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.     

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.     

Evaluation of basic knowledge on food safety and food handling practices amongst migrant food handlers in Peninsular Malaysia

This study was aimed to measure the basic knowledge on food safety and food handling practices among migrant food handlers as these information is scarce in Malaysia. A cross-sectional study was conducted face-to-face amongst 383 migrant food handlers from three major cities in Peninsular Malaysia through questionnaire. Socio-demographic information of all respondents was collected. Questions on food safety knowledge (i.e. food cleanliness and hygiene, symptom of foodborne illnesses and foodborne pathogens) and food handling practices were assessed. The compiled data were analyzed by using the Statistical Packages for Social Science (SPSS) 16.0. Overall, migrant food handlers had poor level of knowledge on food safety with an average food handling practice. Significant effects were observed between respondents’ food safety knowledge and socio-demography (country of origin and educational level) and two factors namely; respondents’ nationality and attendance at food training programs showed significant associations with their food handling practices. Multiple logistic regression analyses revealed that attendance at food training programs was a significant and independent predictor of the respondent’s food handling practice. The study’s findings highlighted issues with regards to the extent of knowledge acquisition on food safety and hygiene by migrant food handlers. Therefore, this warrants improvements not only in the better delivery methods of training modules but also tight enforcement of attendance at the programs by the respective authorities.     

Efficacy of the theory of planned behaviour model in predicting safe food handling practices

The majority of food-borne disease outbreaks result from malpractice during food preparation in small food businesses. Effective food safety management, including the adoption of safe food handling practices learnt during food safety training programmes, is thus an important strategy to limit incidences of food poisoning. This study explores the impact of basic or foundation level food hygiene training on the attitudes, and intentions of food handlers to conduct safe food handling practices at every occasion.The Theory of Planned Behaviour was used to evaluate the relative impact of different influences on the intentions and self-reported behaviours of 249 food handlers, in hospitality settings. Interviews were also conducted with food handlers, and their managers to seek further insight into the changes in attitude and intent to conduct safe food handling practices after basic or foundation level food hygiene training.     

Food safety knowledge,attitudes and self-reported practices of food handlers in institutional foodservice in Accra,Ghana

The aim of this study was to evaluate the food safety knowledge, attitude and practices (KAP) of food handlers from institutional food service establishments that serve hospitals, boarding senior high schools and prisons in Accra, Ghana. A total of 278 food handlers (56.8% of hospital, 30.9% of schools and 12.3% of prison food service) participated in the cross-sectional study. Data was collected by face-to-face interviews, and responses were scored to determine the level of food safety KAP. Respondents who scored ≥70% of the maximum possible score were adjudged to have sufficient knowledge and practices and positive attitudes. Results showed that respondents generally had insufficient food safety knowledge and practices with means scores of 20.99 ± 7.64 (46%) and 9.35 ± 5.62 (52%) respectively. Attitudes towards food safety were generally negative but with a comparatively higher mean score of 12.64 ± 3.06 (63%). Areas of most concern were 1) Lack of knowledge of sources of contamination/cross-contamination and appropriate holding temperatures for food. 2) Poor practices included multiple freeze-thaw cycles for frozen food and 3) Infrequent hand washing during food preparation after coughing or sneezing. There is the need for continuous risk based training to educate and effect behavioral changes among food handlers. This process will encourage positive attitudes towards food safety and consequently promote good food safety practices.     

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.     

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.     

Knowledge,attitudes and self-reported practices of food service staff regarding food hygiene in Edirne,Turkey

The purpose of this study was to evaluate the knowledge, attitudes and practices among food service staff with regards to food hygiene in hospitals in Edirne, Turkey, and to provide baseline data for implementing HACCP in hospital food services by carrying out a questionnaire by a face-to-face interview. The current study shows that food service staff in Edirne hospitals have insufficient knowledge regarding the basics of food hygiene. And also revealed a discrepancy between attitudes and practices towards food hygiene. There is an immediate need for continuous training among food handlers regarding safe food handling practices.     

Perceptions of hygiene training amongst food handlers,managers and training providers – A qualitative study

An important element in the effectiveness of food hygiene training is the support given by managers, both pre and post training, to motivate food handlers to enact the safe food handling practices learnt during training. This study explores the personal views of food handlers, their managers, and accredited training providers towards the provision and evaluation of food hygiene training in the South-West London region, exploring the pre and post training support given to food handlers, and its effects on the attitude and behaviour of food handlers to enact safe food handling practices in the workplace. In total seventy telephone interviews were conducted.Findings demonstrate that most food industry managers are aware of their responsibilities to train food handlers, but often do not provide adequate support to promote the enactment of safe food handling practices, or evaluate its effectiveness. Thus, any positive effects gained from food hygiene training programmes, are ephemeral.     

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.     

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.     

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.     

Food allergens: Knowledge and practices of food handlers in restaurants

This survey evaluated the knowledge of managers and food handlers, who work in restaurants functioning in two large supermarket chains in the metropolitan region of the city of São Paulo (Brazil), concerning food allergies. Twelve restaurants were evaluated, representing a total of 74 people (12 managers and 62 food handlers). Results have shown that even though the survey showed that food handlers had some knowledge on food allergies, allergic people must stay on the alert, questioning the place where they are going to have their meals in terms of the ingredients used, verifying whether the food is really free of allergens, and always observing the labels of food products. This is needed since there is no real concern by these establishments in preparing safe meals in terms of food allergies.     

Socio-economic profile and food safety knowledge and practice of street food vendors in the city of Guwahati,Assam, India

Street food is an integral part of society in all countries – underdeveloped, developing or developed. As such the standard of hygiene maintained is a very vital matter. Every region has its sets of factors affecting the hygiene maintain. In the present study a survey was carried out in Guwahati city to determine the existing socio-economic status and food safety knowledge of street food vendors. Data on socio-economic and business profile of 80 vendors were collected using three standardized proformas.A study was also conducted on the existing knowledge of vendors on food safety and hygiene practices and methods of procurement of raw materials. The knowledge and procurement practices of the vendors were assessed for association with some relevant socio-economic factors. From the study it was observed that majority of street food vendors were mobile food vendors (54%) with the remaining being owners of small restaurants and food handlers. Majority of the food vendors were local to Guwahati city (93%). The average daily income of the mobile food vendors were between Rs. 200 to Rs. 600. It also was noted that only 30%–37% vendors were aware of hygienic practices of food handling and a mere 8%–11% of food vendors had knowledge on biological sources of food contamination.It was concluded that there is a high degree of association between procurement practices with the type of vendors, ownership status and average income. But no outstanding association exists with any socio-economic factor with the knowledge of the vendors on food hygiene. The street food scenario in the city was found to be quite dismal and requires stringent steps to improve matters.     

Development of conscious food handling in Hungarian school cafeterias

The last steps of food chain are particularly important, because this is when the food products reach the consumer. In the catering sector, the responsibility of food handlers are very high in the prevention of foodborne diseases. In this situation, the food handler's work must be conscious. This paper focuses on the issue of consciousness in food handling, which is the relationship between the level of knowledge and the implementation of right practice. The aim of this study is to establish a special food hygiene training model and measure its efficiency. The essence of the training model is to increase the consciousness of food handlers.Food hygiene training was tested at 33 school kitchens, where 145 staff participated. The program lasted for 6 months. Theoretical knowledge was evaluated, using self-administered tests, and food handling practice was measured through observation. Results before and after the intervention program were compared.Deficiencies in hygienic knowledge and in food handling practice were identified in seven areas. Significant increases were observed in theoretical knowledge in the areas of receiving (33.5%) and food waste (11.7%). With regards to the food handling practice, some remarkable positive changes were observed in the fields of storage (33.3%), dishwashing (24.7%), and cleaning (22.0%). Dishwashing, personal hygiene, and cleaning were the areas where such increases were observed, both in their knowledge and practice, that is, consciousness was increased in these areas.The parallel development of hygienic knowledge and food handling practice increased the consciousness in food handling, which is indispensable for ensuring safe food practices. Increasing consciousness make good practice instinctive in everyday work.     

Food safety knowledge,attitudes and practices of street food vendors and consumers in Port-au-Prince,Haiti

This study had the major objective of determining the food safety knowledge, attitudes and practices of vendors and consumers of street food in Port-au-Prince, Haiti. Haiti currently has no food safety legislation in place. 160 consumers and 80 vendors from four different communes (Tabarre, Delmas, Pétion-ville and downtown Port-au-Prince) volunteered to participate in the study. In general, consumers and vendors exhibited average food safety knowledge and attitude levels. Gender, training, level of education and location did not have a significant effect (p < 0.05) on the level of food safety knowledge of the consumers. Vendors were determined to have higher levels of food safety knowledge than consumers, whilst trained vendors had better food safety knowledge and attitudes compared to untrained vendors. The majority of vendors and consumers were aware of the importance of washing hands and proper cleaning with regards to the prevention of foodborne diseases. However, some other aspects were of concern. Consumers and vendors did not know that Hepatitis A, Salmonella spp. and Staphylococcus spp. are pathogens responsible of foodborne diseases. They also had difficulties in identifying the groups at risk of foodborne diseases and most were unaware of the importance of reheating food to fight against foodborne diseases. In the observational part of the study, it was found that in 60% of the cases, flies and animals were evident around the stall and 65% did not have access to potable water. The majority served food with bare hands and did not wash their hands after handling money. Additionally, 70% of the vendors did not chill pre-cooked food. The conditions in which street food vendors operate in Port-au-Prince are largely unacceptable from a food safety point of view and an effort should be made to provide them with adequate infrastructure including potable water, toilets and waste disposal facilities. The results of this study should be used to generate part of the impetus towards the development of enforcement of appropriate food safety legislation in Haiti.     

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.     

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 and the contract catering companies: Food handlers,facilities and HACCP evaluation

The evaluation of implementing the HACCP system in contract catering companies and assessment of the knowledge, attitudes and practices of the food handlers were the main objectives of this study. It was conducted in 20 companies throughout Spain, with visual inspection of facilities and food handler activities, as well as the distribution of a self-administrable questionnaire among the 105 participant catering workers. In addition, samples of surfaces and finished dishes were taken from each kitchen for microbiological evaluation. The results obtained from the questionnaires reflect extensive knowledge and correct behaviors among respondents with a middle- or high-school educational level, stability in the same workplace and positions of greater responsibility. However, the observation of hygiene practices revealed systematic incorrect procedures in 60% of the kitchens. Most observed deviations were related to the lack of HACCP training and information, the temperature of finished dishes, the storage areas and proper cleaning and disinfection. In summary, this study confirms the difficulties inherent in catering companies to effectively implement the HACCP system, such as the lack of well-trained personnel, lack of motivation or adhesion to said system on the part of the workers, and the lack of financial and economic resources to address the deficiencies in the facilities. Specific educational programs and grants are need for an adequate implementation of HACCP in this sector.