Posted By Ian Blenkharn It's good that you ask, I imagine the majority wouldn't bother. Alcohol hand wipes and sprays have their limitation. Basic hygiene standards are esseential, to ensure correct storage of raw and cooked products, appropriate wrapping, disposal etc. You are always going to have problems with money handling, and the approach that uses just one glovce to handle food and an ungloved hand for cash never works reliably. Consider moistened hand wips - you can get medicated ones if you want - from a supplier that cn provide them in plastic drums. These are less liable to evaporation and it is possible to pull off several at once to wipe hands thoroughly. THEN use an alcohol hand rub on cleaned hands. Biggest problem you have will be in training and supervison of staff, but that is a whole new problem

Posted By Ian Blenkharn Yes, exactly....hence the moistened hand wipes to clean hands, followed if needed by an alchol-based sanitizer!

Posted By Chris Packham There is at least one company that manufactures simple hand wash stations that can be located almost anwhere. One organisation that provide support to motorists who have broken down has fitted these into many of their vehicles. I have no commercial interest in this company but will not name them on the forum. If you would like a contact point drop me an e-mail. Chris

Posted By Ian Blenkharn Vehicle mounted hand wash equipment is notoriously troublesome and few users are satisfied with these. The free-standing sign units are designed for clinical areas. They are expensive but effective, and are reliant on water top-ups - this may be a limitation for you, as would be their weight and size. As always, whatever you use must pass the usability test - ie, does it get used effectively, and when required! Tubs of simple hand wipes are widely available. They have their limitations, but are cheap and convenient. Dirty hands can be cleansed effectively using these - choose the ones that pull out in a ribbon, and praise those who come back to ask for more, not grumble about their profligate use!

Posted By Chris Packham Ron You are correct about the wipes. Concentrated use will defat the skin. They are a stopgap until the person can actually wash and rinse their hands (and then hopefully apply a conditioning lotion). The only true answer for hand cleansing is to use water to rinse away the emulsified soil. A hand wipe simply cannot do this. This is not to say that I am opposed to hand wipes. They are useful where water is not immediately available for hand washing, but are perforce a compromise. Alcohol sanitising rubs can actually be formulated so as to refat the skin, i.e. they are buffered with an emollient. Several studies have shown how frequent use of such a product does not result in any reduction of skin hydration, but rather the opposite. Chris

Posted By Chris Packham Ian I have to disagree. Statistics in the U.K. on dermatitis severely understate the facts. If you look at the statistics for those countries where there are relatively good statistics, then you will find that occupational skin disease is one of the major causes of occupational ill health. For example in 2007 in Germany skin disease accounted for 30% of all occupational ill health. I have similar statistics for Denmark. In the US OSHA reviewed their statistics and found that skin disease was far more common that respiratory disease. In fact, the relationship was 2.4 cases of skin disease for every case of respiratory disease. And this is only skin disease. Speak to the HSL and they will tell you of their concern about skin uptake. In fact, in many cases uptake through the skin is more significant that from inhalation. We simply do not have many statistice on this, but one study in the USA concluded that well over 50% of systemic disease in one particular industry was due to skin uptake rather than inhalation. The increase in hand washing in the NHS (and healthcare organisations in other countries) due to the concern about HCAIs has led to a significant increase in cases of dermatitis. Chris

Posted By Juan Carlos Arias I have use portable hand wash stations in the food industry, they only need a plug to ensure the water is heated and they are not that expensive. they basically have a bucket with clean water with a compartment for dirty water. it lasts approximately 100 hand washes and has a mounted hand wash soap dispenser

Posted By Chris Packham Sorry, typo crept in there. It should have read: 30% of all cases of occupational ill health were skin related. Chris

Posted By Chris Packham Ian As and when I have a moment I will put together some of the evidence and e-mail you a document. Believe me, the evidence is there. However, even those authorities where they have good data collection facilities will admit (usually in the bar at a conference) that their statistics are almost certainly an underestimate. One problem is the uncertainty in diagnosis. When does dry, cracked skin officially/medically become dermatitis? You get almost as many opinions as you have medical practitioners. It also depends much on where you are working. I see skin conditions in heavy industry considered "mechanics hands" that in a hospital would certainly be regarded as dermatitis! There is another problem in deciding if, or to what extent, the skin problem is occupational. When investigating skin problems in a workplace for clients it is often difficult to be certain. So many factors can play a role that often (in the words of a leading dermatologist at a conference in Germany two years ago) many of our diagnoses are educated guesses! Chris

Posted By Chris Packham Ian There is no way I could possibly put all the information and statistics on to this forum. The posting would be enormous. However, most the information that I have is in the public domain (some is provided as unpublished statistics from my contacts as someone involved in the prevention of damage to health from workplace skin exposure from sources such as the European Society of Contact Dermatitis) I have put together a brief overview which I will be e-mailing you off the forum. Anyone else interested should e-mail me direct and I will send them the same information. Chris

Posted By Ian Blenkharn blenkharn@ianblenkharn.com

Posted By Ian Blenkharn MT - neither would I, the use of hand rubs on soiled hands is known to be ineffective, hence the suggestion to use impregnated wet wipes to clean hands first. But who is this food safety officer sitting close to you, and what is the value of their anonymous and now second-hand comment? And looking at the data that Chris Packham has sent to me, that comprises a self-written piece of advertising which does not cite any reference source. Chris helpfully cites in an accompanying email an EU review that does not support the incidence rate that he quotes here. I really wonder about the warning at the top of the main forum page that tells us all that "Messages posted on the forums do not constitute advice and do not reflect the values of IOSH. Postings made by forum users should not be relied upon in making or refraining from making any decision." I hope everyone takes appropriate care

Posted By MT I think you answered your own question there Chris. I said that she wouldn't accept use of the gel *in place of handwashing*, and you said that it's commonly used *in combination with handwashing*. Haven't you just agreed with what she said?

Posted By Ian Blenkharn Once again, ex-Cathedra statements but no evidence. When I asked you to support the claims that you made previously, you chose to email me instead of summarising the evidence here. Thank you for sending that, but unfortunately all I received was some unreferenced notes of your own that in no way constiture evidence, and mention of pan-European review of occupational skin disease. That review is accessible at http://osha.europa.eu/en...007049ENC_skin_diseases, and does not tally at all with your previous comments. Perhaps you could now find some authoritative citations to support these latest claims, with which I actually concur. By providing relevant citations, readers here can judge for themselves the accuracy of the comments made.