Tools for environmental health.

This article is provided by NEHA for informational purposes only. It is designed to better inform our members about topical and relevant goods and services available to the environmental health professional. Opinions expressed about any product or service in this column either expressly or implied are solely and completely those of the author/s and do not necessarily represent the views or opinions of the National Environmental Health Association.

A Unique Ultraviolet Penlight and the Latest Information on Hand Hygiene

We remember the fun we had when we were puppy sanitarians, learning to use the tools that were given to us by the state health department. Our selection was magnificent. We were issued a Hobart Fat Tester; a Ringlemann Smoke Scope; pH and chlorine color comparator test kits; two conductivity meters to validate high-temperature short-time pasteurization units; an assortment of thermometers, sample jars, bags, and sealing wax; and a high-intensity, plug-in UV lamp. All in all, the entire assemblage weighed about 150 pounds and took up the entire trunk of a '65 Plymouth. Most of this equipment was used in one place. You took it to your work area, set it up, and ran your samples. That was not the case, however, with the UV lamp. To inspect refrigerated warehouses, the lamp was constantly plugged, unplugged, and replugged into any of the scant number of available outlets. The fun ran out after about a week of lugging around the lamp and extension cord for hours on end. It was such a great improvement when we final ly were given a battery-operated UV lamp. Even though it weighed a bit more than the cord-type unit, the new lamp was both portable and practical. In fact, we featured a variant of our original lamp in our May 1998 column.

Over the past 30 years, our battery-operated lamp has seen many improvements in its power source, the UV-light output, the bulb life, and its carrying straps--but not in its weight. Therefore, we were intrigued when we saw an ad in the Edmund Scientific catalog for a UV penlight that operates on two 1.5-volt AAA alkaline batteries. The penlight is manufactured by MLS Instruments, Inc. (*) The ad did not say much about emission intensity or light directivity, but for our inspection purposes, all we really need is a lamp that emits light somewhere in the UV spectrum shining on a spot large enough to be seen. We took a chance and ordered it.

What a pleasant surprise. The UV penlight exceeded our expectations. Our unit is the model S/N UV pen W (wide beam). At only 2 ounces, it does everything our big light does, except on a much smaller scale that is nonetheless practical for our use. The penlight is elegant in its operation: A single button turns on the lamp, chooses any one of three light intensity levels, and activates the timer with seven settings ranging from one to 60 minutes. With a little practice, the one-button operation becomes second nature. The instruction insert is well written and easily understood. What really sold us on this useful little tool is a few of its features. The peak wave length is 370 nanometers (UVA); its maximum optical UV power output is 2 microwatts (mW) (15.8 mW per square centimeter) which is bright enough to see without dimming of the background lights, and its directivity is 105[degrees], which is large enough to light an area approximately the size of a silver dollar at 1 inch. The light source has an averag e service life of 5,000 hours, which is more than we will use in what is left of our careers, and the batteries last for over 20 hours of operation. All in all, we feel that this tool is well worth the price.

Speaking of price ... the cost of the penlight when ordered from the catalog was $180, including shipping and handling. If you order the light through MLS Instruments' Web site, however, the cost is only $129 plus UPS shipping. We wish that we could have had the benefit of this column when we placed our order.

Great Informational Sources on Handwashing

The word "handwashing" appears numerous times in the Food Code, in environmental health texts, in infection control tutorials, and even in well-constructed HACCP outlines. We rely on handwashing as one of the most significant measures in everything from prevention of foodborne illnesses and nosocomial infections to clean-room protocols to personal health. We have testified in court that the lack of handwashing among kitchen personnel may be responsible for the highest risk of transmitting human pathogens to an incarcerated population, and we cited numerous articles and monographs that supported our argument Our testimony carried the day.

Somehow, though, we always believed that telling someone to wash their hands without telling them how, when, and with what was a sin of omission. In truth, ethically, we cannot hold anyone responsible for something we do not fully understand ourselves. In seeking answers, particularly to the "with what" question, we have relied on vendors of handwashing concoctions to provide us with answers. Although these sources are not very objective, we felt that as long as the magic juice was not yellow and didn't smell like Limburger cheese, we had something we could live with. Over the years, we have come to believe that anything, even pure tap water, is better than nothing. As sanitarians, we know that we have preached the gospel and cited the Code more times than we can count, yet the incident rate of foodborne illness is holding the line. Well, it's good-news time.

The Centers for Disease Control and Prevention developed and sponsored the recently published Draft Guideline for Hand Hygiene in Healthcare Settings. The draft was authored through a collaborative effort of the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force and the Healthcare Infection Control Practices Advisory Committee. The Draft Guideline is an impressive document that is available online at <http://www.cdc.gov/ncidod/hip/hhguide.htm>. (**) Its objective is to "develop evidence-based hand hygiene guideline designed to promote new strategies for improving hand hygiene practices in healthcare facilities and reduce healthcare-acquired infections." The authors look at numerous studies published from 1966 through 2001 and set forth criteria for measuring outcomes including [log.sub.10] reductions in bacterial counts achieved in vitro and in vivo by hand hygiene agents, effects of adherence to handwashing practices, and the incidence and prevalence of healthcare-acquired infections. The Draft Guideline reviews the many commercially available hand hygiene agents and offers an interesting conclusion. And, as with any good book, we do not want to give away the ending but encourage you find out for yourself. We think that you will be pleasantly surprised.

On a similar note, in 1999 the Food and Drug Administration (FDA) Center for Food Safety and Applied Nutrition published a white paper titled Evaluation of Risks Related to Microbiological Contamination of Ready-to-Eat Food by Food Preparation Workers and the Effectiveness of Interventions to Minimize Those Risks. The authors are Jack Guzewich and Dr. Marianne P. Ross. The first section is a literature review pertaining to foodborne-disease outbreaks caused by food workers from 1975 to 1998; the second section deals with interventions to prevent or minimize risks associated with bare-hand contact with ready-to-eat foods. This paper is available online at <http://vm.cfsan.fda.gov/~ear/rterisk.html>. Of particular interest to sanitarians are the three major intervention areas identified and detailed by the paper: exclusion of ill food workers from the workplace, removal of pathogens from the hands of food workers (an excellent review of handwashing), and the use of barriers to prevent bare-hand contact with re ady-to-eat foods.

Both the CDC Draft Guidelines and the FDA white paper should be mandatory reading for all of us who practice in environmental health. There is no excuse for not getting these articles since they are both free of charge and only require a brief download. Happy reading.

Inspection Tip of the Month:

Carry a clean washcloth with you on food inspections. It has about a thousand uses and comes in handy to mop the perspiration from your brow, clean grease from shoes, or provide a secure handhold on a wet surface. We buy them by the dozen from the odd-lot bin at a bed-and-bath discount store. At the price, they are disposable if they become too soiled or heavily stained.

(*.) MLS Instruments, Inc., P.O. Box 2261, Beaverton, OR 97075. Telephone: [phone]; e-mail: <[e-mail]>; Web site: <http://www.mls-instruments.com>.

(**.) Unfortunately between the time we wrote this column and the time it went to press, CDC took the Draft Guideline down from its Web site. A final version of the document is forthcoming. For the latest information, readers should check with CDC's Division of Healthcare Quality Promotion at <http://www.cdc.gov/ncidod/hip/>.