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.     

The relationship among food safety knowledge,attitudes and self-reported HACCP practices in restaurant employees

This study investigates relationships among food safety knowledge, attitudes and hazard analysis critical control point (HACCP) practices in restaurant employees in Taiwan. The authors administered a baseline questionnaire to 542 restaurant employees to assess their food safety knowledge, attitude and HACCP practices. A total of 421 valid questionnaires were returned and used in analysis. Mean scores for each survey item were calculated and used in a structural equation model (SEM) designed to assess interrelationships between the three. Participants scored an average 84.7% correct in food safety knowledge, with highest and lowest correct scores in, respectively, the food poisoning and good hygienic practices (GHP) constructs. The highest score in the attitude section was “concern for food safety” followed by “self-improvement.” With the exception of the food poisoning construct, this study found correlations among knowledge, attitude, and HACCP practices, with attitude mediating the relationship between knowledge and HACCP practices. The implications of these findings are discussed.     

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.     

Restaurant business operators' knowledge of food hygiene and their attitudes toward official food control affect the hygiene in their restaurants

We surveyed the knowledge and attitudes of restaurant business operators (RBOs) with respect to their restaurants' hygiene. A total of 82 RBOs were interviewed and a hygiene evaluation was performed in each of the restaurants by one researcher. Fifty-six food control officials responded to an electronic questionnaire. Based on our results, positive correlations exist between hygiene knowledge of the RBOs, their attitudes toward food hygiene and official food control, and their restaurants' hygiene level. Proper justification of control measures used by food control officials and a negotiative approach appear to be highly important for improving restaurant hygiene.     

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.     

A longitudinal evaluation of food safety knowledge and attitudes among Ontario high school students following a food handler training program

Youth are a unique audience for food safety education, in part due to low food safety knowledge. Although the effectiveness of such education has been explored for primary school and college students, no studies have assessed effectiveness among high school students specifically. We conducted a longitudinal intervention study in Ontario, Canada, between February and May 2015, to measure the baseline food safety knowledge and attitudes of high school students (n = 119; from 8 classes in 4 high schools), and determine whether these factors improved following in-class delivery of a provincial standardized food handler training program. Linear mixed effects regression models were used to model within-student changes in knowledge scores and attitudes over time (i.e., circa 2 and 12 weeks post-intervention), and to investigate associations with student characteristics. At baseline, knowledge and attitudes were poor. Following training, overall knowledge was significantly greater than at baseline, although at three months post-intervention only knowledge of safe times and temperatures for cooking and storing food remained significantly higher than baseline. Following training, students were significantly less interested in learning about how to avoid foodborne disease. Other attitudes, as well as knowledge of cross-contamination prevention and disinfection procedures, remained unchanged. These findings suggest that delivering existing food handler training programs within high schools may be a feasible mechanism for food safety educators to improve students' food safety knowledge, both overall and specific to safe times and temperatures, albeit potentially for short timeframes. Whether knowledge continues to decline beyond three months after training bears further investigation. As well, future research to investigate how students' actual food safety practices may change following such training, and whether improvements in knowledge translate into reduced foodborne disease risk, is warranted.     

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,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.     

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.     

Knowledge,attitudes and self-reported practices of food service staff in nursing homes and long-term care facilities

The aim of this study was to investigate knowledge, attitudes and practices of food service staff in nursing homes and long-term care facilities for the elderly in Sicily, Italy. Association with some demographic and work-related variables was also investigated. This survey provides information and outlines many complex questions concerning the basics of food hygiene. Education level, length of service in the employment and attending courses on food hygiene influenced the knowledge, attitudes and practices of food service staff. This study has evidenced the need for continuous training among food service staff regarding food safety in LTCF and nursing homes.     

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 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.     

Retraining effectiveness in FOODSAFE trained food handlers in British Columbia,Canada

The purpose of this study was to examine the effectiveness of food handler retraining. The food safety knowledge of handlers who had been previously certified by the FOODSAFE training programme in British Columbia, Canada was compared prior to and nine months following FOODSAFE retraining. The previously FOODSAFE trained food handlers were selected from participants of a 2009 survey. Food safety knowledge scores were compared between (1) previously FOODSAFE trained food handlers who received retraining (the intervention group), (2) previously FOODSAFE trained food handlers who did not receive retraining (the control group), and (3) untrained food handlers (the untrained group). Data gathered in a telephone survey demonstrated knowledge scores were significantly higher in the intervention group when compared with the control group, and when compared with the untrained group. No differences in food safety knowledge scores were found based on English as a first language or receiving food safety training other than FOODSAFE. These results support a requirement for periodic recertification of trained food handlers and demonstrate a need for education of untrained food handlers with a food safety training programme.     

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.     

Portuguese consumers' attitudes and perceptions of bivalve molluscs

Bivalves have been promoted as healthy food in many countries. Yet, little information is available about bivalve consumers' purchasing behaviour and attitudes. The aim of this study was to investigate the marketing and quality aspects of several bivalve species with economical value in Portugal and to examine the relationship between each respondent's demographic and socio-economic status with bivalve consumption attitudes and preferences. A randomly selected sample of 1778 people answered a web-based questionnaire. The majority of respondents claimed to consume clams (pullet carpet shell clam and Japanese carpet shell clam) and usually prefer bivalves from national production. Smell, size and cleaned shells were considered as the most important criteria when choosing live bivalves. Most consumers buy clams in supermarkets and revealed good knowledge about the risks associated with its consumption. Trust in the selling establishment and product's label information was the main perceived quality criteria associated to bivalve purchasing. Nonetheless, consumers' attitudes and preferences differed considerably according to their demographic and socio-economic characteristics. The current findings provide a useful tool for producers and stakeholders involved in the trade chain of bivalves to understand the consumption profile and the most important quality criteria involved in bivalve purchase. Additionally, it is an important tool to predict the risks of bivalve consumption as well as to understand the different scenarios of contamination occurring in harvesting areas by national competent authorities.     

Essential tools for food safety surveillance in catering services: On-site inspections and control of high risk cross-contamination surfaces

The aim of this study was to assess the routine food safety procedures carried out in catering services so as to provide a useful monitoring program for managers based on the relevant deviations detected in the observational survey and activities carried out in 15 catering services located in Navarra (region of northern Spain). The main hygiene standards, food handler practices and compliance with the HACCP system were evaluated by means of visual inspections (checklist), monitoring of critical control points (food storage and food processing temperatures, total polar compounds) and microbiological analysis of food-contact and hand-contact surfaces. While general high scores were obtained in the observational survey (73.3% above 36 points), none of the evaluated services had obtained the maximum rate of 48 points. The mayor deficiencies were related to the presence of dirty uniforms, improper hand washing or use of gloves, incorrect disinfection of vegetables and the missing records of stated critical points (temperatures and polar compounds in oil). The performed monitoring activities confirmed the safety of frying oil in all the kitchens, despite the fact that only 33% of them applied scientific methods to measure polar compounds. By contrast, holding temperatures were unsatisfactory in 77% of cold dishes and in 19% of hot meals. Despite the fact that 77% of food contact surfaces were considered acceptable (<4 CFU/cm²), high levels of total mesophilic microorganisms and Enterobacteriaceae were detected in hand-contact surfaces such as aprons and handles. The periodic visual supervision focusing on hygienic practices and the microbiological surveillance of surfaces of high risk for cross-contamination should provide valuable information for improving the knowledge, attitudes and practices of food handlers regarding food safety.     

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.     

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.     

An evaluation of process specific information resources,aimed at hazard analysis,in Small and Medium Enterprises in food manufacturing

Food borne illness continues to be a major global concern, with approximately 76 million cases in the US and 70,000 in the UK annually. The adoption of a food safety management system based upon Codex HACCP principles became a legal requirement in the UK on January 1st 2006 but some companies are inexperienced and fail to implement it correctly. Barriers to HACCP include time, money and expertise, particularly for SMEs and microbusinesses. Lack of expertise is a particular problem when constructing the hazard analysis component of HACCP. A sector specific information resource, using simple language with no technical terms or jargon, was developed to assist SMEs with hazard analysis. One hundred and twenty three SME food manufacturers were recruited and intervention and control groups were assigned, with the intervention group receiving the resource. Evaluation visits were performed after four months. Each company was assessed against a specific tool that determined knowledge, behavior and attitude to food safety. The resource was well received but there was no significant improvement in knowledge, behavior or attitude when comparing the intervention and control group scores. Significant differences in the behavior of SMEs and microbusinesses were evident with SMEs scoring higher in all sections of the resource than the microbusinesses. SMEs also had a significantly higher total knowledge score than microbusinesses but there were no significant differences in attitudes. It is apparent action must be taken to assist SMEs with hazard analysis and full HACCP implementation, but provision of a single resource without additional support is not enough.