• 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 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 Environmental Health Sciences
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• v.35 no.4
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• pp.278-286
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• 2009

The total of 181 students in Seoul were made up questions to analysis hand washing awareness from 2007 to 2008. And their hands were sampled to isolate Staphylococcus aureus for testing antibiotic resistance. The average of hand washing frequency was $2.8{\pm}2.6$ per day in their schools. The rates of the students washing hands before eating food, after outdoor activity and after using bathroom were 22.2%, 24.4% and 49.4%, respectively. The rate of students washing hand less than 20 seconds was 64.4%. The students of 43.3% answered that they thought they were washing hands well. The middle school students were worse than elementary and high school students were aware of the frequency, duration and activity of hand washing. The isolation rate of S. aureus on the hands was 29.4%. The isolates were resitant to ampicillin (28.6%), chloramphenicol (6.1%), erythromycin (31.0%), gentamycin (2.0%), penicillin (79.6%) and tetracycline (6.1%) of 17 antibiotics tested. They were all sensitive to oxacillin and vancomycin.

• Journal of dental hygiene science
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• v.23 no.2
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• pp.132-141
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• 2023

Background: The purpose of this study was to identify the connection between handwashing and toothbrushing, focusing on eating habits, and to verify whether eating habits can be used as an action cue for forming health habits. Methods: This was a cross-sectional study using secondary data from the 2019 community health survey. The participants included 229,099 adults aged 19 years or older, representative of the South Korean people. We employed two dependent variables: one was washing hands, and the other was brushing teeth. Eating habits was a major independent variable. Socioeconomic variables, such as age, gender, income, occupation, economic activity, education, and residence were adjusted as confounders. Multivariate logistic regression was performed to calculate adjusted odds ratio and 95% confidence intervals. Results: Most of the participants had good health behaviors: those who wash their hands and brush their teeth were each approximately 80%. Our finding indicated that brushing teeth and washing hands can be connected with eating habits. After adjusting for confounders, it was found that people who wash their hands before meals (compared to those who did not wash their hands before meals) had a higher toothbrushing rate after meals (i.e., socioeconomic status) (Adjusted Odds Ratio: 2.0, Confidence Intervals: 1.9 to 2.1). Conclusion: Those who practice either washing hands before meals or brushing teeth after meals were found to have a connection between washing hands and brushing teeth based on the results of practicing other health behaviors. This implies that eating habits can be connected as a behavior cue to promote health habits, such as washing hands before meals and brushing teeth after meals.

• 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 Environmental Health Sciences
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• v.45 no.3
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• pp.213-221
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• 2019

Objective: This study was performed to evaluate gender and age differences in hygienic behavior among the general population, focusing on hand-washing habits and the microbial load of hands. Methods: A self-administered questionnaire survey and a separate microbial examination were performed. The Pearson's correlation between hand-washing habits and microbial load was analyzed. Results: In the questionnaire survey on hand-washing habits, gender differences were found in hand-washing frequency, use of hand-washing agents, and hand drying methods (p<0.05). Age differences were found in numbers of washing parts of the hands and also in hand drying methods (p<0.05). Females showed better habits washing hands than did males, as did older people compared to younger. In the microbial examination of indicator bacteria on their hands, younger people tended to show a higher load of total aerobic bacteria than did the older, and females showed a higher load of total coliforms than did males (p<0.05). There were significant relationships between the load of total aerobic bacteria and hand-washing frequency, duration, and method of turning-off water (p<0.05). Conclusions: Although females were expected to show a better practice of hand-washing than were males based on the survey results, they showed a higher level of total coliforms in the hand examination. The older age group showed better hand-washing habits than did the younger age group and had less total aerobic bacteria on their hands. These inter-gender and age differences highlight the need for development and implementation of gender-and age-specific educational programs or campaigns.

• 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 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 Environmental Health Sciences
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• v.35 no.1
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• pp.36-44
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• 2009

Hand-washing has been recognized as a critical factor in controlling infection and cross-contamination. This study was performed to investigate hygienic behavior of male university students focusing on awareness of hand-washing, their hand washing practices, and the difference between their awareness and practices. Both a self-administered questionnaire survey and a separate direct observation in restrooms were carried out at a university campus over a four week period. In the survey, 93.6% of the responded students claimed to wash their hands after using toilet. However, just 16.9% of the observed students actually did so, according to a separate and unnoticed observational study. Among the observed students who washed their hands, 25.0% of them used soap, only 5.0% of them washed four parts of their hands, and 15.0% of them washed their hands for more than 10 seconds. Paper towel was the most common hand drying method in the direct observation and also in the survey. Significant differences between the questionnaire survey and the direct observation (p<0.0l) were found in hand-washing practices, duration of hand-washing, using soap, washing parts of the hand, and hand-drying method after using the toilet. This study indicates that there is a remarkable difference between the male university students' awareness of hand-washing and their hand-washing practices. This study reveals that there is the need for programs or campaigns to increase hand-washing practices of male university students.

• 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.