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.     

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.     

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.     

Will capacity building training interventions given to street food vendors give us safer food?: A cross-sectional study from India

Successful food hygiene training and the consent of safe food handling practices learnt during training are critical elements in the control of food-borne illnesses throughout the world. It is true for food handlers and vendors belonging to all sectors. But, it is all the more urgent for street vendors because they are more exposed to environmental hazards and are predominantly from much weaker socio-economic backgrounds and yet cater to the general mass. Using a cross-sectional study design a sample of 80 street food vendors were selected and provided with training to evaluate the existing Knowledge, Attitude and Practice (KAP) regarding food safety and hygiene and the change of the same after training interventions. Responses regarding KAP on food safety and hygiene before and after training revealed that there was a significant change in their perception to food safety knowledge and also practices. The knowledge level of the food vendors increased from an average 24.35%–66.2% after training interventions. The overall performance rating of full adoption of good hygiene practices by the vendors ranged from 37.5% to 50.8% in post-training period.     

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 hygiene training: Introducing the Food Hygiene Training Model

For many years social cognition models and workplace health education theories have been used to map out the variables and identify determinants of various health-related behaviours, including hand hygiene practice, food handling and the use of food thermometers. Whilst many models and theoretical frameworks identify specific determinants or variables of behaviour and organisational interactions this paper takes a holistic approach to food hygiene training and proposes a new theoretical framework. This framework (The Food Hygiene Training Model) encompasses and utilises various theoretical models and educational theories to recognise the various influences on the training, beliefs, motivations, and conditions required for food handlers to perform safe food handling practices in the workplace. Effective food hygiene training and the enactment of safe food handling practices learnt during training are critical elements in the control of food-borne illnesses throughout the world. Therefore, future food hygiene training strategies, if they are to be effective, should consider the adoption of the Food Hygiene Training Model, to aide overall improvements in food businesses, and thus, an overall reduction of food-borne illnesses.     

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.     

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.     

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.     

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.     

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 law compliance in developed and developing countries: Comparing school kitchens in Lincolnshire–UK and Ashanti Region of Ghana

The demands and requirements of Food Laws remain the same internationally as food hazards present the same risks to individuals including school going age children and adolescents, however different nations with different economic and developmental issues differ in the level of importance attached to Food Law requirements. A questionnaire to assess good hygiene practices in schools in Lincolnshire–UK and Ashanti Region of Ghana to compare compliance with training requirement in Food Laws was administered in 10 Lincolnshire and 45 Ashanti Region secondary schools. Whilst the demands on good hygiene practices remain stringently upheld in schools in the United Kingdom the same could not be said of Ghana. Although 60% of schools in Ashanti Region of Ghana fed between 1000 and 3000 students thrice a day, there was no evidence of food safety management system in all the schools. Staff food and personal hygiene practices including, temperature control, hand washing, avoidance of self-adornments, infectious disease control were substandard. A mandatory requirement by Food Laws in both countries for persons in supervisory position was not stringently complied with as 31% of kitchen matrons reported not to have hygiene qualification in the Ashanti Region of Ghana and 82% of 180 staff sampled had never received hygiene training. The absence of mandatory hygiene training for all food handlers, kitchen managers/matrons with requisite hygiene knowledge and qualification and rigorous enforcement of these remain challenges to good hygiene practices and Food Legislation in Ghana in addition to suitable facilities. The development of food hygiene training programmes towards mandatory certification at different levels of responsibility for the industry is required to help curb the identified challenges.     

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.     

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.     

Foodborne diseases in Malaysia: A review

This paper reviews foodborne diseases occurring in Malaysia and the strategies taken by the Malaysian government. Half of the foodborne related diseases from the early 1990s until today were associated with outbreaks in institutions and schools, mostly due to unhygienic food handling procedures. Outbreak surveillance and monitoring, training and Hazard Analysis Critical Control Point (HACCP) implementation at food service establishments all play a vital role to prevent and/or reduce foodborne diseases. Some of the key agencies from the Malaysian Ministry of Health, academia, industries and research institutions continue to strengthen their collaboration and networking in order to coordinate the prevention and control of foodborne diseases and thus improve public health. Developments to date have shown improvement in surveillance and monitoring. In Malaysia, the main contributing factor to foodborne diseases was identified as insanitary food handling procedures which accounted for more than 50% of the poisoning episodes. Food handlers play a major role in the prevention of food poisoning during food preparation; hence, food handler training is seen as one of the main strategies to increase food safety practices. There are 125 accredited food handlers’ training institutes as of September 2010. The application of knowledge and skills from training into the workplace is important and reasons for limitations of training initiatives 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.     

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 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.