Chapter 7
Personal Hygiene
By the end of this chapter, you will be able to: l
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Explain how to cleanse your hands following the seven-step best practice hand-hygiene technique Describe cleanroom clothing requirements Explain the importance of finger dab tests
Introduction Everything we do in a clean room should help to avoid contamination of the final product. Other chapters will explain how we can do this through following SOPs, using the correct aseptic technique, and working in a properly controlled environment. This chapter looks at how humans can contaminate the clean room environment, and the steps we need to take to control and prevent contamination through good personal hygiene both in and out of the work environment.
List the do’s and don’ts of clean room hygiene and actions
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Human Contamination Humans contribute the most contamination in clean room environments.
Here are some simple steps you should take to try to minimise avoidable contamination: l
Report any illness or skin problems, respiratory infections and gastrointestinal disorders to your manager.
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Cover all cuts and grazes with an impervious plaster.
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Your personal hygiene is important, so take a bath or shower, shave, brush teeth and hair daily before you come to work.
Hands Good Hand Hygiene is vitally important to reduce contamination:
The average human sheds something like 1,000 bacteria carrying particles per minute! As they are working, clean room operators generate millions of particles with every movement. Therefore we must make sure that everybody follows Standard Operating Procedures (SOPs), to minimise the risks we pose. Skin Shedding of skin is a problem in the clean room and dry and broken skin can shed even more. You should be aware of good skin care procedures. However, there is some debate about the use of moisturisers as a potential source of clean room contamination. Body lotions and moisturisers are not sterile and they can form a film over skin leading to less penetration and efficiency of hand disinfectants. Because of this, when you apply moisturiser you should wash your hands thoroughly afterwards. It is better to apply body lotion/moisturisers before you come to work; moisturisers should not be applied at work either before or during your shift. 2
Chapter 7: Personal Hygiene
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Hands and finger nails should always be kept clean.
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Nail polish and false nails should not be worn.
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Nails should be kept short and well maintained.
Hand washing Technique Not only do your nails and hands have to be clean and well cared for but your hand washing technique is critical.
Chapter 7
Personal Hygiene
Here are seven steps for best practice hand washing technique:
5. Rotate around thumbs 1. Palm-to palm
6. Fingertips to palm 2. Back of hands, interlacing fingers
7. Wrists 3. Front of hands, interlacing fingers
As a guide you should carry out approximately six repetitions of each stage of the process. Each step should be performed for 15-30 seconds. Hand washing should take two – three minutes to complete when done properly. A video on best practice may also be viewed. Please go to http://www.medslearning.leeds. ac.uk/pages/aseptics/videos.html to view video number 2 Hand washing Technique.
4. Clasping fingers
Remember: Good hand washing technique should still apply outside the clean room environment. Chapter 7: Personal Hygiene
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Test Yourself Good hand hygiene – Fill in the blanks in the following sentences:
………….....................…. and ………….....................…. should always be kept clean. ………….....................…. and ………….....................…. should not be worn. ………….....................…. should be kept short and well maintained.
Personnel Testing
Hand washing Testing
Training
Hand washing practice should be validated by performing ungloved finger dabs on Tryptone Soya Agar (TSA) plates.
Initial training is undertaken by all potential operators to enable them to work effectively in all areas of the facility. Staff are expected to undertake an evaluation test both initially and at a designated frequency to check their aseptic technique to ensure their working practices do not contaminate the products. Finger Dabs During training finger dabs are carried out by all operators both before and after a working session. The un-gloved “before” dabs assess hand washing techniques to ensure all dirt and bacteria are removed when scrubbing up.
After preparation, gloved finger dabs may be performed, as shown here.
The gloved “after” dabs assess operator technique and bioburden of products. The “after” dabs should be bacteria free. If bacteria are present, this could be due to poor operator technique or poor spraying practices when bacteria are still present on the outer surface of bottles and containers or sundries which may have been passed into the LAFC or isolator.
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As on this illustration this plate shows mould and skin flora growth on a TSA plate. These gloved finger dabs were taken outside the clean room. We would not expect to see this type of result on any finger dabs test taken inside the clean environment.
Chapter 7
Personal Hygiene
Another method of testing handwashing technique is to use a UV light box and special revealing cream can be used to illustrate the effectiveness of hand washing.
The cream is applied to hands, washed off, and then hands are inspected in the UV light box for residue. You can see large areas here that have been missed.
Test Yourself Can you remember the different types of finger dabs taken? List them, and explain why they are taken.
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General Hygiene Clothing l
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Outside shoes should not be brought into the clean room. If you haven’t a separate pair of cleanroom shoes then make sure the soles of your shoes are clean. Overshoes should also be worn. You should always wear clean garments under your clean room clothes.
Only approved clean room clothing is allowed in the clean room.
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Personal mobile phones should not be taken into the clean room.
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Matches are not to be taken in to the clean room.
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Brush or comb hair before coming to work as brushing hair, even in the gowning area, can cause contamination. Do not brush or comb hair in the clean room!
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Avoid rubbing or scratching your hands. Also avoid touching masks, glasses, skin or clean room clothing wherever possible.
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Talk at a modest volume and keep talking to a minimum. Do not sing or whistle.
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Facial tissues are prohibited in the clean room.
Jewellery Jewellery should not be worn. False Nails False nails must not be worn Make up and hair products You must not wear make-up, hair gels and hair sprays in the clean room. This is because they can generate many particles. Not only this, but they also release substances such as aluminium, silicone, carbon, titanium, magnesium, potassium, sulphur and calcium, making them a major source of potential contamination. Information: Spore formation by bacteria requires the presence of calcium and magnesium ions, which are both found in cosmetics and hair products. Other Rules for Good Hygiene l
Eating and chewing are not allowed in the clean room.
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Smoking is not allowed on the premises and tobacco must not be taken in to the unit either.
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Leave keys in your locker.
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Clean Room Clothing The main function of cleanroom clothing is to protect the product being made from contamination. It is specially designed to provide head-to-toe cover with minimal chance of warm air aspirates reaching the room or products.
Chapter 7
Personal Hygiene
The clothing must always be worn when working in cleanrooms and should not be worn outside the cleanroom or changing rooms. Keeping your clean room clothes clean as you put them on is the key to avoiding any contamination. Remember to touch the insides of the clothes only, and if you do touch the outside to adjust, make sure you have disinfected your hands first. Garments should be fastened up at all times and should not be loosened or unfastened during operation. Garments should be checked for wear or damage. Gloves should be regularly disinfected and torn gloves should be changed as soon as possible.
Lancer Coats
There is a video available to watch on the correct procedures for putting on cleanroom clothing. Please go to: http://www.medslearning.leeds.ac.uk/pages/ aseptics/videos.html to view video number 3 Putting on Cleanroom Clothing. The type of clean room garment required is dependant on the classification (or ‘grade’) of the room you are working within. Here are some different examples: Images supplied by Micronclean
Hoods, boots and suit Further information on cleanroom clothing is available in a handbook from Micronclean called Garment Management for Controlled Environments: An Introduction www.micronclean.co.uk
Undergarments
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Task Find out the types of clean room clothing required for each different grade of room in your work place. Discuss with your trainer/supervisor. List them below, with the room type and explain why they are necessary Clean room
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Grade
Clothing worn
Reason
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Personal Hygiene
Gloves
Dropped Items
When putting on sterile gloves:
If you drop an item on the floor during the manufacturing process, leave it until the end of the session. If you do have to pick anything up from the floor, consumable items should be discarded or disinfected according to your local procedure.
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Remember not to touch the exterior surface of the gloves.
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Touch the inside of the glove to hold and pull onto hands.
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Leave the cuffs folded down until both gloves are on.
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Pull up folded cuffs over garment cuffs.
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Leave the inner packaging on the bench until you exit the clean room.
Important: Change your gloves immediately in the changing area after picking up any item up.
Your gloves should remain intact throughout the session and you should inspect them constantly during aseptic processing to check for holes. If you find a hole, change them immediately following your local SOP. Gloves should be cleaned regularly, and always between products. If you remove your hands from the critical zone, your gloves should be cleaned before re-entering the LAFC or isolator. Videos on gloving technique (non-sterile and sterile gloves) are available to view. Please go to: http://www.medslearning.leeds. ac.uk/pages/aseptics/videos.html to view video number 4 Gloving Technique-Non sterile Gloves and video number 5 Gloving Technique-Sterile Gloves. Important: Whenever gloves are removed hands must be immediately disinfected as bacteria will have moved to the surface of your hands under your gloves.
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Activity Make sure you watch the following videos at the location below http://www.medslearning.leeds.ac.uk/pages/aseptics/videos.html and then refer to your local procedures: Hand Washing Technique
video 2
Putting on Clean Room Clothing
video 3
Gloving Technique- Non Sterile Gloves
video 4
Gloving Technique- Sterile Gloves
video 5
If there are any variations in your local procedures, make a note of them below. Hand Washing:
Putting on Clean Room Clothing:
Gloving Technique – Non Sterile Gloves:
Gloving Technique – Sterile Gloves:
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Personal Hygiene
Questions
Q1
What actions should you take to minimise the risk of contamination in each of the following situations?
a) If you have a cut or a scratch?
b) If you have a stomach upset?
c) If you have a cold?
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Q2
Why should you not apply moisturiser before entering the clean room?
(3) Chapter 7: Personal Hygiene
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Q3
What are the rules for wearing of makeup, false nails and jewellery in the clean room, and why are these rules in place?
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Personal Hygiene
Q4
List the seven stages of hand washing. How many repetitions should you make at each stage?
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Number of repetitions of each stage: .............. Chapter 7: Personal Hygiene
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Q5
List 6 items that you must not take into a clean room.
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Chapter 7: Personal Hygiene
