphs.

This research study is yet another in a growing body of scientific evidence supporting the efficacy of the Sani-Twice approach which has been submitted for journal publication. Field tests started in the desert of the Mid-East, solving a military foodservice issue, and were followed by a successful two-year study in another desert, Las Vegas, under the guidance of the Southern Nevada Health District (SNHD).

SaniTwice solved another issue for local schools in Las Vegas by providing an alternative hand cleansing method for use during water outages.

62 percent alcohol

70 percent alcohol

 Suggested Action Prior to Formal Codification

SNHD, along with other interested jurisdictions, now awaits national codification and incorporation into the Model Food Code. This issue was addressed at the last assembly of the Conference for Food Protection in Providence, R.I., April 9-14, 2010.  For those Model Food Code watchers and anyone attending the Conference For Food Protection, the title of this issue was "Sequential Application of Hand Antiseptic for Use in No-Water Situations".

Discussion was decidedly in favor of codification as it was two years ago at the previous CFP in San Antonio Texas where the vote was about 21-3 in favor of the SaniTwice resolution. The principal regulator members of Council III called for the formation of a committee to report back at CFP 2012.

No one callenged the research or the test methods. There was no science-based explanation of their action other than the Model Food Code requires handwashing with water. There was also a technical question as to whether the Center for Drug Evaluation and Research, CDER, should weigh in on this.

If you degerm your hands with water and a naibrush, would we need CDER approval? We think not but apparently if the science says you can reduce hand pathogens by log 2, by balancing water shortage with added friction and chemical action, it is not enough for codification in the Model Food Code. 

While this technical issue is resolved, which could take yet another two years, operators have a choice: Deploy the superior protocol, SaniTwice, to protect public health and the health of their business or continue with the poorer efficacy alternative of the "trickler" handwash with its associated risk. Food safety accountability places the operator first in line, not the regulator. Regulatory can close an operator down for violations. The operator can self-destruct with an outbreak.

SaniTwice Icons for Kitchen Designers

In anticipation of its eventual codification, SaniTwice icons have been developed to facilitate the computer aided design process, allowing designers to build in sanitizer stations, particularly important in public service areas where food safety is a high priority and water is scarce or distant. This added design feature was introduced March 18th at the Foodservice Consultant Society International's (FCSI) conference in Minneapolis.

SaniTwice was also presented by Jim Mann, Executive Director of the Handwashing For Life Institute, at the 2010 USDA/FDA Food Safety Education Conference in Atlanta, March 23-26, 2010. Dr. Christine Moe of Emory University joined Jim for that session.  Her work on human norovirus multiplies the value of the SaniTwice protocol for operators concerned about the norovirus threat. Her innovative work was recognized with an NSF Leadership Award in 2008.

Test Method Description for the Beef Broth Study

Testing was conducted using a modification of the methodology in the Food and Drug Administration Tentative Final Monograph (TFM) for Effectiveness Testing of an Antiseptic Handwash or Health Care Personnel Handwash (FR59:116, 17 June 94, pp. 31448-31450).  Twelve subjects were tested in a randomized cross-over design with a single wash with each test product configuration.  Hands were contaminated with a beef broth medium containing E. coli ATCC#11229. Log10 reductions from baseline were calculated for the test product.
Citation: Conducted at BioScience Laboratories, Inc., Study # 081211-150, March 12, 2009.

For the Hamburger Study:
Same as above but hands were contaminated by handling raw hamburger contaminated with E. coli ATCC#11229. Log10 reductions from baseline were calculated for the test product.
Citation: Conducted at BioScience Laboratories, Inc., Study # 091238-150, date March, 2010.

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