Knowledge,attitudes and practices of food handlers on food safety in food service operations at the Universiti Kebangsaan Malaysia

This study was conducted to determine the level of knowledge, attitudes and practices of food handlers in food service operation at the main campus of Universiti Kebangsaan Malaysia (UKM) regarding food safety. Data were collected from 112 food handlers through questionnaires which consisted of questions about knowledge, attitudes and practices. The results showed that there was significantly positive correlation among the three levels and respondents possess good scores for knowledge (19.68 ± 3.87) about personal hygiene, foodborne diseases and temperature control of food; for attitudes (89.26 ± 8.66) on safe food handling, and for practices (90.02 ± 8.23), specifically for appropriate hand washing, use of gloves in food preparation and prevention of food hazards. About 73.2% of respondents never attend any training related to food safety and majority show poor knowledge of pathogens associated with disease-causing agents as well as critical temperatures for storage of ready-to-eat foods. Therefore, effective and ongoing training on food safety and hygiene must be given to all food service employees to ensure the safety of food provided.     

Food safety knowledge and training participation are associated with lower stress and anxiety levels of Brazilian food handlers

The objectives of this study were: 1) identify the state anxiety, trait anxiety levels and perceived stress levels of food handlers and; 2) Verify the association of these scores with food safety variables like: food safety knowledge, attitudes, practices and with job characteristics. This study involved 183 randomly selected food handlers from different food businesses in Santos city, Brazil, as follows: street food kiosks, beach kiosks, restaurants, hospitals and school meal services. To evaluate knowledge, attitudes and self-reported practices, a structured questionnaire was used. Observed practices were evaluated using a checklist. The State Trait Anxiety Inventory – STAI was applied to assess the levels of state and trait anxiety with a score range from 10 to 80. To evaluate stress the Perceived Stress Questionnaire – PSQ was used with a score range from zero to one. Food handlers presented 39.22; 10.1 (mean; standard deviation) of state anxiety score, 39.58; 9.6 of trait anxiety score and a perceived stress score of 0.36; 0.09. Observed practices presented a weak negative correlation with state anxiety (r = −0.26; p = 0.014) but not with trait anxiety (r = −0.18; p = 0.09) and stress (r = 0.03; p = 0.78). Using generalized linear models were observed that a higher stress level, trait anxiety and state anxiety were found in food handlers who do not participated in food safety training and with lower knowledge scores of food safety. These findings show that training can not only improve knowledge but possibly empower food handlers, increase their self-efficacy and reduce anxiety and stress levels.     

The role of theoretical food safety training on Brazilian food handlers' knowledge,attitude and practice

The objectives of this study were 1. to identify the relationship of theoretical training with knowledge, attitudes, self-reported practices and observed practices and 2. to identify variables that influence observed practices. This study was cross-sectional and involved 183 randomly selected food handlers from different food businesses in Santos City, Brazil, as follows: street food kiosks, beach kiosks, restaurants, hospitals and school meal services. To evaluate knowledge, attitudes and self-reported practices, a structured questionnaire was used. Observed practices were evaluated using a checklist. A researcher observed and followed each food handler throughout the process of food handling/preparation during a workday. The majority of participants (68.3%) had participated in at least one food safety training session. The average percentage of correct answers on the knowledge questionnaire was 64%. Food handlers who had undergone training presented higher knowledge scores but did not differ from those who had not regarding attitudes, self-reported practices and observed practices. A regression model was used to study the variables associated with observed practices (p < 0.001). The variables related to observed practices were the knowledge score (β = 0.27, p < 0.01), experience (in years as a food handler) (β = 0.19, p = 0.01), the relationship between the number of meals and the number of food handlers (β = −0.19, p = 0.01), buildings and facilities adequacy (β = 0.20, p = 0.01) and the presence of a nutritionist (β = 0.42, p < 0.001). This study showed that training based on theoretical aspects is not related to the attitudes, self-reported practices and observed practices of Brazilian food handlers from different food services. However, training seems to be an effective tool for improving knowledge. The current wording of Brazilian legislation motivates food handlers to undergo training only for certification. Food safety laws should not only require certification but also enable the establishment of policies to monitor and ensure the adequacy of food services.     

The evaluation of food hygiene knowledge,attitudes, and practices of food handlers’ in food businesses in Turkey

The purpose of this study was to evaluate knowledge, attitudes, and practices concerning food safety issues among food handlers in Turkey, conducting face to face interview and administrating questionnaire. Of the 764 food handlers who responded, 9.6% were involved in touching or distributing unwrapped foods routinely and use protective gloves during their working activity. A majority of participants (47.8%) had not taken a basic food safety training. The mean food safety knowledge scores was 43.4 ± 16.3. The study demonstrated that food handlers in Turkish food businesses often have lack of knowledge regarding the basic food hygiene (critical temperatures of hot or cold ready-to-eat foods, acceptable refrigerator temperature ranges, and cross-contamination etc.). There is a immediate need for education and increasing awareness among food handlers regarding safe food handling practices.     

Evaluating levels of knowledge on food safety among food handlers from restaurants and various catering businesses in Vienna,Austria 2011/2012

The aim of this study was to detect the most important gaps in knowledge on food safety among food handlers in Vienna, Austria and to identify possible differences in levels of knowledge between food handlers from restaurants and catering companies. The survey was conducted from May 2011 to January 2012 in Vienna and 234 food handlers participated. The average knowledge score for all food handlers was 76%. We revealed no significant difference between the two sample groups; food handlers from catering businesses scored similar (75%) to those from restaurants (76%). Persons with a training at their current workplace (internal and external) scored significantly higher (82%) then persons without an on the job training (71%). Food handlers passing the mandatorily required yearly food safety training had a higher knowledge than persons without this on-the-job training (p ≤ 0.001); 23% of the food handlers didn't participate in any training during the last year. The study identified substantial knowledge gaps concerning correct temperatures for cooking, holding and storing foods. Data from this project underline the value of harmonized action in the field of food safety, but also indicate considerable potential for further improvement in Austria.     

Knowledge,attitude and practices of food safety amongst food handlers in the coastal resort of Guangdong,China

In order to identify risk factors contributing to foodborne disease outbreaks in Guangdong province, China, the present study evaluated the knowledge, attitude, and practices (KAP) of food safety among food handlers in a coastal resort area that has a high incidence of foodborne disease outbreaks from Vibrio parahaemolyticus. The KAP of 171 food handlers from 22 food establishments—including seven food establishments in which outbreaks had occurred and 15 in which outbreaks had not occurred—were evaluated.A self-administered questionnaire designed to access the KAP of food safety was completed by the food handlers. The majority of respondents didn't know the maximum stored time at room temperature and the most common agent of foodborne disease in seafood. Most of the respondents' attitudes about food safety and training were positive. When asked about the practices undertaken, about one-fifth of the respondents admitted they had mixed food (raw and cooked) containers in varying degrees. There was significant variance among different food establishments, different ages, and different times of training. Training programs may achieve good results, but training should be more selective, educate the trainees to realize food safety is more important than fresh seafood, target how to cook seafood and lower the risk of microbiology in food, and conduct particularly focused training among managers and newcomers.     

Hand hygiene knowledge,attitudes and practices among food handlers at primary schools in Hulu Langat district,Selangor (Malaysia)

The purpose of this study was to investigate the hand hygiene knowledge, attitudes and practices of food handlers from 38 primary schools in Hulu Langat district, Selangor State in Malaysia. Hand hygiene knowledge, principally regarding ready-to-eat foods, the existence of bacteria and correct hand-washing methods were lacking among the food handlers. From the observations reported herein, the use of masks and hand-washing with proper technique were neglected by most food handlers. In the demographic profile analysed, there were significant differences (p ≤ 0.05) in the following areas: hand-washing practices between genders (p = 0.039), hand hygiene attitudes and glove use between nationalities (p = 0.002 and p = 0.029, respectively); and personal hygiene knowledge between groups with different levels of education (p = 0.048). This study revealed a slightly positive relationship between hand hygiene knowledge and self-reported practices of food handlers (r = 0.249, p = 0.022). The results showed that further continuous effort should be invested in hand hygiene education and enforcement for food handlers from primary schools in the Hulu Langat district. This study provided data about the current knowledge, attitudes and practices of food handlers from institutional foodservice operations in Malaysia regarding hand hygiene.     

Food safety and handling knowledge and practices of Lebanese university students

The aim of this study was to assess the level of food safety handling knowledge and practices among 1172 Lebanese university students (mean age 20.0 ± 1.6 SD) and to explore the association between their knowledge/practices and the socio-demographic and academic characteristics. Participants were undergraduate students enrolled in the Lebanese American University from different majors and years of study, from different areas of residence, living alone or with others, and having working or non-working mothers. They completed a questionnaire of 16 food handling practices and 14 food safety knowledge questions related to preparation, cross-contamination, storage and hygiene. On average, the students scored 53.6 ± 15.8% and 44.7 ± 14.3% on the knowledge and practices parts, respectively. Female students scored higher on both practices and knowledge questions than male students; however, the difference was significant (p < 0.001) for the practices part only. Health-related majors scored significantly (p ≤ 0.001) better on both practices and knowledge questions. Senior students scored highest on the knowledge questions, followed by juniors, sophomores and finally freshmen and the difference was borderline significant (p = 0.07). The area of residence had a significant (p = 0.006) effect on the food safety practices questions. Students living with parents scored higher in both knowledge and practices parts than those living alone or with roommates; howkver, the difference was significant (p = 0.009) in the knowledge part only. Students who cook all the time showed a significant (p = 0.001) lower difference in terms of their food safety knowledge compared to those who cook less frequently. Food handling practices and food safety knowledge scores were significantly (p < 0.001) related with a weak to moderate correlation coefficient (R = 0.231). Our results confirm the need for ongoing educational initiatives to improve the relatively low food awareness among the Lebanese young adults group.     

Food handlers’ knowledge on food hygiene: The case of a catering company in Portugal

The aim of this study was to assess the food hygiene knowledge of professional food handlers from an institutional catering company which manufactures and distributes meals to the canteens of schools, kindergartens and nursing homes in Portugal. A total of 101 food handlers from 18 geographically distributed business units were assessed. Data collection employed a previously used, multiple-choice questionnaire, aimed at exploring the food safety knowledge and practices of individual respondents. The average score of questions answered correctly was 13 out of 23 (56.5%) with a standard deviation (SD) of 3.22. However, the percentage of correct answers varies with the issues questioned, being significantly lower on issues such as temperature control (p < 0.001) and sources of contamination/high-risk foods (p < 0.001). The level of knowledge was influenced by the level of formal education (p = 0.025) of respondents. The results reinforce the importance of conducting a preliminary assessment of training needs and evaluating the effectiveness of training.     

Food safety knowledge and practices of food handlers,head chefs and managers in hotels' restaurants of Salvador,Brazil

This study aimed to assess the knowledge level, attitudes and practices of food handlers, and knowledge and practices of head chefs and managers in hotels' restaurants of Salvador, Brazil. Data collection was done through the application of interviews with 265 food handlers and with 32 head chefs and managers. In addition, the influence of the presence of nutritionist in restaurants was evaluated. The results showed that 88.0%, 96.6% and 76.0% of handlers had knowledge, attitudes and practices appropriate for personal hygiene, respectively. However, some errors were observed such as the non-use of disposable gloves when handling or distributing food (39.6%), tasting food with their hands (28.7%), and usually talking while handling food (52.5%). Statistical analysis did not indicate a significant association between the knowledge, attitudes and self-reported practices by handlers. However, it was found association between handlers that presented good satisfaction with the job and handlers that introduced appropriate practices. Regarding to chefs and managers, the results indicate that the knowledge was unsatisfactory, even 75% of respondents have training certificate in food safety. A significant percentage of respondents were unaware of the legislation adopted in restaurants (37.5%), and only 43.8% of them knew the recommended cooling temperature for food preservation. However, adequate practices to reduce cross-contamination was observed. Still, the presence of the nutritionist in restaurants influenced positively on the adoption of the current legislation in hotels' restaurants, as well as in the participation of the handlers in training, showing in this way the creation of a positive culture among the handlers.     

Educational needs assessment and practices of grocery store food handlers through survey and observational data collection

Grocery store associates in deli/bakery departments prepare and serve an increasing number of ready-to-eat (RTE) foods and full meals. The shift to more convenience foods and take-home meals highlights the need for effective food safety training programs in retail grocery establishments to prevent foodborne illness. Through qualitative and quantitative methods, food safety knowledge, training preferences, needs, and current practices of grocery stores deli/bakery food handlers in Southwest and Southern Virginia were explored. Deli employees (n = 78) completed a 34 question survey eliciting information on demographics, food safety training needs, preferences and knowledge. In an additional phase of this project, a subset of those originally surveyed (n = 15) were observed for food handling practices (6 h per person). Observational data collection focused on cross-contamination, glove use and hand washing. Most grocery store deli/bakery food handlers reported wanting frequent hands-on, interactive one-on-one training lasting less than 2 h. The target audience's largest knowledge gaps included correct temperatures for cooking, reheating and cooling foods. Observed behaviors did not correlate with food safety knowledge. For example, greater than 95% of participants reported using correct hand washing techniques; however, observational behavior data showed less than 50% of hand washing events observed were correct. Additionally, food handlers were observed not washing hands prior to putting gloves on as well as practicing bare hand contact with RTE foods. The creation of short, hands-on or interactive trainings for retail grocery food handlers that focuses on changing food handling and preparation behaviors may enhance the food handler's safe food handling practices.     

Study on food safety concerns,knowledge and practices among university students in Saudi Arabia

Food Safety is important not only for the health of consumers but also the entire food industry and regulatory authorities. University students are an important target group as they are most likely to engage in risky eating behaviors and food handling practices making them susceptible to foodborne illness. The objectives of this study were to assess the level of food safety concerns, knowledge and practices among male and female university students of King Saud University, Saudi Arabia. Information concerning sociodemographic and academic characteristics and food safety knowledge were collected using self-administered questionnaire. Food safety questions were divided into four sections that covered key food safety concepts. A total of 808 students took questionnaires of which 66.08% responded (mean age 21.1 ± 2.9). Major food concerns for students were food taste, food temperature, food presentation, wellness of cooked food, cleanliness of serving area and appearance of food handlers. Students displayed good knowledge concerning food safety. Respondents were most knowledgeable about the cleanliness of kitchen surfaces and utensils, prevention of cross contamination and hand hygiene but demonstrated poor knowledge about heat treatment of food and temperature. Good knowledge of food safety was reflected in food safety practiced by the students except temperature control. Chi-square test results revealed that both male and female students demonstrated comparable food safety knowledge and practices. This is probably the first gender-based report on the food safety concerns, knowledge and practice among students of King Saud University, Saudi Arabia. The study highlights the need for educational programs that aim not only to provide knowledge but also encourage the students to practice the food safety measures strictly.     

Improvement of food safety in school meal service during a long-term intervention period: a strategy based on the knowledge,attitude and practice triad

The objective of the present study was to evaluate the development of food safety scores in school meal services during the application of a systematic intervention based on the knowledge, attitude and practice triad. A total of 68 public schools were included in the study. School meal services were assessed every three months with a checklist, which resulted in eight evaluations over two years. A program was developed and implemented in all the schools during this period that was comprised of three steps: 1) theoretical training, 2) implementation of action plans in situ and 3) weekly visits to motivate food handlers and monitor good practices. These steps were designed to promote changes in the attitudes and practices of food handlers. An ascending linear function was observed for the school meal services' general adequacy percentage over time. Positive developments were also observed regarding buildings and facilities, processes and procedures, distribution of meals, integrated pest management, water control, controls and records, health and safety of employees and equipment and utensils. Our results suggest that the proposed intervention strategy performs well in making school meal services conform to good practices and that strategies in this context should be permanent and continuous.     

Knowledge of food safety and handling in households: A survey of food handlers in Mainland China

The objective of the study was to provide a picture of knowledge of food safety and handling in households and identify a demographic profile of “high-risk” groups with the poorest knowledge. A national survey of food handlers in Mainland China (n = 482) was conducted using previously validated closed questionnaires. The questionnaire consisted of 26 knowledge questions, which included 5 scales that covered key concepts of food safety and handling in households, and 7 demographic questions. The respondents demonstrated a very low level of knowledge and the mean score awarded to them was 7.95 (knowledge scores from 0 to 26). The data were further analyzed to determine differences in knowledge between populations of different demographics. Differences were found between male and female respondents (p < 0.01), urban and rural respondents (p < 0.01) and respondents with different income levels (p = 0.04). Two “high-risk” groups with the lowest level of knowledge are 1) male food handlers with a per capita annual income of less than 30,000 CNY (4773 USD) and 2) female food handlers who live in rural areas and have a per capita annual income below 30,000 CNY (4773 USD) and deserve special attention. This is the first national survey in Mainland China and the results suggested that developing educational programs related to food safety and handling in households of Mainland China are urgently needed.     

Evaluation of the effect of person-in-charge (PIC) program on knowledge and practice change of food handlers in Dubai

The effect of Person in Charge (PIC) intervention on knowledge and practice of food handlers in Dubai was evaluated. Data were collected from 48 food establishments located in 4 zones in the city. Each establishment was visited twice in the assessment. In each visit, the same set of 12-knowledge questionnaire was asked and 20 observable practices evaluated. Hand and cutting board swabbing were also conducted to evaluate the personal hygiene of food handlers. Results showed that all the groups gained additional knowledge on food safety during training except group 4. Irrespective of knowledge gained, some of the trained PICs were unable to change food safety and handling practices at place of work. In group 1, the performance got worsen by 12%. Group 2 and 3 showed 4.3% and 10.3% improvement in food safety practices respectively. While, group 4 remained almost same as before the PIC intervention. With regards to cutting board swabbing, results showed that group 1 dropped by 16.6% while the remaining groups improved by 41.6%. In the case of hand swabbing all establishments in group 1 showed satisfactory results after training. Group 2, group 3 and group 4 showed 41.7% improvement. Statistics revealed that there was a significant improvement in the performance of food handlers in hand swabbing after the intervention with mean values of 60.4% and 85.5% before and after respectively. In the case of cutting board swabbing, there was a considerable improvement but not statistically significant at (p < 0.05) with mean values of 41.6% and 62.5% before and after respectively.     

Food safety knowledge,attitudes and practices of street food vendors and consumers in Ho Chi Minh city,Vietnam

This study had the major objective of evaluating the food safety knowledge, attitudes and practices of consumers and vendors of street foods in Ho Chi Minh City (MCMC), Vietnam. There were three main surveys performed in this study. A total of 120 consumers and 40 street food vendors from four districts [Binh Thanh (BT), Thu Duc (TD), district 3 (D3) and district 8 (D8)] in HCMC contributed to the study on a voluntary basis. The surveyed consumers had adequate levels of food safety knowledge and attitudes. No significant difference (p > 0.05) occurred between the food safety knowledge levels of the consumers on the basis of gender. However, significant differences (p < 0.05) occurred on the basis of age, education level, food safety training status and location. In contrast, the street vendors had poor food safety knowledge and attitude levels. No significant differences (p > 0.05) were observed in the food safety knowledge levels of the vendors on the basis of gender and age. However, significant differences (p < 0.05) were found on the basis of food safety training status and education level. It was also noted that the vast majority (95%) of the vendors had not received any food safety training. With regards to the practices, it was determined that 52.5% of the vending sites were open air stands without any protection from the sun, wind and dust. 52.5% the vending stalls had no direct access to potable water, while 47.5% did not have adequate hand washing facilities and a further 30% lacked proper waste water and food disposal facilities. In addition, 52.5% of the vendors did not separate raw, partially cooked food and cooked food products. These findings highlighted that street food vendors in HCMC generally have poor food handling practices and most are operating under unhygienic conditions. These results should provide the Vietnamese government with even more reasons to increase their current efforts to improve the safety of street foods and food safety awareness of the consumers.     

Food handling: Comparative analysis of general knowledge and practice in three relevant groups in Portugal

A self-administered questionnaire designed to assess “Knowledge” and “Practice” of public hygiene measures was tested in a group of food handlers (n = 79) and two groups of undergraduate students (n = 152). Students were poorly acquainted with practical aspects, relating specifically to temperature control and food storage requirements. A significant proportion of food handlers lacked basic knowledge and understanding of microbiological hazards, hygiene and safety rules. The mean food safety “Knowledge” score among food handlers was 55.0 ± 18 and the mean “Practice” score was 69.0 ± 17. The results point to the need to improve training and increasing awareness of the measures imposed by food safety laws in Europe.     

Knowledge, attitudes and practices of workers on food hygienic practices in meat processing plants in Fars, Iran

This cross-sectional study was conducted to evaluate the knowledge, attitudes and practices of food workers in four meat processing plants in the Fars province, southern Iran. A self-administered, structured questionnaire was designed and completed by 97 food workers during November 2006–January 2007. Results indicated that the respondents had acceptable level of knowledge, excellent attitudes and poor practices toward food hygiene measures. Almost all of the food workers (97.9%) were aware of the critical role of general sanitary measures in the work place while there was lack of knowledge about microbial food hazards in the majority (67–78%) of them. A significant negative correlation was observed between knowledge and practices (r_s = −0.20, P = 0.04), and attitudes and practices (r_s = −0.27, P = 0.009), revealing that increased knowledge and even attitudes toward food safety does not always result in positive change in food handling behaviors.     

Food safety knowledge of foodservice workers at a university campus by education level,experience, and food safety training

Food safety knowledge of university foodservice workers was evaluated and the relationship between food safety knowledge and education level, length of employment, and food safety training was assessed using a 40-item food safety questionnaire. Each knowledge question was scored as “1” for a correct answer and as “0” for an incorrect answer. The relationships between the level of education and food safety knowledge scores and length of employment in the foodservice industry and food safety knowledge scores were determined using bivariate correlation analysis. A total of 63.5% of the respondents had limited knowledge, 79% were well-informed about hygiene practices, while 33.9% of persons knew of correct time-temperature control measures. Kendall's tau = 0.067; p = 0.294 revealed a lack of strength of the relationship between education level and food safety knowledge. The relationship between length of employment and food safety knowledge was Kendall's tau = −0.133; p = 0.121. No mean differences (p = 0.426) were observed for mean knowledge scores between groups of food safety trained and untrained persons. Neither education level, nor the length of employment in the foodservice industry had a significant impact on food safety knowledge. The authors recommend that in order to improve food safety knowledge, attention should be given to the planning, implementation, monitoring, and evaluating food safety education programs.