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PubMedDate not supplied

[Assessment of the effectiveness of health training courses offered for food handlers in a health care district of Gandía, Valencia].

BACKGROUND: Food poisoning is a major Health Care issue. Health training is one of the mechanisms available for preventing these illnesses. The purpose of this study is that of ascertaining whether food handlers improve their knowledge regarding food handling practices by attending the courses which are offered for being awarded the handler card and of analyzing the impact of sociodemographic variables on the degree of knowledge prior to taking the course. METHOD: Pre-Post type assessment study on a sample of 500 handlers who came to the Public Health Center in the town of Gandfa (Valencia) to take a training course in October 1997-February 1998. A self-test questionnaire taken prior to and following the course to gauge knowledge and other variables was used. RESULTS: A significant difference was found between the pre-test and the post-test, except with regard to the subject of personal hygiene. Those handlers having worked at this occupation for a longer number of years or who had prior health training answered correctly more often. CONCLUSIONS: The training courses heighten the degree of knowledge regarding food-handling practices. In training courses, greater emphasis must be placed on the subjects of food preservation, preparation and serving than on those of personal hygiene or facility cleanliness. Nonetheless, it would be of interest to research whether any changes in attitudes occur as an initial approach to assessing the effectiveness of the training and ascertaining whether any intention exists of putting the knowledge acquired into practice.

Adult↗
PubMed2003

Risk factors for norovirus, Sapporo-like virus, and group A rotavirus gastroenteritis.

Viral pathogens are the most common causes of gastroenteritis in the community. To identify modes of transmission and opportunities for prevention, a case-control study was conducted and risk factors for gastroenteritis attributable to norovirus (NV), Sapporo-like virus (SLV), and rotavirus were studied. For NV gastroenteritis, having a household member with gastroenteritis, contact with a person with gastroenteritis outside the household, and poor food-handling hygiene were associated with illness (population attributable risk fractions [PAR] of 17%, 56%, and 47%, respectively). For SLV gastroenteritis, contact with a person with gastroenteritis outside the household was associated with a higher risk (PAR 60%). For rotavirus gastroenteritis, contact with a person with gastroenteritis outside the household and food-handling hygiene were associated with a higher risk (PAR 86% and 46%, respectively). Transmission of these viral pathogens occurs primarily from person to person. However, for NV gastroenteritis, foodborne transmission seems to play an important role.

Adolescent↗
PubMed1991

Enteral feeding and infection in the immunocompromised patient.

Evidence is accumulating that immunocompromised individuals are at an increased risk of infection from foodborne pathogens including Campylobacter jejuni, Listeria monocytogenes, Salmonella spp. Normal bacterial flora and contaminants of foods and enteral feeds can also result in nosocomial infection in susceptible individuals. Safe food handling, low-microbial diets, and measures to reduce bacterial contamination of enteral foods can reduce exposure to potential pathogens in the food supply.

Cross Infection↗
PubMed1989

Food hygiene behaviour among hospital food handlers.

One hundred and sixty one food handlers in two hospital settings were evaluated for their knowledge and practice of certain aspects of food hygiene. They were also screened for nasal carriage of Staphylococcus aureus as well as for enteric pathogens and parasites. Positive responses to selected food hygiene behaviours such as handwashing before handling food and daily change of clothes were very high and encouraging. However, only a very small proportion (28.6%) were observed to have actually washed their hands especially between handling cooked and uncooked foods. The nasal carriage of Staphylococcus aureus was 24%. The significance of the isolation of the different enteropathogens is discussed. From an epidemiologic perspective, the foodhandlers were individuals from the lower socioeconomic class with low level of education. Because of their unique role in the hospital community, there is a need for continuous medical surveillance of this group of employees. Also a periodic in-service programme of health education on food safety and hygiene should be introduced to alert them of their responsibilities.

Adult↗
PubMed1996

Food safety: review and implications for dietitians and dietetic technicians.

Section 103 (d) of the Americans with Disabilities Act directs the secretary of health and human services to identify, publish, and annually review a list of pathogens transmitted via food contaminated by infected food handlers. The secretary is also directed to publish means by which diseases on the list are transmitted. The intent of the list is to protect disabled food handlers when they become ill and to provide managers with information for determining when to remove or reassign disabled food handlers who have infectious or communicable diseases to jobs that do not involve handling food. Pathogens often transmitted via food contaminated by infected food handlers are Salmonella typhi, Shigella species, Staphylococcus aureus, Streptococcus pyogenes, hepatitis A virus, and the Norwalk and Norwalk-like viruses. This article discusses section 103 (d) and for each of the six pathogens describes characteristics and growth requirements, types of foods involved in outbreaks, factors that contribute to foodborne outbreaks, and prevention and control measures. Human beings are the only reservoir of Sal typhi. The source of Shigella species is the intestinal tract of human beings and other primates. Human beings are the common reservoir of Staph aureus and Strep pyogenes. Staph aureus is frequently found in the nose and on the skin of healthy people, whereas Strep pyogenes is carried in the throat of infected or asymptomatic carriers. Foodborne viruses of public health concern originate in the human intestine. Foods that favor the multiplication of Sal typhi are often foods that require no cooking. Many outbreaks of foodborne disease attributed to Shigella species and viruses have been associated with salads. Moist, high-protein, and salty foods that have been cooked are most often involved in outbreaks of staphylococcal foodborne illness. Foods usually implicated in Strep pyogenes outbreaks are predominately composed of milk, eggs, or meat. Dietitians and dietetic technicians can use three approaches to reduce the incidence of foodborne disease attributed to food handlers: conducting training and education programs, implementing a Hazard Analysis and Critical Control Points system, and supporting certification of foodservice managers.

Disease Outbreaks↗
PubMed2026

Critical insights on the application of the theory of planned behaviour to food handlers' food safety practices.

Foodborne diseases remain a significant public health concern, often linked to unsafe food-handling practices. The Theory of Planned Behaviour (TPB) is widely used to predict and explain food safety behaviours, yet its application in this field has not been systematically and in-depth evaluated. This review evaluated how the TPB has been applied to study food handlers' behaviour, focusing on methodological approaches, use of the TACT (Target, Action, Context, and Time) framework, validity, elicitation studies, and reliability. Seventeen studies were included following a systematic search of four databases (Scopus, Web of Science, Wiley Online Library, and Taylor & Francis Online). Data were extracted on behaviour definition, aim of study, main findings, use of indirect and direct TPB measures, use of elicitation studies, internal consistency, content validation, analytical methods used, and any extensions to the original TPB framework. Key elements related to adherence to core TPB principles and measurement practices were extracted using a Checklist. Most studies used direct measures of TPB constructs, and only a few reported procedures for content validation. Considerable variability was found in the reporting of key measurement and psychometric practices. Five studies fully applied the TACT framework, while nine incorporated additional factors such as knowledge and moral norms. Elicitation studies were conducted in five cases where indirect measures were employed. Analytical approaches were mainly based on multiple linear regression, with limited use of more advanced techniques such as structural equation modeling. Twelve studies reported internal consistency results. Overall, the review highlights opportunities to strengthen methodological practices in future TPB research on food safety. Greater attention to conducting and reporting content validation, full application of the TACT framework, reporting of internal consistency, and consistent inclusion of elicitation studies when using indirect measures may enhance transparency, reinforcing the credibility and trustworthiness of research findings. A major methodological limitation of this review was that screening and data extraction were conducted by a single reviewer and no formal quality or risk-of-bias assessment of the included studies was performed. Despite these limitations, the findings provide practical guidance for the development and validation of TPB-based questionnaires and may support more robust food safety research, interventions, and policy initiatives aimed at improving food handlers' practices.

Humans↗
PubMed2002

Food handlers' beliefs and self-reported practices.

Despite an increase in the number of food handlers receiving food hygiene training, a high proportion of food poisoning outbreaks still occur as a result of poor food handling practices. This paper uses elements of social cognitive theory to examine the beliefs of food handlers towards food safety and to determine food handlers' self-reported practices. Questionnaires were completed by 137 food handlers from 52 small to medium-sized food businesses in Wales. Generally, food handlers were aware of the food safety actions they should be carrying out but identified a number of barriers which would prevent them from implementing these practices. These barriers included lack of time, lack of staff and a lack of resources. Despite 95% of respondents receiving food hygiene training, 63% admitted to sometimes not carrying out food safety behaviours. All the food handlers also perceived their business to be of relatively low risk and yet all businesses prepared high risk foods. This research highlights the need for training to be based around a risk-based approach and demonstrates that behavioural change will not occur merely as a result of training. Food safety practices will only be implemented given adequate resources and an appropriate management culture.

Attitude to Health↗
PubMed2004

Observation versus self-report: validation of a consumer food behavior questionnaire.

A reliable and validated set of food safety behavior questions that could be used with confidence when evaluating food safety education programs was identified in this study. A list of 29 food-handling and consumption behaviors rank-ordered within five pathogen control factors by nationally recognized food safety experts was the basis for the development of the behavior questions. Questions were evaluated for reliability and several forms of validity. During a kitchen activity session, 70 graduates of a nutrition education program completed four food preparation tasks while being observed and videotaped. The individuals also participated in an in-depth interview to validate behaviors that could not be observed during the food preparation activity, e.g., refraining from preparing food for others when experiencing diarrhea. Criterion validity was established by comparing questionnaire responses to observed behavior and interview responses. Twenty-eight questions met the validity criterion (> or = 70% agreement between observed and interviewed responses and self-reported responses), with three or more questions from each of five pathogen control factor areas. Observation assessments revealed that hand washing was more likely to be performed prior to beginning food preparation than between working with raw meats and fresh produce. Errors in methods of washing hands, utensils, and preparation surfaces between food preparation tasks were common. Most participants did not use thermometers to evaluate doneness but still cooked to safe internal temperatures. The results provide a tool that educators can use to evaluate food safety programs and will help guide the development of more effective food safety education programs targeting needed improvements in behavioral skills.

Adult↗
PubMedDate not supplied

Seroprevalence of hepatitis A among hospital dietary workers: implications for screening and immunization.

Hepatitis A is a self-limited, virally mediated infection of the liver. The usual mode of transmission is by the fecal-oral route. Employees of food-service establishments who are infected with the hepititus A virus can transmit the disease when handling food products. The Centers for Disease Control and Prevention recommends the use of the hepatitis A vaccine among dietary workers who may be at risk for contracting and spreading the disease. Because hepatitis A infection can often be a subclinical disease, the incidence of cases reported is not indicative of its true prevalence. The objective of this study was to document the seroprevalence of hepatitis A among hospital dietary workers. Dietary workers at a suburban hospital were interviewed to determine if they had been exposed to hepatitis A and if they had a history of hepatitis A infection. Serum was obtained from each subject and tested for the presence of hepatitis A antibodies. The Abbott HAVAB EIA kit was used for the detection of immunoglobulin G (IgG) and IgM hepatitis A antibodies. Of 119 subjects, 56 (47%) were women, and 63 (53%) were men; the subjects had a mean age of 42 years (range, 20-66). Fifty-one subjects (43%) were born in the United States, and 68 subjects (57%) were born outside of the United States. Of the 119 subjects, only 2 (2%) had a known history of hepatitis A infection, yet 67 (56%) had hepatitis A titers; 52 (44%) were susceptible to the disease. One subject had received the hepatitis A vaccine. Fifty-five of 68 foreign-born subjects (81%; 95% confidence interval, 71-91%) had hepatitis A antibodies versus 12 of 51 US-born subjects (24%; 95% confidence interval, 12-36%). The foreign-born subjects had a mean age of 28 years at the time of their arrival in the United States. In conclusion, a large number of foreign-born hospital dietary workers have hepatitis A antibodies without a history of disease. Immunization of this group of dietary workers may not have any beneficial effects, nor is it cost-effective.

Adult↗
PubMed1977

Effect of freezing on incidence and levels of Clostridium perfringens in mechanically deboned chicken meat.

Paucity of information about the effect of plant practices on microbiological condition of comminuted chicken meat prompted this investigation. Commercially deboned chicken backs and necks were analyzed for levels of aerobic organisms, incidence and levels of Clostridium perfringens vegetative cells and spores before and after 4-6 weeks at -23 degrees C. Initially vegetative cells were isolated more frequently than spores. Frozen storage significantly reduced incidence and levels of vegetative cells and spores but did not affect levels of aerobic organisms. After frozen storage (a common industrial practice), with good food handling practices, C. perfringens should pose no undue hazard when comminuted chicken meat is incorporated into other food products.

Animals↗
PubMed2000

Food handlers and foodborne diseases: knowledge, attitudes, and reported behavior in Italy.

The purpose of this study was to evaluate knowledge, attitudes, and behavior concerning foodborne diseases and food safety issues among food handlers in Italy. Face-to-face interviews were conducted within a random sample using a structured questionnaire. Of the 411 food handlers responding, 48.7% knew the main foodborne pathogens (Salmonella spp., Staphylococcus aureus, Vibrio cholerae or other Vibrio spp., Clostridium botulinum, hepatitis A virus), and this knowledge was significantly greater among those with a higher education level, in practice from a longer period of time, and who had attended education courses (P < 0.05). A vast majority (90.4%) correctly indicated those foods classified as common vehicles for foodborne diseases, and only 7.1% of food handlers were able to name five different food vehicles, each of which transmit one of the five pathogens. The proportion of those who were able to specify a food vehicle that transmitted hepatitis A virus was significantly higher for those with a higher educational level and with a longer food-handling activity. A positive attitude toward foodborne diseases control and preventive measures was reported by the great majority of food handlers, and it was more likely achieved by those who had attended education courses. This attitude was not supported by some of the self-reported safe practices observed for hygienic principles, because only 20.8% used gloves when touching unwrapped raw food, and predictors of their use were educational level and attending education courses. Results strongly emphasize the need for educational programs for improving knowledge and control foodborne diseases.

Adolescent↗
PubMed1992

Foodhandling practices of Dunedin caterers: a cause for concern.

AIM: Foodhandling practices in the Dunedin catering industry were assessed to determine if they were correct, preventing the transmission of foodborne disease to the public. METHOD: A random sample of 300 foodservice outlets was selected. Information was collected during personal interviews with managers using a prepared questionnaire. Potentially dangerous practices were further analysed and summed to identify "at risk" operations. RESULTS: Response rate was 71%. Thirty-six percent of restaurants, 27% of takeaway bars and 25% of deli-bars and butchers could have been considered at risk operations. Few managers had any formal training in preparing and serving food, and less than 20% of managers and personnel had any food hygiene training. CONCLUSIONS: Current legislation and its enforcement is unable to adequately address incorrect food handling practices. It is recommended that revisions of the law emphasise the importance of correct practices and their enforcement. Food hygiene training should become compulsory for all who work in the catering industry.

Cooking↗
PubMed1997

Salmonella: a villain in 'food poisoning'.

The majority of these reports occurred during and shortly after the hottest summer recorded in Melbourne. It has been suggested that meat coming from the abattoirs may have carried a higher than usual load of organisms. Variability of the severity of the symptoms is related to host factors and food handling as well as to the virulence of the particular serovar. Investigations by the staff of the Department of Human Services revealed some major errors in food handling in some situations and minor breaches in others. Mishandling by consumers is also likely (Lester et al 1997). Such outbreaks serve to remind us not only of the importance, particularly in hot weather, of careful handling of meat, especially smallgoods, but also of the need for rapid notification to the appropriate authority of diarrhoeal illness where food is suspected to be the cause.

Abattoirs↗
PubMed1989

Foodborne gastroenteritis due to Norwalk virus in a Winnipeg hotel.

Within 1 week four separate incidents of gastroenteritis presumed to be foodborne were reported by guests of a Winnipeg hotel. Investigation revealed poor food-handling practices and illness among the kitchen staff. Elevated bacterial counts and Escherichia coli were found in 15 of 24 samples of food tested, and Staphylococcus aureus was isolated from 2 pastry samples. Culture of 14 stool samples for bacteria yielded Clostridium perfringens in 1 sample from a staff member and coagulase-positive S. aureus in 2 samples from staff members and 3 from guests. All of the S. aureus isolates were nonenterotoxigenic and had three different phage patterns. Electron microscopy and immunoelectron microscopy revealed the prototype Norwalk virus in five (56%) of nine stool samples; four samples were from guests, and one was from a kitchen employee. The employee had had diarrhea 24 hours before the first outbreak and was thus believed to be the source of the virus infection, possibly through food handling. This is the first report of Norwalk virus isolation and the first of foodborne Norwalk virus transmission in Canada. A review of foodborne Norwalk virus infections is presented.

Acute Disease↗
PubMed1994

Safe food manufacturing.

Food safety is a growing preoccupation of the health authorities and the major food companies in any European country. All the aspects of food manufacturing, from the raw materials until the product is consumed have to insure they are innoxious to human health, eliminate any harmful effects related either to food handling or consumption in domestic or common eating places, as well as protect, as much as possible, our environment. Thus, the food manufacturer has to examine step-by-step the security of the agro-cultures, their composition, but also the possible residues of pollutants and contaminants, or chemicals used to protect them against various pests and determine the possible loss or retention of these substances during technological processes. Animal raw materials should not contain veterinary drug residues or an abnormal amount of some components that result from inadequate feeding. Care should be taken to ensure the security of foods manufactured by biotechnology processes. The organisms and the whole processes used in food biotechnologies should eliminate any impurities. Any minor food ingredients, such as food additives, are under a permanent revision from the point of view of their safety. The industry reacts immediately if any justification requires that a particular food additive should not be used. In other words all the raw materials must conform to their specifications. Technological processes must create a food with an adequate microbiological quality, e.g. free of pathogens and their toxic metabolites. Any danger of microbiological contamination or accidental pollution, such as mechanical particles, chemical substances, etc. should be eliminated. The particular role of food packaging is crucial, since this is a barrier to protect the food against further parasites or microbial contamination and preserve the food from alterations due to enzymatic reactions that require particular oxygen and water activity conditions. The packaging should also protect against possible criminal damage. In addition, the material of packaging should not allow micro-migration to the food. It should be inert against its food content. Another aspect of food packaging that has to be taken into account is its recovery and recyclability. Finally, the food manufacturer has to ensure that the nutritional value of the product does not diminish through its shelf-life. The consumer should be advised about the effects of culinary practices since some of them, such as deep frying or grilling under certain circumstances, may create undesirable substances potentially harmful to human health. The food manufacturing in the context of the environment protection requires a separate issue.(ABSTRACT TRUNCATED AT 400 WORDS)

Consumer Product Safety↗
PubMed2003

Quantitative risk assessment of human campylobacteriosis associated with thermophilic Campylobacter species in chickens.

A quantitative risk assessment comprising the elements hazard identification, hazard characterization, exposure assessment, and risk characterization has been prepared to assess the effect of different mitigation strategies on the number of human cases in Denmark associated with thermophilic Campylobacter spp. in chickens. To estimate the human exposure to Campylobacter from a chicken meal and the number of human cases associated with this exposure, a mathematical risk model was developed. The model details the spread and transfer of Campylobacter in chickens from slaughter to consumption and the relationship between ingested dose and the probability of developing campylobacteriosis. Human exposure was estimated in two successive mathematical modules. Module 1 addresses changes in prevalence and numbers of Campylobacter on chicken carcasses throughout the processing steps of a slaughterhouse. Module 2 covers the transfer of Campylobacter during food handling in private kitchens. The age and sex of consumers were included in this module to introduce variable hygiene levels during food preparation and variable sizes and compositions of meals. Finally, the outcome of the exposure assessment modules was integrated with a Beta-Poisson dose-response model to provide a risk estimate. Simulations designed to predict the effect of different mitigation strategies showed that the incidence of campylobacteriosis associated with consumption of chicken meals could be reduced 30 times by introducing a 2 log reduction of the number of Campylobacter on the chicken carcasses. To obtain a similar reduction of the incidence, the flock prevalence should be reduced approximately 30 times or the kitchen hygiene improved approximately 30 times. Cross-contamination from positive to negative flocks during slaughter had almost no effect on the human Campylobacter incidence, which indicates that implementation of logistic slaughter will only have a minor influence on the risk. Finally, the simulations showed that people in the age of 18-29 years had the highest risk of developing campylobacteriosis.

Abattoirs↗
PubMed2004

Food safety knowledge, attitudes, and behaviors among Puerto Rican caretakers living in Hartford, Connecticut.

Household food safety education is needed to minimize the risk of exposure to foodborne pathogens. The Latino population in the United States is growing at a fast rate and has become the largest minority group in this country. However, little research has been done to identify the food safety behavioral risks faced by Puerto Ricans. Ten in-depth household observations and a quantitative survey on food safety knowledge, attitudes, and behaviors (n = 100) were conducted to understand food-handling techniques among Puerto Rican caretakers of young children. This was followed by two focus groups (n = 12) to further characterize food safety knowledge, attitudes, and behaviors and the proper media channels for the delivery of food safety education. Even though 97% of survey participants reported washing their hands with soap and water before preparing foods, only 1 of the 10 participants in the household observations actually did it. About 60% of the household participants washed the cutting boards with soap and water compared with 89% of survey participants who claimed to do it. In the survey, 5% reported to know the meaning of cross-contamination, and 71% (n = 80) to use the same cutting board for meats and vegetables. Overall, 96% of survey participants did not use a thermometer to check if meats were cooked properly and only 10% defrosted their meats in the refrigerator. Statistically significant relationships (P < 0.05) were found between speaking English and knowing the meaning of cross-contamination and how to use a meat thermometer. Employed individuals and those with higher education were also more likely to be familiar with the term pasteurization. These results fully justify the delivery of culturally appropriate food safety education in this community.

Adolescent↗