• Journal of Environmental Health Sciences
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• v.36 no.2
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• pp.95-107
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• 2010

Hand-washing is one of the major factors in personal hygiene and public health. This study was undertaken to investigate the hygienic behavior of food-service employees, focusing on awareness of hand washing, hand washing practices, and the load of index microorganisms (aerobic plate count, total and fecal coliforms, Escherichia coli, and Staphylococcus aureus) on the hands of food-service employees. A questionnaire survey completed by direct interview, direct observation of restrooms by the researcher and trained observers, and microbiological examination according to the Food Code of Korea were carried out. In the survey, a positive attitude toward hand washing compliance was reported; however, improper hand washing and poor hand hygiene of the food-service employees were seen under direct observation. Significant differences (p<0.05) were found between the questionnaire survey and the direct observations in hand washing compliance after using the toilet, duration of hand washing, use of hand washing agents, use of hand washing tools, washing of different parts of the hands, hand-drying method, temperature of water, and method of turning off the water. Samples taken from employees' hands before washing showed higher levels of bacteria than those taken during work and/or after washing (p<0.05). Poor hand washing practices were indicated by the positive results for total and fecal coliforms, E. coli, and S. aureus on the hands of some food-service employees. This study showed that there is a marked difference between the food-service employees' awareness of hand-washing and their actual hand-washing practices. The poor hand hygiene of and improper hand washing by the food-service employees should be addressed for improved food safety.

• Journal of the Korean Dietetic Association
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• v.15 no.3
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• pp.220-231
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• 2009

The principal objective of this study was to evaluate elementary students' awareness of the importance of hand washing, as well as their hand-washing behavior. The data was collected by self-reported questionnaire from 697 students in elementary schools with serving food in a classroom in Busan. Their hand-washing frequency was high, at '3~4 times per day (37.0%)'. 51.0% of the respondents did not wash their hands that often because they were 'not accustomed' to washing their hands, and 35.9% of respondents regarded washing their hands as 'annoying'. The most frequently reported hand washing agent was 'soap and water (71.4%)'. Approximately 95~98% of the respondents always washed their hands after using the bathroom, 87.9% of them washed their hands before eating food, and 86.7% of them washed their hands upon returning home. However, 27.3%, 34.1% and 65.9% of the respondents did not wash their hands after handling money, after eating, and after coughing or sneezing, respectively. Significant factors related to increased hand-washing frequency were gender (p<0.001) and the period of attendance at kindergarten (p<0.05). The mean scores of importance and performance of hand washing were significantly higher for girls than for boys. The group with higher rate (over 4.5/5.0) for the importance of sanitary hand-washing behavior showed significantly higher scores in hand-washing behavior before serving food and before eating than those of the lower rated group (below 4.0/5.0). This study shows that sanitation education is required not only for food handlers but also for students in school foodservices.

• Journal of Preventive Medicine and Public Health
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• v.40 no.3
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• pp.197-204
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• 2007

Objectives : This study was conducted to evaluate the public's awareness of the importance of hand washing and to compare perceptions on the habit of hand washing with actual hand washing behavior. Methods : Data were collected by observing 2,800 participants washing their hands after using public restrooms in seven cities nationwide and by surveying 1,000 respondents (age > 14 years) through telephone interviews using a structured questionnaire. Results : Although 94% of the survey respondents claimed to mostly or always wash their hands after using public restrooms, only 63.4% of the observed participants did wash their hands after using public restrooms. Significant factors related to increased adherence to hand washing were female gender, approximate ages of 20 to 39 years by their appearance, and the presence of other people from the observation. About 79% of the survey respondents always washed their hands after using bathrooms at home, 73% washed their hands before handling food, and 67% washed their hands upon returning to their home. However, 93.2% and 86.3% of the survey respondents did not wash their hands after coughing or sneezing and after handling money, respectively. Although most of the survey respondents (77.6%) were aware that hand washing is helpful in preventing communicable diseases, 39.6% of the survey respondents did not do so because they were 'not accustomed' to washing their hands and 30.2% thought that washing their hands is 'annoying'. Conclusions : This is the first comprehensive report on hand washing behavior and awareness of the general population in Korea. The result of this study in terms of individual behavior and awareness of hand washing are comparable with similar studies conducted in other countries. However adherence to hand washing is still low and needs to be increased. The results of this study can be used as a baseline in setting up strategies and activities to promote adherence to hand washing.

• Journal of Food Hygiene and Safety
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• v.25 no.2
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• pp.133-142
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• 2010

This study was performed to investigate awareness of hand washing, hand washing behavior, and the levels of indicator microorganisms on hands of food handlers who work in the food court and cafeteria of a university campus. The three methods used were questionnaire survey by interview, direct observation in restrooms, and microbiological examination according to the Food Code of Korea. A positive attitude toward hand washing compliance was reported by the responded food handlers; however, improper hand washing and poor hand hygiene of the food handlers were recognized by the unnoticed direct observation. Significant differences were found between the questionnaire survey and the direct observation (p < 0.05) in hand washing compliance after using the toilet, duration of hand washing, use of hand washing agent, washing different parts of the hands, hand-drying method, temperature of water, and method of turning off the water. Samples taken from their hands before work showed higher level of standard plate count, total and fecal coliforms, and Escherichia coli than those taken after washing with water. After washing hands with antiseptic liquid soap, the bacterial populations including Staphylococcus aureus on hands were dramatically reduced. This study indicates that there is a remarkable difference between the food handlers' awareness of hand washing and their hand washing behavior. Poor hand washing compliance and hand hygiene were indicated by the positive results of total and fecal coliforms, E. coli, and S. aureus on hands of some food handlers. The findings of this study suggest that the hand hygiene of the food handlers need to be improved. More training/education on hand washing and hand hygiene of the food handlers should be necessary.

• Journal of the Korean Dietetic Association
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• v.4 no.2
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• pp.235-244
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• 1998

Hand washing is an important component of hygiene program for food handlers. Hands can be a source of direct or indirect contamination of foods with pathogenic microorganisms. In this study, the effectiveness of hand washing methods and the use of 70% alcohol solution against transient skin bacteria was tested in an university foodservice facility. 70% alcohol solution is sprayed for 5 seconds automatically when hands are placed in the dispenser. Samples were taken using swab technique in meat cutting area, vegetable trimming area, and vegetable cutting area: before and after washing hands according to planned methods, and after being sprayed with 70% alcohol solution after washing hands. The bacteriological analysis of total plate counts, coliform, fecal coliform of food handlers' hands was done. Statistical data analysis was completed with Mann-Whitney U test and Kruskal-Wallis model using the SPSS program. The levels of initial contamination of workers' hand were significantly different by the work areas($x^2$=9.156, p<0.01). Workers in the vegetable trimming area had more heavily soiled hands than in the other work areas. Mean of TPC counts and coliform was 8.97×$10^5$ CFU/12.4$cm^2$, 2.93×$10^2$ MPN/12.4$cm^2$ respectively, but fecal coliform was not detected. Transient bacteria were removed from hands after washing and using 70% alcohol solution but were not removed completely. Mean reduction percentage in TPC varied among work areas and ranged from 93.19% to 94.99%, and in coliforms from 97.31% to 100%. A significant difference in TPC was found between before and after hand disinfection (Z=-2.714, p<.01) and between standardized hand washing procedures and un-standardized hand washing procedures(z=-2.301, p<.01). Subjects using the hand sanitizer showed a great elimination of TPC(99.45% reduction), but this effect was valid only after following proper washing procedures. Based on the results, the most effective hand washing method was recommended as the combination of the standardized hand washing procedure with warm-water and use of the 70% alcohol solution. The results can be used to develop hand hygiene programs and training strategies for enhancing hand hygiene practices for food handlers in foodservice operations.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.15 no.3
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• pp.342-349
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• 2008

Purpose: This study was done to develop data for a hygiene promotion program for elders living on rural islands. Method: Self-administered questionnaires were used to collect data. Results: Most of the elders reported brushed their teeth and washing their faces twice a day. For other types of washing, 98.8% of reported washing their hands after the toilet and 22.8% reported washing their anus after defecation. Most of the elders reported changing their underwear two to three times a month and cutting their nails more than four times a month. Itchiness was reported by 24%. There were significant differences according to age for teeth brushing, face washing, shampooing, bathing, washing hands after the toilet, and cutting nails. According to sex, there were significant differences in teeth brushing, face washing, washing hands after using the toilet, washing anus after defecation, changing underwear, cutting nails, and feeling itchy. The elders showed significant differences in bathing, changing underwear, and cutting nails according to subjective economic status. They showed significant differences in teeth brushing and changing underwear when they lived with their families. Conclusion: In order to develop a proper hygiene promotion program for the elderly, their age, sex, and physical condition should be considered as well as their environmental, economical, and geographical condition.

• Journal of Environmental Health Sciences
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• v.38 no.3
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• pp.241-250
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• 2012

Objectives: This study was performed to investigate hygienic behavior of food handlers and general population focusing on awareness of hand-washing and the microbial load of their hands. Methods: A questionnaire survey and microbiological analysis were carried out for sixty-four people each. Samples for microbiological analysis were collected through the glove-juice method from the hands, and were analyzed for the presence of aerobic plate counts, total coliform, fecal coliform, Escherichia coli, Staphylococcus aureus, and Salmonella spp. according to the Food Code of Korea. Results: In the survey, significant differences between the food handlers and general population (p < 0.01) were found in hand-washing frequency, duration, use of hand-washing agents, washing parts of hands, hand-drying method, and method of turning off water. In eight different situations among the ten particular situations in their daily life, more food handlers responded to wash their hands than general population (p < 0.05). Bacterial load on hands with general population was consistently higher than with food handlers (p < 0.05), however, percentages of positive hands of S. aureus and Salmonella spp. were not. Conclusions: Poor hand hygiene practices were indicated by the positive results for E. coli, S. aureus, and Salmonella spp. on the hands of some respondents in both groups. This study reveals that there is the need for programs or campaigns to increase hand-washing practices of both groups.

• Journal of Korean Biological Nursing Science
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• v.16 no.3
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• pp.157-163
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• 2014

Purpose: This study investigated the microorganisms in the hand before and after hand washing, using plain and antibacterial soap. The purpose of this study was to provide details, for educational purposes, of hand washing methods that should be used by college students for their hand hygiene. Methods: This study was arranged using a randomized control group pretest-posttest design. Data obtained through questionnaires were collected from college students in Gangwon Province. This study involved three groups under different conditions. The first and the second group washed their hands with plain and antibacterial soap, respectively. The third group members were educated about hand washing and they then washed their hands with plain soap. In addition, we collected samples to investigate the removal rate of Escherichia coli and Staphylococcus aureus, which can cause bacterial disease, by using sterile swabs from the hands in group 3. Results: The removal rates of bacteria in the first and the second group after hand washing with plain and antimicrobial soap were 62.7% and 76%, respectively. The third group, who were educated concerning proper hand washing, showed a figure of 72.8%. Conclusion: Repeated and more consistent education of college students concerning proper hand washing would be important in order to improve their knowledge, attitude, and performance with regard to hand washing.

• Journal of Environmental Health Sciences
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• v.39 no.1
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• pp.71-82
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• 2013

Objectives: This study was performed in order to investigate hand hygiene practices among food-service businesses employees based on the awareness of hand-washing and load of indicator bacteria on their hands. It focused on the comparison of full-time and part-time workers in food-service workplaces. Methods: A direct-interview questionnaire survey and microbiological analysis were carried out with sixty workers each. Samples for microbiological analysis were collected through a modified glove-juice method from the hands of the food-service workers and were analyzed for aerobic plate count, total coliform, fecal coliform, Escherichia coli, Staphylococcus aureus, and Salmonella spp. Microbiological analysis was done according to the Food Code of Korea. Results: Significant differences (p<0.01) were found in the survey between the full-time and part-time workers in hand-washing frequency, use of hand-washing agents, and hand-drying methods. More full-time workers responded to washing their hands after preparing food, after visiting outside, after handling raw materials, and before putting on gloves/when changing gloves than did part-time workers (p<0.05). No remarkable difference was found in bacterial load on the hands except in the aerobic plate count between the two groups. The detection of E. coli, S. aureus, and Salmonella spp. on the hands of some food-service workers in both groups revealed poor hand hygiene practices. Conclusions: The results of this study indicate that there is a need for training programs in order to improve hand hygiene practices and strict hand hygiene compliance by food-service workers.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.11
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• pp.5714-5722
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• 2013

This study was done to investigate characteristics, knowledge, attitude, and performance on hand washing by nursing students who are prone to have clinical practice. Data were collected from 418 students in 3 nursing colleges from September to October, 2011 using questionnaire. The mean frequency and duration of hand washing were 7.2 times a day and 19.1 sec. The mean scores of knowledge, attitude, and performance on hand washing were 11.34(range 0~15), 3.42(range 1~5), 3.6(range 1~5), respectively. Above a half of students don't know about appropriate duration for hand washing and precautions after washing hands. Washing hands after rubbing nose, coughing, sneezing and handling the money and removing watch before hand washing were little performed. These results should be useful in development of education program for improving hand washing performance of nursing students.