Modern myths endure as widely held beliefs that continue to be circulated and endorsed through frequent repetition, often in face of significant evidence to the contrary. In the age of the internet, the proliferation and distribution of maritime health and wellbeing information on social media platforms has reached unprecedented heights.
Unfortunately, there is a growing trend of disseminating information that is either inaccurate, intended to cause alarm and fear, or is based on purported research findings to promote the sale of products that have no empirical evidence to support the claims of the companies selling them. This epidemic of viral misinformation and pseudoscience presents a risk to maritime public health—namely, the tendency to disregard scientifically validated data in favor of unproven health solutions.
To combat myth-making, it’s crucial for medical and public health professionals working in the maritime industry to unite and actively refute false claims. This can be achieved by urging critical evaluation of information sources and by offering clear, factual explanations to demonstrate the inaccuracies of such messages.
The recent observance of World Hand Hygiene Day on May 5th presents an opportune moment to debunk some of the common myths and misconceptions surrounding handwashing. Disease prevention is an important element of risk mitigation strategies employed to protect the health and safety of all on board. Providing accurate information to both crew and shore-based managers supports informed decision-making within maritime organizations.
Three Maritime Myths Regarding Hand Hygiene
While the act of cleaning one’s hands is a relatively simple and straightforward process, improper hand hygiene practices can inadvertently increase the likelihood of spreading illness, rather than protecting our own health and the well-being of those around us.
Let’s take a look at some popular misconceptions within the maritime industry regarding hand hygiene to separate fact from fiction.
Myth #1 – Hot water is better than cold water for washing hands
Research has long indicated that there is no scientific evidence to support claims that the temperature of water used in handwashing has any observable impact on its efficacy to remove bacteria. This assertion has been further reinforced by recent studies, including an article published in the Journal of Food Protection by Jensen et al. (2017), which concludes that “no significant difference in washing effectiveness was found at different temperatures (15 to 38°C).”
If you’re working in the cruise industry and anticipating a change to Vessel Sanitation Program (VSP) guidelines—which mandate that handwashing facilities in food areas must “provide water at a temperature of at least 38°C (100°F)”—temper your expectations. Although the 2022 amendments to the FDA Food Code, which many VSP standards are modeled on, lowered the minimum temperature for hot water at handwashing stations from 38°C (100°F) to 29.4°C (85°F), the FDA’s rationale for warm water remains the same: to achieve the maximum surfactant effect of soap. Essentially, the underlying principle is that warm water enhances soap’s cleaning power, thereby improving its capacity to break down grease and grime.
An additional justification for water temperature regulation is to facilitate the act of handwashing itself: the more comfortable the water temperature, the more time one is likely to spend washing their hands. Furthermore, water that is too hot may potentially harm the skin.
Myth #2 – Wearing gloves reduces the need for handwashing
Hundreds of thousands of single-use gloves are used in food operations on maritime vessels every year. No photograph taken inside a ship’s galley—intended for future sharing on social media—would be complete without all crew members donning gloves to symbolize high standards in food safety on board. Despite the long-standing recommendation and adoption of gloves in food handling processes, their benefits continue to be questioned. A variety of studies, including those previously referenced, have highlighted the challenges associated with their use.
Health authorities and governments worldwide have either enshrined glove-wearing in legislation, or strongly encouraged, that food employees wear gloves when handling ready-to-eat (RTE) food items. Research by Yap et al. (2019), which examined hygiene practices related to hands and gloves among food handlers during sushi preparation in commercial establishments, revealed a higher incidence of cross-contamination when sushi was made without gloves.
Conversely, a three-year review carried out by Campden BRI (a British organization that provides expert support to the food and beverage industries), challenges the results of the sushi preparation research. The study involved collecting swab samples from the hands and gloves of workers at three RTE food factories, with findings indicating that glove use results in an equal or greater amount of microbial contamination compared to bare hands.
The principle argument against food handlers wearing gloves is an overreliance on their use, leading to complacency and a false belief in their protective ability. Gloves are not a substitute for proper hand hygiene practices. Wearing gloves can be an effective tool in preventing cross-contamination of food; however, their utility is contingent upon the individual’s commitment to established hygiene protocols.
Wearing gloves does not mean hands need to be washed less frequently. There is a tendency among food handlers to continue using the same pair of gloves for longer than they should. The key distinction is an added requirement of regularly changing the gloves. This additional step is likely a contributing factor to the ineffectiveness of gloves to minimize or eliminate bacterial contamination, particularly in food processes that necessitate frequent glove replacement over a short timeframe.
Myth #3 – Alcohol-based hand sanitizers are effective against norovirus
Norovirus—a pathogen extensively addressed in our previous article “How Murphy’s Law Can Help Prevent Disease Outbreaks”—is the leading cause of gastroenteritis outbreaks on cruise ships. Should you find yourself on board during a norovirus outbreak, it’s likely you’ll observe a common strategy by cruise lines of deploying additional hand sanitizers throughout the vessel. This measure is, however, more for guest perception than it is for effectively preventing further transmission of the virus.
Viruses are infectious pathogens that carry their own genetic blueprint in the form of DNA or RNA, the code which guides their replication process. They possess a protein shell, known as a capsid, that encases and protects their genetic code. Furthermore, certain viruses, referred to as “enveloped” viruses, have an extra protective layer around their capsid called an envelope. SARS‑CoV‑2, the strain of coronavirus that causes COVID-19, is one such virus.
In contrast, “non-enveloped” viruses—including norovirus, rotavirus, and hepatitis A—lack this additional outer protective layer. Interestingly, the absence of an envelope actually renders these viruses more resilient to various environmental factors (e.g., disinfection, heat, UV, etc.) compared to their enveloped counterparts.
This enhanced resilience can be attributed to the location of a virus’s fusion proteins (FPs), the molecular keys that enable viruses to penetrate and enter the cells of a host. For non-enveloped viruses, the FPs are found on the capsid, whereas for enveloped viruses, they are located on the envelope. In essence, fusion proteins are a crucial component of a virus’s ability to infect and propagate within an organism.
When enveloped viruses are exposed to disinfectants, their envelopes are compromised, leading to the disintegration of the fusion proteins and the virus’s capacity to infect. Alcohol-based sanitizers, while effective at neutralizing many types of microbes, are not as good at inactivating non-enveloped viruses, like noroviruses, as the capsid is more resistant to disinfection than an envelope.
Studies have shown that washing hands with soap and water is a more effective method for removing noroviruses from hands because soap, through its surfactant action, can disrupt the virus’s capsid rendering it inactive.
The Principles of Hand Hygiene Are Universal
Other common hand hygiene myths include:
- Antibacterial soaps are significantly more effective in microbial reduction than “normal” soap. No definitive evidence has been found that proves antibacterial soaps are better at preventing illness than ordinary soap.
- Properly washing your hands is the benchmark of good hand hygiene. Equally crucial is the subsequent drying of hands, a step that must not be neglected. Research indicates that residual moisture on hands can facilitate the transmission of bacteria. This implies that without adequate drying, there’s a likelihood of bacteria persisting post handwash.
The core tenets of hand hygiene are universal. They remain the same regardless of rank, department, or function on board: every seafarer has a role to play in disease prevention. By incorporating proper hand hygiene practices into everyday routines, individual crew members can be instrumental in preventing the spread of illness on board.
Misinformation regarding what constitutes successful health strategies will persist. The internet and social media are here to stay. The promotion of so-called comprehensive solutions claiming to address intricate health problems and the presentation of established methodologies as innovative breakthroughs will continue for the foreseeable future.
There is no shortcut to achieving public health excellence. While there are emerging technologies that warrant further investigation, preventing disease at sea largely depends on consistently maintaining high standards of hygiene.
Martha Rogers, a professor at the Fuqua School of Business at Duke University, is quoted as saying, “When your headlights aren’t on, the best rearview mirror available isn’t likely to improve your driving.” Maritime organizations must discern and apply reliable health data to decision-making processes, ensuring judicious use of their resources and avoiding the trap of ineffective solutions.