Efficacy of Different Alcohol-based Hand Disinfectants in Reduction of Hand Contamination among Food Handlers in Alexandria, Egypt

Aims: To assess hand contamination among food handlers working at the cafeterias of Pharos University and to compare the efficacy of different alcohol-based hand rubs (ABHRs) in reducing hand contamination among them during routine work.

Study Design: Pre/post test quasi experimental study.

Place and Duration of Study: The study was carried out in the period from April to August 2018 and included fifty volunteered food handlers at the cafeterias of Pharos University, Alexandria, Egypt.

Methodology: Dominant hand direct finger-print samples were collected from the fifty participants during a pre-intervention visit to estimate the prevalence of hand contamination. In four following visits, another 400 finger-print samples were collected before and after applying four different hand disinfectants: three liquid ABHRs and a hand-rubbing gel. Samples were microbiologically examined for identification of contaminants. The different formulae were evaluated regarding their efficacy in reducing the count of hand contaminants.

Results: Thirty out of fifty (60%) of the finger-print samples were positive for one or more microbial contaminants. Coagulase-negative staphylococci (CNS) were the most prevalent isolates; detected in 66% of samples. The isolation rate of potential food borne contaminants was significantly higher among food handlers who served for less than five years (80%), compared to only 16.7% among those who served for more than ten years (P=0.001). The isolation rate of contaminants was significantly lower among participants who washed their hands after visiting the toilet (45.8%), compared to 73.1% among those who didn’t (p=0.05). A significant percentage reduction in the microbial count was recorded for all formulae used; with the gel hand rub being the least reducing formula.

Conclusion: Hand contamination with food borne pathogens is highly prevalent among food handlers. Liquid formulae of hand disinfectants containing propanol, applied for 15 seconds, are more efficient than those containing ethanol and than the gel formulae.