Blending available resources into an effective protocol.
From a Food Code perspective there is but one handwash. We like to think of it as a minimum and one of perhaps many. Handwashing For Life designates a soap-water 15 second hand wash, with a 2.0 gpm flow of warm water and paper towel drying, as its Core Hand Wash. Depending on risk, adjustments are made at the operator level to exceed the minimum where required.
Technically, a handwash is blend of four factors, four resource categories:
- Chemical action
Water, both hard and soft, and warm or cold, cleans somewhat and is the primary chemical for handwashing. Substitutes for water include alcohol which also cleans but can be supported with additional actions as with water.
Soap or detergents (surfactants) are the second most common chemical for cleaning. These vary widely in effectiveness and can be fortified with antibacterial agents.
Rinsing is largely chemical with some degree of a physical element. A water flow of 2.0 gpm speeds the process far better than a trickle of water.
- Physical action
Vigorous hand-to-hand scrubbing is the first physical action, whether using water, soap and water, or alcohol.
The use of a single-use paper towel is commonly seen as a drying step but significant cleaning is an additional benefit.
A nailbrush can be used to intensify the friction and compensate for other factors. The nailbrush can even make a hand sanitizer wash great, using a single-use brush, followed by removal with a paper towel.
Variables in adhesion between contaminants and the skin are many. A nailbrush can be an equalizer.
Scrub times can be increased beyond Food Code guidelines for deeper cleaning. They also can be decreased for dealing with low-risk touches.
Hot water cleans better than cold but risks of scalding and comfort define 105F as the top of a realistic range. Cooler water is quickly raised by the body's temperature and by the friction of vigorous scrubbing.
Alcohol hand sanitizer can be effective in a variety of protocols where access to water is restricted. There are even formulations that are effective on norovirus. Costs of these sanitizer-based solutions will always provide a self-regulating factor where running potable water is available.
Convenience tends to drive compliance but doesn't fit on a physical science scale and isn't commonly considered a resource. How do we measure the effect of convenience in the context of the Model Food Code? The single soil/single handwash view limits its value in making everyday risk-based decisions. A casual touch of the face does not require the same handwash as after deboning raw chicken.