There is a general agreement that hand sanitation is a problem, but how that problem is best addressed is not always clear. The arguments to wear gloves and to not wear gloves are both persuasive. However, no one solution seems to be the answer, and there is no magic bullet that will prevent the spread of disease.
Although studies have been conducted that show hand washing reduces the number of pathogens on the hand, there are others that show that significant log reduction of microorganisms may not always be achieved to make bare hands safe for contacting foods. Also, few, if any, studies have been done to demonstrate that wearing gloves reduces the number of foodborne illnesses. With this in mind, consider the evidence that does exist to support each argument.
At the heart of the debate is the question of how the transmission of microorganisms on hands (sometimes referred to as "restroom germs") can be limited or stopped. The obvious first step is to wash hands frequently, especially after using the restroom. Even after washing, though, residual amounts of pathogens can be left on the skin, especially under the nails, in between fingers, and in cuts, abrasions or sores. Donning gloves after proper hand washing will limit the spread of germs by protecting food from any germs left on the hand.
Some opponents to gloves state that high levels of bacteria can build up inside the glove and be passed on to foods. However, these high levels of germs are generally due to the normal bacteria that live on the skin, which do not cause foodborne illnesses. In fact, the germs most likely to cause disease are also the easiest to remove during hand washing because they generally remain on the surface of the skin.
Unfortunately, hand washing does not happen as often as it should, and hand washing is not always done in a way that removes sufficient microorganisms.
Surveys done with hidden cameras show that hand washing is not properly carried out in foodservice operations. A recent study by the American Society for Microbiology found that only 58% of men and 75% of women washed their hands after using the restroom.
Arguments against wearing gloves include the thought that employees wearing gloves tend to not wash their hands as much, as their hands don't "feel as dirty" as they would if using bare hands during food preparation or service. More training needs to be done, whether gloves are worn or not, in the realm of hand washing. Food workers need to understand not only why they must wash their hands, but also how to wash their hands correctly. Even with proper hand washing, disposable gloves may be necessary. Evidence shows that sufficient microorganisms may not be removed from hands and a second line of defense is needed when handling ready-to-eat foods or food contact surfaces, even after washing hands.
On the other hand, it is believed that gloves can fail and let bacteria and viruses from the hand pass through to the outside of the glove. Estimates on how many gloves “leak” range widely from 13% to 85%. Opponents to glove use claim that these leaks can cause more problems than bare hands alone. They conjecture that gloves trap food and moisture inside, which allows bacteria to grow to higher numbers than would be found on bare hands. However, a document presented to the FDA showed that even gloves that leaked prevented hand contamination 77% of the time when tested. With proper hand washing, gloves add an important barrier to the contamination of foods by pathogens left on the hands after washing.
Maybe an even more important area of contention in the glove debate addresses the perceptions that employees have about gloves. Some foodservice workers can be lulled into a false sense of security by wearing gloves and never changing them or neglecting to change gloves as often as they should. Gloves should be changed as often as one would wash their hands - namely when soiled, after 4 hours of continuous use, or in between handling raw foods and ready-to-eat foods. Other employees believe that the glove is there to protect them from the food. Wearing gloves can also lead to the loss of sensation of food debris on the hands, causing hands to be washed less frequently. All of these issues can be handled by teaching employees to wash hands and change gloves frequently.
Hand washing and glove use may not be enough though. According to the FDA Food Code, excluding ill food workers and restricting their food-related tasks with certain gastrointestinal symptoms or diagnoses is also necessary to prevent foodborne illness. Some believe that excluding sick employees from food preparation areas will be more effective than wearing gloves. However, there are some inherent problems with the exclusion concept. Some foodservice employees are too embarrassed about their symptoms to tell a manager about them. Also, many in the food industry do not have sick benefits and cannot afford the unpaid time off needed to recover from their illness.
Having a "Foodborne Illness Reporting Agreement" on file for each employee in advance, can encourage employees to report their symptoms or illness to their manager, so they may be assigned duties that minimize their contact with foods. However, employees can sometimes be carriers of a disease, and not exhibit any symptoms, occasionally picking up with germs they picked up from ill family members and friends. In such cases, gloves and other barriers can be helpful in minimizing risk of disease transmission.
And what do customers think about employees wearing gloves? Generally, observing employees wearing gloves tends to make the customer feel safer, especially if they can see the food being prepared. Customers often have no idea if employees have washed their hands and seeing employees wear gloves is a reassuring sign to the customer that the food is safe. But only if gloves have been changed properly. If customers observe gloves being used for touching body parts, trash, money, then continuing to handle foods with the same gloves, it can destroy the customer's confidence in the food worker completely.
Paul McGinnis is the VP of Marketing for Ecolab's Food Safety Specialties division (formerly Daydots). He is an author and a speaker, and currently serves as editor-in-chief of Food Safety Solutions magazine.