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PubMed2004

The hazard analysis and critical control point system in food safety.

The Hazard Analysis and Critical Control Point (HACCP) system is a preventive method of ensuring food safety. Its objectives are the identification of consumer safety hazards that can occur in the production line and the establishment of a control process to guarantee a safer product for the consumer; it is based on the identification of potential hazards to food safety and on measures aimed at preventing these hazards. HACCP is the system of choice in the management of food safety. The principles of HACCP are applicable to all phases of food production, including basic husbandry practices, food preparation and handling, food processing, food service, distribution systems, and consumer handling and use. The HACCP system is involved in every aspect of food safety production (according to the UN Food and Agriculture Organization [FAO] and the International Commission on Microbiological Specifications for Foods [ICMSF]). The most basic concept underlying the HACCP system is that of prevention rather than inspection. The control of processes and conditions comprises the critical control point (CCP) element. HACCP is simply a methodical, flexible, and systematic application of the appropriate science and technology for planning, controlling, and documenting the safe production of foods. The successful application of HACCP requires the full commitment and involvement of management and the workforce, using a multidisciplinary approach that should include, as appropriate, expertise in agronomy, veterinary health, microbiology, public health, food technology, environmental health, chemistry, engineering, and so on according to the particular situation. Application of the HACCP system is compatible with the implementation of total quality management (TQM) systems such as the ISO 9000 series.

Centers for Disease Control and Prevention, U.S.↗
PubMedDate not supplied

Ethnographic study on childhood diarrhoeal diseases in a rural Nigerian community.

Mothers in thirty households in a rural Nigerian community were subjected to ethnographic studies on food handling practices as they relate to diarrhoeal diseases in children. The study had a first phase of three open-ended unstructured interviews each lasting about 2 hours and a second phase of direct observations on food handling practices during preparation, administration and storage by mothers. Results indicated that as many as 20 (66.7%) of the mothers identified diarrhoea as a common cause of childhood diseases. Diarrhoea due to food contamination was recognized by as many as 18 (60.0%) respondents. Four important food handling practices relating to water treatment, handwashing before preparation and feeding, administration and storage were recognized in the first phase but the claimed practices in the first phase differed significantly from the observed practices in the second phase (p < 0.025). Many (32.1%) mothers had contaminating food handling behaviours. The low literacy level, poverty and lack of good personal hygiene among the studies population were the most likely causes of the behaviours observed.

Anthropology, Cultural↗
PubMed1996

Recent developments in hygiene behaviour research: an emphasis on methods and meaning.

This paper discusses some of the recent developments in hygiene behaviour research, focusing on operational research. A series of "rapid' assessments of hygiene behaviour were carried out in Kenya, Tanzania and Ethiopia with a view to preparing a field handbook entitled Hygiene Evaluation Procedures (HEP). The HEP handbook is intended primarily for field personnel in water supply, sanitation and health/hygiene education projects who want to design and conduct their own systematic assessments of hygiene behaviour in their localities. The short studies provided useful practical insights into the concerns and needs of project staff for whom research allowances (human, material and time resources) are often very limited. In this paper emphasis is placed on both methodological and heuristic developments as the two are inseparable. It is suggested that in the domestic sphere, hygiene behaviour with respect to the disposal of children's faeces and domestic water use are two of the key areas that remain of universal relevance to water/sanitation related interventions. These can be assessed rapidly and effectively by using two indicators: means of disposal of children's faeces and handwashing at 'critical' times--after defaecation, after handling and/or disposing of children's faeces, before handling food and before feeding young children and eating. Appropriate combinations of anthropological methods and participatory tools for measuring these indicators are described. The practical relevance of the resulting data for project design and implementation is highlighted.

Adult↗
PubMed2004

Salmonellosis in persons infected with human immunodeficiency virus: a report of seven cases from Malaysia.

Persons infected with human immunodeficiency virus (HIV) have an increased risk of salmonellosis when compared to the general population. We describe seven such patients with Salmonella bacteremia, of whom two had recurrent salmonellosis. In the latter two cases the infection was unusually severe, characterized by widespread infection, bacteremia and relapse, despite standard antimicrobial therapy. HIV-infected individuals will benefit from education on the source of Salmonella, mode of acquisition and prevention through safe food handling and food preparation practices. Because of the difficulty of eradicating Salmonella infection in patients with acquired immunodeficiency syndrome, long-term suppressive treatment with antimicrobials is warranted.

AIDS-Related Opportunistic Infections↗
PubMed1996

[Infantile diarrhea: knowledge and attitudes of mothers at a primary care center].

OBJECTIVE: To study the knowledge and attitudes of mothers at a health centre to babies' diarrhoea. DESIGN: A crossover, observational and prospective study. SETTING: Paediatrics clinic at a health centre in the city of Valencia. PARTICIPANTS: 142 mothers who attended the clinic of their own accord. MEASUREMENTS AND MAIN RESULTS: The mothers themselves filled out a questionnaire on what diarrhoea was, its causes, hygiene measures to prevent it and their response when it appeared. 80.3% accurately defined diarrhoea. 94.4% recognised that micro-organisms were the cause. All mothers of unweaned babies not being breast-fed sterilised the feeding bottle adequately and had a proper water-supply. 89.4% said they washed correctly both hands and food before handling food. Although 89.4% knew they should give more liquid to their babies during diarrhoea, only 24.6% used an adequate oral rehydrating solution and 24.2% said they made their babies fast for long periods. Most said they would consult the doctor if their baby had diarrhoea (79.6%) and would go back to the doctor if they noticed complications (96.5%). CONCLUSIONS: Mothers attending a health centre in Valencia had a good attitude to diarrhoea prevention. They often committed errors in oral rehydration and feeding of a baby with diarrhoea, which might cause problems. However their frequent attendance at the doctor's may help avoid these problems.

Adult↗
PubMedDate not supplied

Consumer concerns: motivating to action.

Microbiologic safety is consumers' most frequently volunteered food safety concern. An increase in the level of concern in recent years suggests that consumers are more receptive to educational information. However, changing lifestyles have lessened the awareness of foodborne illness, especially among younger consumers. Failure to fully recognize the symptoms or sources of foodborne disease prevents consumers from taking corrective action. Consumer education messages should include the ubiquity of microorganisms, a comprehensive description of foodborne illnesses, and prevention strategies. Product labels should contain food-handling information and warnings for special populations, and foods processed by newer safety-enhancing technologies should be more widely available. Knowledge of the consequences of unsafe practices can enhance motivation and adherence to safety guidelines. When consumers mishandle food during preparation, the health community, food industry, regulators, and the media are ultimately responsible. Whether inappropriate temperature control, poor hygiene, or another factor, the error occurs because consumers have not been informed about how to handle food and protect themselves. The food safety message has not been delivered effectively.

Communication↗
PubMed1999

A National Australian Food Safety Telephone Survey.

A sample of 1,203 randomly selected Australian households participated in a national telephone food safety survey. All respondents were aged 18 years or over, were the main grocery buyers of the household, purchased red meat products at least once a month, and regularly prepared food in the household. There were significant gaps observed in the food safety knowledge of many respondents surveyed. Forty percent of respondents thawed raw meat at room temperature, 85% allowed cooked foods to cool at room temperature before refrigerating, and almost 70% of respondents were not aware of the correct refrigeration temperature for storage of perishable food. Almost 25% of respondents failed to identify that washing hands before handling food and during food preparation was important in reducing the risk of cross-contamination and possible foodborne illness. Seventy-five percent of the respondents recognized that there was a likelihood of foodborne illness occurring in the home, and 25% of respondents had changed their eating habits because of publicity surrounding food poisoning outbreaks. The findings raise important concerns about domestic food handling practices in Australian homes and the level of food safety knowledge in the community generally.

Adolescent↗
PubMed2006

Food safety perceptions and behaviors of Kentucky consumers.

In several areas, Kentuckians practice more risky health behaviors than most of the rest of the nation. The Health Belief Model states that individuals with lower perceived risks practice less healthy behaviors. This study sought to determine if this was true for food safety by assessing food safety perceptions and behaviors of Kentucky consumers. Data were collected through a telephone questionnaire based on a survey by the U.S. Food and Drug Administration; 728 respondents participated. Food safety perceptions were analyzed by examining participants' responses to confidence in the safety of the food supply, perception of likelihood of people becoming sick because of foodborne illness, and perception of where food safety problems are most likely to occur. Significant differences were found in food safety perceptions for age, gender, household income, education, and employment in the food industry. Analysis of food safety behaviors revealed differences in food handling behaviors for gender, education level, household income, race, and households with a member aged 65 years or older. Significant relationships were found between respondents' food safety perceptions and behaviors. In general, Kentucky consumers who perceived higher risks exhibited safer food handling behaviors. Strategies to increase the understanding of real and perceived food safety risks in the home combined with strategies that target specific demographic groups may be the most effective approach to improve food handling practices. A better understanding of consumers' food safety risk perceptions and behaviors could lead to more effective food safety education materials and messages.

Adolescent↗
PubMed2002

Risk factors for salmonella food poisoning in the domestic kitchen--a case control study.

Domestic kitchen food handling risk factors for sporadic salmonella food poisoning are largely unknown. We compared food consumption and food handling practices, opportunities for cross contamination and refrigerator temperature control, in 99 households in South East Wales in 1997/8 with a case of salmonella food poisoning, and control households matched for electoral ward. On univariate analyses, cases were significantly more likely than control respondents to have purchased free-range eggs in the preceding week, and more likely than control households to have handled frozen whole chicken in the previous week, and to handle raw chicken portions at least weekly. In multivariate analysis, only consumption of raw eggs and handling free-range eggs were significant risk factors, independent of the age structure of the family and of the season.

Adolescent↗
PubMedDate not supplied

Food safety knowledge, perceptions, and behaviors among middle school students.

OBJECTIVE: To assess the level of food safety knowledge, perceptions, and self-reported food-handling behaviors among middle school students. DESIGN: Baseline questionnaire administered in class that assessed background characteristics, knowledge, behaviors, and perceptions related to food safety. PARTICIPANTS: 178 seventh and eighth grade students from 4 schools in central Pennsylvania. MAIN OUTCOME MEASURES: Food safety knowledge, perceptions, and self-reported food-handling behaviors. ANALYSIS: Independent samples t test tested differences between genders and bivariate correlation analysis explored associations among knowledge, perceptions, and behavior (P <.05). RESULTS: Food safety knowledge score was 7.2 +/- 1.6 of a maximum of 10 points. Perceived self-efficacy and severity of a foodborne illness were high, but perceived susceptibility was low. Girls scored higher on the self-efficacy and severity scale (P <.01). Self-efficacy correlated positively with knowledge and behavior (P <.0001) and severity with knowledge (P <.01). One fifth reported taking risks in food handling and one fifth reported having been sick because of something they ate. CONCLUSIONS AND IMPLICATIONS: There is a disconnection between middle school students' food safety knowledge, perceptions, and behaviors. A need for relevant and motivating food safety education exists in this group.

Adolescent↗
PubMed1997

Food safety training needs exist for staff and consumers in a variety of community-based homes for people with developmental disabilities.

OBJECTIVE: To determine staff and consumer-focused food safety training needs in community-based homes for people with developmental disabilities as well as dietitians' perceptions of food-handling practices in these homes. DESIGN: Direct-care staff and dietitians were surveyed according to a modified Dillman method using a mailed, self-administered questionnaire. Main outcome measures included food-handling knowledge, attitudes, and practices of staff and consumers as reported by staff and dietitians; critical control points in safe food preparation in the homes based on the Hazard Analysis and Critical Control Point system; and learning preferences of staff and consumers. SUBJECTS: A 10% probability sample of direct-care staff in homes for people with developmental disabilities in western Massachusetts and a nonprobability sample of dietitians who work with this population were surveyed. Results are reported from 132 and 18 respondents, respectively. STATISTICAL ANALYSES PERFORMED: Descriptive statistics, chi 2 statistic, and the Fisher's exact test. RESULTS: Staff knowledge of safe food preparation is lacking in several areas, including storage and handling procedures. Although staff and consumers do not always follow safe food-handling practices, the staff reported that they follow recommended food-handling practices more often than the dietitians reported they do. Most staff and dietitians reported that staff and consumers had never attended a food safety training program, but that all of the critical control points surveyed would be somewhat helpful if they were included in a food safety workshop. APPLICATIONS: A food safety training program would be beneficial for staff and consumers. Programs should be geared to staff and include ideas and materials for consumers. Consumer modules could then be adapted to individual learning levels by direct-care staff in the homes. The Safe Food at Home workshop was developed on the basis of the results of this study and incorporates the approaches described in this article.

Adult↗
PubMedDate not supplied

Safety of vendor-prepared foods: evaluation of 10 processing mobile food vendors in Manhattan.

OBJECTIVES: Unsanitary food handling is a major public health hazard. There are over 4,100 mobile food vendors operating in New York City, and of these, approximately forty percent are processing vendors--mobile food units on which potentially hazardous food products are handled, prepared, or processed. This pilot study assesses the food handling practices of 10 processing mobile food vendors operating in a 38-block area of midtown Manhattan (New York City) from 43rd Street to 62nd Street between Madison and Sixth Avenues, and compares them to regulations stipulated in the New York City Health Code. METHODS: Ten processing mobile food vendors located in midtown Manhattan were observed for a period of 20 minutes each. Unsanitary food handling practices, food storage at potentially unsafe temperatures, and food contamination with uncooked meat or poultry were recorded. RESULTS: Over half of all vendors (67%) were found to contact served foods with bare hands. Four vendors were observed vending with visibly dirty hands or gloves and no vendor once washed his or her hands or changed gloves in the 20-minute observation period. Seven vendors had previously cooked meat products stored at unsafe temperatures on non-heating or non-cooking portions of the vendor cart for the duration of the observation. Four vendors were observed to contaminate served foods with uncooked meat or poultry. CONCLUSIONS: Each of these actions violates the New York City Code of Health and potentially jeopardizes the safety of these vendor-prepared foods. More stringent adherence to food safety regulations should be promoted by the New York City Department of Health.

Commerce↗
PubMed1999

A nursing home outbreak of Clostridium perfringens associated with pureed food.

OBJECTIVE: To investigate and ascertain the source of a nursing home outbreak of gastroenteritis in Melbourne in 1997. METHOD: A retrospective cohort study. We obtained fecal and food samples and environmental swabs, and reviewed food handling. RESULTS: There were 25 cases, and 21 of these had their meals pureed (liquidised). The relative risk for eating pureed food and becoming ill was 5.8 (95% CI 2.2-15.4). Clostridium perfringens and its enterotoxin was detected in nine fecal samples. Samples of pureed food tested positive for coliforms. CONCLUSIONS: This outbreak was caused by C. perfringens contaminating pureed food. Food liquidising provides opportunities for re-contamination of cooked food through the use of contaminated equipment and deficiencies in food handling practices. Pureed foods should be reheated to 70 degrees C after liquidising to inactivate pathogens. IMPLICATIONS: Health care facilities need to take specific precautions to manage the special hazards involved in preparing pureed food.

Aged↗
PubMed2005

Relationship between consumer food safety knowledge and reported behavior among students from health sciences in one region of Spain.

A survey was conducted to investigate the relationship between knowledge about food safety and actual food handling practices among Spanish university students (mainly from the health sciences disciplines) who usually prepare meals at home. Based on level of education in food safety topics, students were divided in three groups: high, which included students from Food Science and Nutrition; medium, which included students from other health sciences; and low, which included students from non-health-related studies. More than two thirds of the 562 people selected had an accurate knowledge of the eight foodborne pathogens included in the survey, but only 5.2% were able to identify Staphylococcus aureus as a foodborne pathogen. Significant differences in responses were found depending on educational level concerning the food safety topic. For food handling, up to 60% of the responses reflected accurate knowledge of proper storage of prepared meals and washing of hands and materials to avoid cross-contamination. However, with the exception of questions related to storage temperature, there was considerable difference between knowledge and reported behavior. Although 98.6% of the participants recognized the importance of hand washing before and during food preparation, only one quarter (24.4%) affirmed that they washed their hands with soap and water. On questions concerning food practices, more accurate answers were given by the older students. Women answered questions regarding cross-contamination more accurately, whereas men were more accurate in response to questions concerning temperature and food preservation. In general, students with more knowledge of food hygiene had better reported practices, but even these students reported some high-risk behaviors. These results confirm the need to improve educational programs, ensuring that the acquired knowledge actually modifies consumer behavior.

Adult↗
PubMed2004

A survey of food hygiene knowledge and attitudes among Chinese food handlers in Fong Song Tong district.

The purpose of this study was to find out the knowledge and attitudes concerning food hygiene among Chinese food handlers in Fong Song Tong district, and to analyze the impact of variables on the degree of knowledge and attitudes. Face-to-face interviews were conducted within Chinese food handlers in Fong Song Tong district using a self-designed questionnaire, which contained food hygiene knowledge and attitudes. Main knowledge outcome measures included food handling, personal hygiene and legislation issues. Questionnaires were completed by 580 (72.0%) Chinese food handlers from 91% premises of the district. 71.2% Chinese food handlers could respond correctly to eight or more out of 11 knowledge questions and 1.4% respondents only achieved full scores of knowledge. Fully correct response of personal hygiene knowledge was statistically and significantly higher than food handling knowledge (p<0.05). 79.0% of respondents showed their need of more food hygiene education. Male respondents, age less than 30, secondary education or above, five years or more of working experience, or who had previously attended a health training within the last two years, generally performed better on the knowledge of food hygiene. Chinese food handlers working in the kitchen and owners' beliefs on 'cleaning the kitchen before getting off duty' was reasonable. Those with secondary education at least, or who had prior participation in a health training within the last two years would need more food hygiene knowledge than the people aged over 30 or who were the owners. It would be more motivated by changing the traditional training model, community-based education in an optimum situation, additional authoritative information, attitudes and intentions of learning on food hygiene.

Adult↗
PubMed2005

What does the food handler in the home know about salmonellosis and food safety?

Food-borne illness causes a significant burden of disease globally. The majority of confirmed cases of food-borne illness in Malta are caused by salmonellosis. Detailed case investigations by the Disease Surveillance Unit, Malta, revealed that most of the notified cases of infectious intestinal disease are most likely to be due to poor food safety practices in the home. Consumer awareness studies have shown that, in general, consumers are aware of the recommended food safety precautions, yet still adopt high-risk behaviours. Three focus groups and a small case control group were formed to gather information on local consumer knowledge and attitudes towards safe food handling in the home. The responses from the three focus groups were analysed and grouped into general themes. The information obtained from these results was then used to plan a local food safety health promotion strategy. The results show that individuals who had been exposed to salmonellosis, or who had a dependant who had been exposed, had developed a higher level of food safety knowledge and awareness. Variations between knowledge and self-reported practices make it apparent that persons have to be convinced that food safety measures are effective before they take action to change their behaviour. In conclusion, consumer education strategies need to emphasise the burden of illness, making safe food handling meaningful to consumers. Continuous reinforcement of the messages may be effective in empowering the consumer to foster behaviour change.

Case-Control Studies↗