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PubMedDate not supplied

Are ball pits the playground for potentially harmful bacteria?

Ball pits, enclosed play areas with padded floors and pits of small plastic balls, have become popular features for children at fast food restaurants. This pilot study sought to identify and confirm bacterial organisms that place children at a potential health risk in three play pits within fast food restaurants. Data for this descriptive study were randomly collected from restaurants offering play pits with multicolored, round, hollow, plastic balls within urban communities of the Tidewater region of Virginia. Specimens were collected from entrances into the ball pits as well as various areas of the bottom lining to incur a representative sample. Results indicated an increased level of normal flora as well as nonhuman flora, demonstrating that bacteria are present within the ball pits. The results question the safety of these play pits for both health care providers and parents. Nurses play a vital role in public awareness through health education. Disinfection protocol and proper handwashing are the keys to making ball pit play areas safe for children.

Bacterial Infections↗
PubMed2005

Adolescent exposure to and perceptions of environmental tobacco smoke.

Environmental tobacco smoke (ETS) poses an underappreciated risk to adolescent health. This study examined perceptions of adolescents (n = 574) regarding ETS. About one half (54%) were exposed to ETS the previous week, and one third (30%) were exposed to 3 or more hours of ETS the past week. Concurrently, 29% believed that breathing someone else's cigarette smoke had little or no effect on their health. Most adolescents (56%) believed that smoking should not be allowed in restaurants without bars but were less supportive of prohibiting smoking in restaurants with bars (20%) or in bars (14%). Two thirds (69%) of adolescents believed that the government should be involved in making laws that protect the health of people who work in bars and restaurants. Almost one half (49%) believed that the government should be involved in passing laws that make it illegal for people to smoke in public places. Odds ratios revealed that females, nonwhites, younger students, nonsmoking students, and students who believed that ETS exposure had a moderate or major effect on health were statistically significantly more likely to support clean indoor air ordinances in select locations compared to males, whites, older students, students who smoke, and students who perceived that ETS exposure has little to no effect on health.

Adolescent↗
PubMed2006

The role of race and poverty in access to foods that enable individuals to adhere to dietary guidelines.

INTRODUCTION: The increase in obesity and disparities in obesity and related chronic diseases across racial and ethnic and income groups have led researchers to focus on the social and environmental factors that influence dietary intake. The question guiding the current study was whether all communities have equal access to foods that enable individuals to make healthy dietary choices. METHODS: We conducted audits of community supermarkets and fast food restaurants to assess location and availability of food choices that enable individuals to meet the dietary guidelines established by the U.S. Department of Agriculture (e.g., fruit and vegetable consumption, low-fat options). We used 2000 census data to assess the racial distribution and the percentage of individuals living below the federal poverty level in a defined area of St Louis, Mo. Spatial clustering of supermarkets and fast food restaurants was determined using a spatial scan statistic. RESULTS: The spatial distribution of fast food restaurants and supermarkets that provide options for meeting recommended dietary intake differed according to racial distribution and poverty rates. Mixed-race or white high-poverty areas and all African American areas (regardless of income) were less likely than predominantly white higher-income communities to have access to foods that enable individuals to make healthy choices. CONCLUSION: Without access to healthy food choices, individuals cannot make positive changes to their diets. If certain eating behaviors are required to reduce chronic disease and promote health, then some communities will continue to have disparities in critical health outcomes unless we increase access to healthy food.

Black or African American↗
PubMedDate not supplied

Support for tobacco control policies among youth in North Carolina.

BACKGROUND: The objective of this research was to examine attitudes toward tobacco control policies among middle and high school students in North Carolina. Specifically, we report data on knowledge of the harmfulness of secondhand smoke and support for restaurant and school-based smoking restrictions. METHODS: The statewide North Carolina Youth Tobacco Survey was administered to a representative sample of 3,073 middle school and 3,261 high school students in the fall of 2003. The overall response rate for the middle and high school samples was 77.0% and 77.4%, respectively. Support for tobacco policies was analyzed by smoking status and by knowledge of the harmfulness of secondhand smoke RESULTS: The vast majority of respondents in the middle school (87.6%) and high school (91.6%) reported that secondhand smoke was "definitely" or probably" harmful. However, less than half of middle school (48.6%) and high school (40.2%) students responded that smoking should be banned in restaurants. Even among the select group of students who had never smoked and who believed secondhand smoke was harmful, support for such a ban was less than 60% at both school levels. CONCLUSIONS: Youth in North Carolina are aware of the health risks of secondhand smoke, but are not convinced of the need to restrict smoking in restaurants. These results point to the need for more youth-focused advocacy and education around smoking restrictions, both to reduce youth exposure to secondhand smoke and to solidify voter support for such protections once they reach adulthood.

Adolescent↗
PubMed2006

Incidence of enteric bacterial pathogens in water found at the bottom of commercial freezers in calabar, southeastern Nigeria.

Bacteriological analysis of water that accumulates at the bottom of freezers in restaurants when the power was cut in Calabar, southeastern Nigeria, was carried out using standard procedures. Mean heterotrophic bacterial counts and Escherichia coli counts ranged from 3.1 +/- 0.02 to 7.1 +/- 0.30 x 10(4) cfu/ml and 0.2 +/- 0.10 to 0.6 +/- 0.50 x 10(4) cfu/ml, respectively, indicating heavy bacterial contamination whose source was mostly fecal. There was no significant difference (p > 0.05, 0.01) in bacterial counts between freezers. Some biochemically identified enteric bacterial pathogens were Salmonella typhi, Shigella sp, enteropathogenic E. coli, Yersinia sp, Klebsiella pneumoniae, Vibrio cholerae O1 and Vibrio parahaemolyticus. This reveals that the hygienic quality of the food items stored in the freezers and the hygienic status of the restaurants are in doubt. Infection could be going on unnoticed and thus endemicity maintained in the area. The pathogens showed alarming antibiotic resistance. The water in the freezers was a "soup" in which different species of the enteric pathogens were close to each other and could transfer drug resistance among themselves. Public health education of restaurant operators in southeastern Nigeria is recommended.

Colony Count, Microbial↗
PubMed2007

Cooperation through moral commitment.

Actions that promote fairness are sometimes consistent with the pursuit of individual self-interest, sometimes not. The diner who leaves a generous tip at a favourite local restaurant, for example, may do so partly out of a sense of obligation to the waiter. But we need not invoke fairness to explain the tip, which is, after all, a prudent investment in obtaining good service in the future. In contrast, narrow self-interest cannot explain why travellers might leave tips in restaurants located along interstate highways. Because it is unlikely that they will ever visit these restaurants again, their failure to tip cannot affect the quality of service they expect to receive in the future. So it is hard to escape the conclusion that concerns about fairness must be implicated when diners tip on the road. Of course, merely to assert the existence of a sense of fairness does not really explain why people often set aside concern for narrow self-interest. It simply raises the more fundamental question of why people have a sense of fairness in the first place. It is this question I will discuss.

Cooperative Behavior↗
PubMed1989

"Dine to Your Heart's Content": an assessment of the program in Virginia.

The "Dine to Your Heart's Content" program in Virginia was examined from the perspectives of both patrons and restaurateurs. Both groups were tested on knowledge of food composition relative to fats and oils. Additionally, restaurateurs responded to questions concerning the need for nutrition education for their personnel. Eighty-eight percent of the 178 patrons expressed an interest in following a heart-healthy diet: 55% maintained that they always or often were motivated by health-related considerations when selecting menu items. The most important characteristics of the menu items (5-point scale, 1 = least important) were reported to be low cholesterol (3.85 +/- 1.01), low saturated fat (3.77 +/- 1.05), low total fat (3.76 +/- 1.03), low sodium (3.69 +/- 1.15), and low calorie (3.57 +/- 1.13). Fifty-seven percent of the patrons were aware of the program, but most of them dined in participating restaurants less than half of the time they dined out. There were no significant differences between the scores of patrons and restaurant personnel regarding knowledge of fat and oil content of foods. The overall mean score for the entire group was 6.09 +/- 3.4 points out of a possible 13 points. Restaurateurs cited nutrition education for waitstaff and assistance in the identification of appropriate menu items as aspects of the program most in need of further development. The major disadvantage of the program cited was potential negative attention drawn to some menu items. Overall, however, restaurateurs concurred that the advantages of participation in the program outweighed the disadvantages. All of them stated that the major advantage of the program was the ease with which a public service could be provided to their patrons while, simultaneously, the image of the restaurant was enhanced.

Adult↗
PubMedDate not supplied

Strategies and willingness of rural restaurateurs to promote healthy foods.

Nutritionists need to understand the willingness of restaurateurs to prepare and sell healthy foods, as Canadians frequently eat meals at food services. The lunch trade restaurants under the jurisdiction of a rural and semi-rural Alberta health unit were surveyed by telephone. Two thirds of the restaurants were family-style and had 100 seats or fewer. Five of 20 healthy foods were rated as difficult to serve, due to: lack of customer demand; lack of food availability; and the need to maintain the quality of fresh vegetables, fruits and milk products. Many restaurateurs are willing to change internally by training staff (88%) and by trying new recipes (84%). Staff education materials perceived to be helpful by 80% of restaurateurs included video/audio tapes, information sheets and posters. Restaurateurs were most willing to use menu inserts (76%), table tents (68%) and door decals (72%) to promote healthy foods. Nutrition services should focus on how restaurants can make changes to include healthy foods through food preparation and menu items.

Alberta↗
PubMed1977

Impact of fast food meals on nutrient intake of two groups.

Two groups in different population centers were studied to determine how often consumers frequented fast food restaurants, and consequently, how heavily they relied on this type of food for nutrients. A questionnaire was answered by 280 customers of two fast food restaurants of the same chain. They were asked how often they patronized fast food restaurants, their specific food choices, and other pertinent questions. Food choices were evaluated for energy and seven nutrients on the basis of published analyses of the menu items of the particular fast food chain. Fifty-two per cent of the subjects in the two groups considered their purchases to be meals. Seventy-seven per cent of these consumed one-third or more of the recommended dietary allowance for protein, but no more than 30 per cent received that amount of the other nutrients examined, including food energy. Calcium and particularly vitamin A were least often consumed in amounts equal to one-third of the recommended allowances. Consumer choices were responsible for low consumption of calcium, but no good sources of vitamin A were included on the menus. Fast food items were purchased so infrequently by the majority of our respondents that nutrient composition of the fast food meals or snacks would be of concern in only a small number of cases. This study indicates that any attempts to improve nutritive value of fast food snacks or meals must include efforts to lead consumers to make wiser food choices, as well as encourage the fast food industry to provide rich sources of all the nutrients in their menus.

Adolescent↗
PubMed1997

Prevention of Vibrio vulnificus infections. Assessment of regulatory educational strategies.

CONTEXT: Vibrio vulnificus-related disease caused by eating contaminated raw oysters prompted California to implement regulatory educational initiatives in 1991. OBJECTIVE: To assess California guidelines and education efforts with regard to the prevention of V. vulnificus infections in Los Angeles County and to evaluate compliance with state regulations mandating posting of warning signs concerning risks of eating raw oysters. DESIGN: Review of epidemiologic investigations of V. vulnificus infections in Los Angeles County between 1993 and 1995; telephone interviews of patients or surrogates; and a survey of restaurants serving raw oysters in Los Angeles County. SETTING: General community. MAIN OUTCOME MEASURES: Prior warning of patients and posting of warning signs in restaurants. RESULTS: Recent cases of V. vulnificus infections in Los Angeles County suggest that a unique, vulnerable group (uninsured Hispanic men with viral or alcoholic liver disease) has not been reached through education efforts. Of a total of 11 cases, information regarding being warned about the hazard of eating raw shellfish was available for 8; of these, only 1 case was reported as having been warned, but he had misunderstood the preventive message. Warning signs were not posted adequately in more than 50% of restaurants surveyed and one third of these establishments had signs in English only. Warnings were never located on dining tables and rarely included in menus. CONCLUSION: A more effective strategy is required to prevent V.vulnificus infections in Los Angeles County.

Animals↗
PubMed1985

Metabisulfite challenge in patients with idiopathic anaphylaxis.

Bronchospasm, urticaria, angioedema, and anaphylactoid reactions have been attributed to sulfiting agents. These compounds are commonly used as preservatives in some drugs and foods, often in restaurants. Oral challenges with sodium metabisulfite were performed in 12 patients with idiopathic anaphylaxis (IA). Nine of these had episodes possibly caused by sodium metabisulfite because of clear temporal relation of episodes of IA to restaurant meals. One patient who had severe urticaria with exacerbations with restaurant meals and 10 control subjects were studied. No urticarial, asthmatic, or anaphylactoid reactions occurred in our patients. Sulfiting agents did not trigger episodes of IA in these 12 patients or urticaria in the patient with severe chronic idiopathic urticaria.

Adult↗
PubMed1987

Monosodium L-glutamate-induced asthma.

Ingested chemicals, including aspirin and sulfites, are becoming increasingly recognized as provokers of acute severe asthma. In order to investigate the asthma-provoking potential of the widely used flavor enhancer, monosodium L-glutamate (MSG), we challenged 32 subjects with asthma, a number of whom gave histories of severe asthma after Chinese restaurant meals or similarly spiced meals. The subjects received an additive-free diet for 5 days before challenge and were challenged in hospital, after an overnight fast, with 500 mg capsules of MSG. They were challenged in a single-blind, placebo-controlled fashion with increasing doses of MSG from 0.5 gm to 5.0 gm. Thirteen subjects reacted. Seven subjects (group 1) developed asthma and symptoms of the Chinese restaurant syndrome 1 to 2 hours after ingestion of MSG. Six subjects (group 2) did not develop symptoms of Chinese restaurant syndrome, and their asthma developed 6 to 12 hours after ingestion of MSG. These challenge studies confirm that MSG can provoke asthma. The reaction to MSG is dose dependent and may be delayed up to 12 hours, making recognition difficult for both patient and physician.

Adolescent↗
PubMed2005

Food service workers' self-reported food preparation practices: an EHS-Net study.

This study was conducted by the Environmental Health Specialists Network (EHS-Net), a network of environmental health specialists and epidemiologists at federal and state health agencies, whose mission is to improve environmental health practice. One of EHS-Net's primary goals is to improve the understanding of the underlying causes of foodborne illness using a system-based approach. As part of this ongoing effort, EHS-Net analyzed data from a telephone survey of food service workers designed to increase our understanding of food preparation practices (a cause of foodborne illness) in restaurants. Results indicated that risky food preparation practices were commonly reported. Respondents said that at work they did not always wear gloves while touching ready-to-eat (RTE) food (60%), did not always wash their hands or change their gloves between handling raw meat and RTE food (23% and 33%), did not use a thermometer to check food temperatures (53%), and had worked while sick with vomiting or diarrhea (5%). Several factors were associated with safer food preparation practices. Workers responsible for food preparation reported washing their hands and wearing gloves when handling RTE food more often than workers not responsible for food preparation. Workers who cooked reported changing their gloves more often than workers who did not cook. Older workers and managers reported washing their hands more often than younger workers and non-managers. Workers in chain restaurants more frequently reported using thermometers than workers in independently owned restaurants. This study provides valuable information concerning the prevalence of food preparation practices and factors that may impact those practices. Additional research is needed to better understand those factors.

Adult↗
PubMed2005

Biodegradable municipal solid waste: characterization and potential use as animal feedstuffs.

Five different fractions of the biodegradable municipal solid waste (BMSW) were evaluated as potential animal feedstuffs. For each source of waste (meat waste (MW), fish waste (FW), fruit and vegetables waste (FVW), restaurant waste (RW), household waste (HW)), samples were obtained from small shops (butchers, fishmongers, fruit and vegetable shops), restaurants and a MSW treatment plant (household waste). The chemical composition, microbiological characterization, dioxins, furans, PCB's and mineral content were determined for every type of waste fraction. The analysed biodegradable waste presented high moisture content (from 60% to 90%). Some fractions were dense in one nutrient: meat waste in ether extract, fish waste in crude protein, fruit and vegetable waste in nitrogen free extract. The other studied fractions (restaurant fraction and household fraction) presented a more balanced composition, but the presence of toxic concentrations of contaminants such as metals was higher than European legislation permitted values in animal feeding. From a microbiological standpoint, a heat treatment at 65 degrees C for 20 min was sufficient to ensure microbiological quality of the samples. This treatment was also advisable to reduce the moisture content: a lower moisture content facilitates the waste handling and processing and, therefore, the inclusion of these waste fractions in commercial animal diets. This paper presents a potential alternative for the recovery of organic matter content in municipal solid waste. The results obtained in this research and the feedstuffs legislation in force related to animal feed, indicated that some of the studied biodegradable waste fractions (meat waste, fruit and vegetable waste and fish waste) could be considered as alternatives to typical raw materials used in animal feeds.

Animal Feed↗
PubMed1989

Diphtheria in Stockholm, with a theory concerning transmission.

Since 1984, diphtheria has been diagnosed in Sweden, mainly among men abusing alcohol. During the first half of 1986, eight cases of diphtheria were discovered in the city of Stockholm. The first three were among men abusing alcohol. The following five cases had no connection with them. These five persons were employed in two companies housed in the same building. The only connection between them was that they ate their lunch at the same restaurant. One alcohol-abusing man had worked temporarily in the kitchen of this restaurant during the week before the five cases of diphtheria arose. He knew one of the first three patients well. A throat swab taken from him a month after the five cases had been diagnosed was negative. It was suspected however, that this man might have been a carrier of Corynebacterium diphtheriae during the week that he worked in the kitchen. Tests for C. diphtheriae antitoxin revealed that the kitchen staff had high antitoxin titres although they lacked a history of basic immunisation. Even so, C. diphtheriae could not be isolated from their throats and it has not been possible to establish the mode of transmission. The most reasonable theory of transmission is that the organism was introduced into the kitchen by the man employed there temporarily and that it was spread by food served in the restaurant. This theory has not been proved but is discussed in order to facilitate future investigations of a similar outbreak.

Adult↗
PubMed2003

[Surveillance and testing of domestic installations according to the new drinking water regulations].

Effective 1.1.2003 the new drinking water regulation (TrinkwV2001) was enacted. For public health authorities new tasks result, for example the monitoring of house installations with supply of drinking water for the public, in particular in hospitals, old person nursing homes, kindergartens, schools, hotels, restaurants etc. Public health authorities are obligated to establish a monitor programme on the basis of suitable controls by random sampling. The investigations of drinking water are to extend to at least the parameters, which can change in the house installation unfavourably. In view of the multiplicity of the plants which can be supervised the question arises, how far public health authorities can conscientiously fulfil their monitoring obligation. The Ministry of Health MFAS of Lower Saxony initiated country-wide a working group developed for a pattern administrative regulation, which, revised by the "Länderarbeitsgemeinschaft Umweltbezogener Gesundheitsschutz" LAUG, has been published in some Lands of the German Federal Republic with changes. The pattern administrative regulation plans to examine hospitals and old person nursing homes at least 1 x annually, schools and kindergartens every 5 years, other communal facilities, sport and leisure facilities, hotels and restaurants after a risk evaluation by random sampling at least however one plant per 10,000 inhabitants. Restaurants in stations, ports and airports are to be controlled at least once annually. The drinking water investigation is to extend to micro-biological parameters, like E. coli, coliform germs, germs tested at 22 degrees C and 36 degrees C as well as the chemical parameters copper and lead. The investigation on Legionella pneumophila in the warm-water system can be arranged in individual cases. In this article the considerations for these defaults are described, and pointers to a practicable risk assessment are given.

Environmental Monitoring↗
PubMed2005

Young people driving after drinking and riding with drinking drivers: drinking locations--what do they tell us?

OBJECTIVE: The present study investigated the extent to which drinking in specific locations and heavy drinking mediated the effects of overall alcohol use on driving after drinking (DD) and riding with drinking drivers (RWDD) among young people. Additionally, this study examined the relationships among ethnicity, gender, drinking in specific locations, and DD and RWDD. METHOD: Using random-digit dialing procedures, participants were recruited to take part in a telephone survey in California, United States of America. Participants were 1,534 youth, ages 15-20 years (mean age = 17.6). Latinos, African Americans, and Asian Americans were over-sampled to allow cross-group comparisons. Along with background characteristics, overall alcohol use, heavy drinking, drinking in specific locations, DD, and RWDD were measured. RESULTS: Latent variable structural equation modeling showed that European Americans, males, older adolescents, those who have a driver license, and those who drive more often were more likely to report drinking alcohol in the past year. Heavy episodic drinking and drinking in cars increased both DD and RWDD. Drinking in restaurants also increased DD. The effects of overall alcohol consumption on DD were entirely mediated through heavy episodic drinking and drinking in restaurants and cars. Alcohol consumption had both direct and indirect effects on RWDD. With the exception of being Latino and frequency of driving, the effects of the background variables on RWDD were all entirely mediated through alcohol consumption. CONCLUSIONS: Heavy drinking and drinking in specific locations appeared to be important unique predictors of both DD and RWDD. In light of the relationship between drinking in restaurants and in cars, and DD, prevention programs and policies aimed at underage drinking should focus on developing more effective responsible beverage service programs, increasing compliance with laws limiting alcohol sales to youth, and enforcing graduated driver licensing and zero tolerance laws.

Adolescent↗
PubMed2004

Risk factors for sporadic Campylobacter infection in the United States: A case-control study in FoodNet sites.

Campylobacter is a common cause of gastroenteritis in the United States. We conducted a population-based case-control study to determine risk factors for sporadic Campylobacter infection. During a 12-month study, we enrolled 1316 patients with culture-confirmed Campylobacter infections from 7 states, collecting demographic, clinical, and exposure data using a standardized questionnaire. We interviewed 1 matched control subject for each case patient. Thirteen percent of patients had traveled abroad. In multivariate analysis of persons who had not traveled, the largest population attributable fraction (PAF) of 24% was related to consumption of chicken prepared at a restaurant. The PAF for consumption of nonpoultry meat that was prepared at a restaurant was also large (21%); smaller proportions of illness were associated with other food and nonfood exposures. Efforts to reduce contamination of poultry with Campylobacter should benefit public health. Restaurants should improve food-handling practices, ensure adequate cooking of meat and poultry, and consider purchasing poultry that has been treated to reduce Campylobacter contamination.

Adolescent↗