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PubMed2004

Knowledge, attitudes, and practices of food service staff regarding food hygiene in Shiraz, Iran.

BACKGROUND: The practice of safety measures by the food service staff in hospitals is necessary for the prevention of food-borne outbreaks. Hospitalized patients are more vulnerable to potential hazards, and neglecting these principles can lead to increased morbidity and mortality. METHODS: We assessed the knowledge, attitudes, and practices of food service staff regarding food hygiene in government and private hospitals in Shiraz, Iran. Two questionnaires were designed, one for food service staff and the other for supervisors. Thirty-one hospitals were approached, and the response rate was 99.5%. Four models were developed regarding knowledge, attitudes, and practices, and a multiple logistic regression analysis was performed. Comparison among the government and private hospitals was done. RESULTS: This study showed that personnel had little knowledge regarding the pathogens that cause food-borne diseases and the correct temperature for the storage of hot or cold ready-to-eat foods. Older personnel had better attitudes and practices. Females practiced safety measures less often than did males. Personnel working in hospitals with fewer than 300 beds also had better practices. Most of the personnel had positive attitudes, but disparity between attitude and practice was noted. CONCLUSION: There is a dire need for education and increased awareness among food service staff regarding safe food handling practices.

Adult↗
PubMed2003

Food hygiene practices of food vendors in secondary schools in Ilorin.

This descriptive study was carried out to determine food safety practices among food Vendors in secondary schools in Ilorin. Pre-tested questionnaire and observational checklist were administered to 185 respondents recruited using inclusion and exclusion criteria. One hundred and eighty-two (98.4%) of the subjects were females and only 6(3%) were teenagers. One hundred and two (56.8%) had no formal education while 72(39% had received training on food hygiene. Pre-employment medical examination practice was high 141(76%) but periodic medical examination was low 30(16%). Sixty-one (33%) and seventy-two(39%) respondents prepared food well in advance and reheat food before sale respectively. Vendors who prepared food well in advance (over 4 hours) were found to practise food re-heating more than those who prepared food within 4 hours before sale, and this is statistically significant. The major unhygienic practices observed among the food vendors were poor care of used utensils 100(54%), use of previously used water for washing and cleaning, lack of covering apron among the vendors 128(69%) and lack of wash hand basin for immediate cleaning 61(33%). Only 85(46%) of the respondents used soap and water to clean their utensils while the rest 100(54%) used unhygienic methods to clean their utensils. It was observed that respondents who used soap and water for cleaning, vended food at locations that were relatively closer to water source, compared to other vendors who used other methods to clean their utensils. This is also statistically significant. Unkempt fingernails, skin lesions and poor food protection from flies were some of the food contaminating risk factors observed in the study. The need exists for food vendors and other food handlers to be trained on basic principles of safe food handling.

Adolescent↗
PubMed2004

Hospital food handlers in Niterói, RJ, Brazil: intestinal parasitism.

A survey for intestinal parasites was carried out with food handlers from two private and three public hospitals in Niterói City, RJ, Brazil. The aim of this research was to verify the enteroparasites prevalence in this professional group. The investigation was divided in two phases. The first phase consisted of interviews with the participants; coproparasitological exams using Lutz, Faust et al. and Baermann techniques; under fingernail material analysis, using Mello et al. modified method; and educational lectures to food handlers. In the second phase, coproparasitological exams were repeated. Positive results were observed in 14.2% (17/120) and 17.1% (12/70) of the individuals in the first and second phases respectively. The most frequent parasite was Entamoeba coli, detected in 48.5% (16/33) of the samples with positive results. Under fingernail residues were observed in 19.2% (23/120) of the food handlers. E. coli cysts were found in one fingernail residue, likewise they were detected in the feces of the same food handler. Such data showed a potential transmission risk of intestinal parasites by food handling, indicating the need of adopting a diagnosis/orientation procedure as a bi-annual routine activity in hospitals, in order to improve the food service quality and population health condition.

Adult↗
PubMed1997

[Enteroparasitoses in food handlers of the public schools in Uberlândia (Minas Gerais), Brazil].

A prospective study based on a parasitologic survey was carried out with a view toward controlling enteroparasitoses in food handlers who work in public primary schools in Uberlândia, Minas Gerais, Brazil. The study subjects were 264 individuals from 57 schools, from whom three fecal samples (C) were collected: C1 in September 1989, C2 in April 1990, and C3 in September 1990. The participants were predominantly female (259 women and 5 men) and ranged in age from 20 to 66 years. A total of 792 samples were preserved in 10% formalin and analyzed using the method of Hoffman, Pons, and Janer. Intestinal parasites were found in 17%, 10%, and 10% of the C1, C2, and C3 samples, respectively. The following organisms were found in C1: Giardia lamblia (8%), ancylostomids (6%), Ascaris lumbricoides (3%), Entamoeba histolytica (2%), Strongyloides stercoralis, Hymenolepis nana, Taenia sp., and Trichuris trichiura (less than 1% each). Parasites found in C2 were: ancylostomids (5%), G. lamblia (2%), A. lumbricoides (1%), S. stercoralis, H. nana, Taenia sp., and Enterobius vermicularis (less than 1% each). In C3, the parasites observed were: ancylostomids (5%), G. lamblia (3%), A. lumbricoides (2%), S. stercoralis, and E. vermicularis (less than 1% each). After each collection, the individuals found to be infected received specific treatment. The authors recommend the establishment of epidemiologic surveillance through periodic parasitologic exams, specific treatment, and training on hygienic food handling and personal hygiene for all food handlers.

Adult↗
PubMed2001

Pre-employment health assessments for food handlers: a survey of occupational physicians in the food industry.

The format of pre-employment health screens within the food industry varies considerably. The aim of this study was to produce a consensus on the content of a screen that will enable employees to handle food with minimum risk to the product and employee. A questionnaire was sent to the 63 members of the Food Industry Medical Association, of whom 45 (71%) responded. As a minimum, a questionnaire completed by the applicant is thought to be sufficient. Applicants reporting health problems need to be assessed by a health professional.

Food Contamination↗
PubMed1994

Evaluation of the safety of domestic food preparation in Malaysia.

Food-handling practices were studied in 119 and 158 households, respectively, in an urban and a rural community in Peninsular Malaysia. Hazard analyses, including microbiological analysis of foods, were carried out in two households in each community and in a house that prepared food for distribution in the urban area. Kitchen hygiene was generally acceptable, although rated "poor" in some instances in the rural area. Food prepared for lunch was usually sufficient for dinner also, the leftover items being stored at ambient temperature until required. In the house that prepared food for distribution, breakfast was prepared during the evening, stored at ambient temperature overnight, and reheated before sale the next morning. There was a local preference for cooking food at temperatures close to boiling point; this reduced the numbers of vegetative cells but not those of spores. In some stored foods the populations of Staphylococcus aureus, Bacillus cereus and mesophilic aerobic bacteria increased, the last-mentioned reaching spoilage levels. Reheating reduced the populations of proliferating bacteria in most foods to acceptable levels but would not have destroyed heat-resistant enterotoxins. Because of their importance in combating acute bacterial foodborne disease, the control of the temperature and time factors during the cooking and storage of food should receive special attention in education on health and food safety.

Cooking↗
PubMed1991

Urticarial contact dermatitis in food handlers.

OBJECTIVE: To show that prick testing (using fresh samples of the food suspected from the patient's history) and not only patch testing is the appropriate investigation in selected cases of hand dermatitis in patients who spend considerable time handling foods (for example, catering workers, cooks). SETTING: The Contact and Occupational Dermatitis Clinic at the Skin and Cancer Foundation, a tertiary referral centre in Sydney. PATIENTS: Fourteen patients with hand dermatitis present for an average of 6.17 years referred by dermatologists and occupational health physicians. INTERVENTIONS: Patch and prick tests were performed for each patient. RESULT: In all patients prick tests identified the food allergens. Seafood was the most common allergen giving positive results in 10 patients. Patch tests did not identify any of the food allergens. Of the 14 patients nine were followed up and seven of these had been forced to change their career direction. CONCLUSION: Prick testing is the appropriate investigation in selected cases for the diagnosis of urticarial contact dermatitis in food handlers.

Adolescent↗
PubMedDate not supplied

[1st isolation of strains of Staphylococcus aureus producing toxic shock syndrome toxin 1 in food handlers in Argentina].

Thirty nine milk handlers from a factory of dairy products in the Province of Buenos Aires were examined for their nasal carriage of S. aureus strains capable of producing toxic-shock-syndrome toxin-1 (TSST-1). In addition, chance samples of handled foods, crude milk and milky fermented derivates (MFD) were studied. Strain isolation was made on Mannitol Salt Agar and on Baird-Parker Agar. Typical colonies were identified by their biochemical properties. Cultures that were found to be S. aureus were selected for analysis of the TSST-1 production. Eight milk handlers (20.5%) were carriers of S. aureus strains. Seven isolates (87.5%) were classified as biotype A (human ecovar) and 1(12.5%) was classified as biotype B (swine and poultry ecovar). Three out of 8 S. aureus biotype A isolates (37.5%), produced TSST-1. Taking into account the number of milk food handlers sampled (39), the carried rate of toxigenic strains was 7.6%. Three S. aureus strains were isolated from crude milk; 1(33.3%) was classified as biotype B and 2(66.6%) as biotype C (cattle and sheep ecovar). Thirteen S. aureus strains were isolated from MDF; 5(38.0%) were classified as biotype A, 1(7.7%) as belonging to biotype B and 7(53.8%) as belonging to biotype C. None of them had the ability to produce TSST-1.

Animals↗
PubMed1997

A mixed foodborne outbreak with Salmonella heidelberg and Campylobacter jejuni in a nursing home.

OBJECTIVE: To investigate a mixed Salmonella heidelberg and Campylobacter jejuni foodborne outbreak in a nursing home. DESIGN: Retrospective cohort study with a nested case-control design. Cases were defined by positive stool-culture results. Controls needed to be both asymptomatic and culture-negative. SETTING AND PATIENTS: Residents of a 580-bed nursing home in Brooklyn, New York. RESULTS: Of the 580 residents, 119 (21%) developed illness. Of the 93 symptomatic patients who submitted specimens, cultures were positive for S heidelberg in 24 (26%), C jejuni in 14 (15%), and both microorganisms in 25 (27%). Only the pureed diet was associated highly with infection by either Salmonella (odds ratio [OR], 17.6; 95% confidence interval [CI95], 4.8-68.7; P < .001), Campylobacter (OR, 13.3; CI95, 3.2-59.2; P < .001), or both organisms (OR, 8.9; CI95, 2.7-30.3; P < .001). Among the 42 pureed foods served during the 5 days before the outbreak, five meat or poultry items were associated most strongly with culture positivity. Of these five meat items, only a chopped-liver salad was implicated by the two employees reporting illness. A reported food-handling error occurred when ground, cooked chicken livers were placed in a bowl containing raw chicken-liver juices. INTERVENTION: Recommendations for proper cleaning and sanitizing of kitchen equipment to prevent cross-contamination between raw and cooked foods. CONCLUSIONS: Mixed foodborne outbreaks occur rarely. During this outbreak, contamination of a single food item with multiple bacterial pathogens was the likely source of transmission. Improper food-handling techniques that promote growth of one microorganism also allow growth of other pathogens that may be present. Because different sources and routes of transmission may be implicated for different pathogens, specific preventive measures may vary depending on the organisms involved.

Campylobacter Infections↗
PubMed2003

Enteric illness in Ontario, Canada, from 1997 to 2001.

Enteric illness is a common problem worldwide. In Ontario (population of 11.4 million, 2001 Census of Canada), laboratory-confirmed cases of "reportable" enteric diseases are reported to local health units. Public health staff members investigate these illnesses and subsequently report details to the Ministry of Health and Long-Term Care through an electronic reporting system. From 1997 to 2001, 44,451 sporadic cases of illness attributable to eight enteric pathogens (Campylobacter, Salmonella, verotoxin-producing Escherichia coli, Yersinia, Shigella, hepatitis A, Listeria, and Clostridium botulinum) were reported. This number was less than the 56,690 cases reported from 1992 to 1996. Campylobacter accounted for the highest annual average incidence rate at 42.3 cases per 100,000 persons, with Salmonella following at 22.6, verotoxin-producing E. coli at 3.7, Yersinia at 3.0, Shigella at 2.7, hepatitis A at 2.3, and Listeria at 0.3. The 4 months from June to September accounted for almost half (46.5%) of all cases. For 74.0% of the outbreaks associated with these eight enteric pathogens, foodborne contamination was identified as the mode of transmission. Poultry and other meat items accounted for 68.4% of the food items when food was identified as the vehicle. Admittedly, the "foods" and "modes of transmission" identified may have been subject to investigator bias based on previous knowledge. The most common risk setting, which was reported in approximately half of the cases, was private homes; travel-associated illness and restaurants were the second and third most frequently reported risk settings at 24.6 and 14.1%, respectively. Findings from this study suggest that public health efforts should be directed toward safe food handling in the home during the summer months.

Adolescent↗
PubMed1997

Strategies to control Salmonella and Campylobacter in raw poultry products.

Foodborne illness is a major public health concern. The largest number of foodborne illness cases attributed to poultry and poultry products are caused by paratyphoid serotypes of Salmonella and by Campylobacter jejuni. The effective prevention of foodborne disease requires an understanding that contamination can be introduced into foods at numerous points along the food chain. Since multiple entry points exist for foodborne pathogens, multifaceted intervention approaches are required to successfully control contamination of poultry during the various phases of the growth period and processing procedure of broiler chickens. Strategies during the grow-out period (the period during which day-old chicks are raised to six- to seven-week-old broiler chickens) include sanitation, biosecurity, vaccine and drug therapy, and biological control procedures, such as those aimed at preventing colonisation. There are also many critical control points identified in the processing plant which reduce contamination. These include temperature controls (washer and product), chemical interventions, water replacements and counter-flow technology in the scalder and chiller, and equipment maintenance. Transportation and food handling at retail outlets and by the consumer (i.e., storage at the proper temperature and adequate cooking) are the final critical control points in the farm-to-table continuum. It is important to apply risk reduction strategies throughout the food chain. These include: easing the development and implementation of voluntary animal production 'best management practices', implementing in-plant hazard analysis and critical control point systems, developing effective transportation and refrigeration standards, working to facilitate adoption of the model Food Code in all States and providing educational materials and support for public health activities nationwide.

Animals↗
PubMed1981

The occurrence of Campylobacter jejuni in fresh food and survival under different conditions.

Campylobacter jejuni was an almost regular finding in chickens and in minced meat from pigs and cattle sold in ordinary food stores. The bacteria survived on the food at 4 degrees C for one week and frozen at -20 degrees C for three months. None of the strains tested survived heat treatment at 60 degrees C for longer than 15 min. C. jejuni is apparently a frequent guest in most kitchens. Correct food handling and heat treatment to at least 60 degrees C for 15 min should be enough to prevent infection.

Animals↗
PubMed2005

A training course on food hygiene for butchers: measuring its effectiveness through microbiological analysis and the use of an inspection checklist.

The effectiveness of food hygiene training for a group of retail butchers was evaluated with the aim of verifying whether the butchers modified their behavior in the light of knowledge gained and whether their acquired knowledge or behavior change was sustained over a period of time. Microbiological analysis (enumeration of mesophilic and coliform bacteria and Escherichia coli) of a raw semiprocessed product (stuffed rolled beef) was conducted, and an inspection checklist was issued before the training course (T0). Initial results were later compared with results obtained 1 month (T1) and 6 months (T6) after the training. The checklist comprised 89 items classified into five categories: A, approved suppliers and product reception; B, storage conditions and temperature control; C, flow process, food handling procedures, and conditions of the window display unit; D, facility design and proper cleaning and sanitizing of equipment, utensils, and work surfaces; and E, pest control system, water supply control, and garbage disposal. The inspection results were recorded as "yes" or "no" for each item. Compliance with food safety procedures was recorded as the percentage of "yes" answers. The bacterial counts were significantly higher at T0. At T6, there was no significant increase in bacterial counts. There was a significant improvement in food safety practices at T1 and T6 compared with T0 for all categories. When comparing T0 and T1, the largest increases in the compliance scores were seen within categories C and D. No significant decrease in scores for compliance with food safety practices was observed at T6. Supervision and refresher activities may be necessary to maintain behavioral changes for a longer period of time.

Animals↗
PubMed1992

A foodborne outbreak of group A streptococcal disease at a birthday party.

A severe foodborne outbreak of group A streptococcal disease (T28) affected 122/169 people (72%) who attended a church party or ate leftovers from the party. The median incubation time was 42 h. Muscular pain or weakness and fatigue usually preceded pharyngeal symptoms. Complications included otitis media with perforation, peritonsillitis requiring tonsillectomy, arthritis and pericarditis. A 45-year-old man died 36 h after he developed an influenza-like illness, and at necropsy there were histological signs of early streptococcal septicaemia. The strain produced erythrogenic exotoxins B and C. Streptococci were probably transmitted by sliced eggs on sandwiches. Laboratory experiments showed that there was an increment in viable count of streptococci with 6 logs after incubation in egg yolk for 24 h at room temperature. The unusually warm climate and flaws in food handling routines contributed to this large foodborne epidemic.

Adolescent↗
PubMed1996

Rapid sampling of extracellular dopamine in the rat prefrontal cortex during food consumption, handling and exposure to novelty.

We report the effects of physiological stimuli on extracellular dopamine (DA) in the medial prefrontal cortex (PFC) of the rat determined on-line in dialysates obtained every 5.5 min. The detection limit for DA was 0.03-0.1 pg/5 microl injection using a conventional HPLC set-up. Basal levels in PFC were at the detection limit, therefore 3 microM nomifensine was included in the Ringer perfusion fluid, producing readily detectable DA levels of 0.9 pg/injection. Perfusion with 3 microM TTX for 30 min decreased DA within 11 min to 10% of control. The routine use of rapid sampling of extracellular DA was applied to study cortical DA release in relation to behaviour. Exposure to a novel environment for 5.5 min led to an increase to 135%. Presentation of a food pellet to food-deprived rats resulted in a rapid increase to 150% within 5.5 min, which lasted 30-40 min, which is 10-20 min more than the time spent eating. Handling the rat for 5.5 min increased DA in PFC within 5.5 min to 160% and in 11 min to 190% of control followed by a 25-min period of a 50% increase, probably reflecting increased arousal. The results suggest that emotional arousal is a common denominator of increased cortical DA release and that responses are graded depending on the intensity of the stimulus.

Animals↗
PubMed2004

Risk factors for transmission of foodborne illness in restaurants and street vendors in Jakarta, Indonesia.

In a previous risk factor study in Jakarta we identified purchasing street food as an independent risk factor for paratyphoid. Eating from restaurants, however, was not associated with disease. To explain these findings we compared 128 street food-vendors with 74 food handlers from restaurants in a cross-sectional study in the same study area. Poor hand-washing hygiene and direct hand contact with foods, male sex and low educational level were independent characteristics of street vendors in a logistic regression analysis. Faecal contamination of drinking water (in 65 % of samples), dishwater (in 91 %) and ice cubes (in 100 %) was frequent. Directly transmittable pathogens including S. typhi (n = 1) and non-typhoidal Salmonella spp. (n = 6) were isolated in faecal samples in 13 (7 %) vendors; the groups did not differ, however, in contamination rates of drinking water and Salmonella isolation rates in stools. Poor hygiene of street vendors compared to restaurant vendors, in combination with faecal carriage of enteric pathogens including S. typhi, may help explain the association found between purchasing street food and foodborne illness, in particular Salmonella infections. Public health interventions to reduce transmission of foodborne illness should focus on general hygienic measures in street food trade, i.e. hand washing with soap, adequate food-handling hygiene, and frequent renewal of dishwater.

Adult↗
PubMed2002

An outbreak of infections with a new Salmonella phage type linked to a symptomatic food handler.

In December 2001, the South Australian Communicable Disease Control Branch investigated an outbreak of gastrointestinal illness linked to a Korean style restaurant in metropolitan Adelaide. Twenty-eight people were identified as having experienced gastrointestinal symptoms subsequent to dining at the restaurant between 9 and 12 December 2001. A case-control study implicated mango pudding dessert (OR 16.67 95% CI 2.03-177.04) and plain chicken (OR 10.67 95% CI 1.04-264.32). Nineteen cases and one food handler submitted faecal specimens that grew Salmonella Typhimurium 64var. Two samples of mango pudding and one sample of pickled Chinese cabbage also grew Salmonella Typhimurium 64var. The infected food handler reported an onset of illness 2 days before cases first reported eating at the restaurant. The food handler's only role was to prepare the mango pudding dessert in an area external to the restaurant's kitchen. Illness was strongly associated with consumption of a contaminated mango pudding dessert, with contamination most likely resulting from the symptomatic and culture positive food handler who prepared the dish. This outbreak demonstrates the importance of excluding symptomatic food handlers, and the need for appropriately informing and educating food handlers regarding safe food handling procedures. Restaurants with staff and management from non-English speaking backgrounds should be specifically targeted for education that is both culturally sensitive and language specific.

Adolescent↗