Perceptions of risks of eating undercooked meat and willingness to change cooking practices

Quantitative microbial risk assessment of Salmonella in fresh chicken patties

Quantitative microbial risk assessment (QMRA) has witnessed rapid development within the context of food safety in recent years. As a means of contributing to these advancements, a QMRA for Salmonella spp. in fresh chicken patties for the general European Union (EU) population was developed. A two-dimensional (Second Order) Monte-Carlo simulation method was used for separating variability and uncertainty of model's parameters. The stages of industrial processing, retail storage, domestic storage, and cooking in the domestic environment were considered in the exposure assessment. For hazard characterization, a dose-response model was developed by combining 8 published dose-response models using a Pert distribution for describing uncertainty. The QMRA model predicted a mean probability of illness of 1.19*10-4 (5.28*10-5 - 3.57*10-4 95 % C.I.), and a mean annual number of illnesses per 100,000 people of 2.13 (0.96 - 6.59 95 % C.I.). Moreover, sensitivity analysis was performed, and variability in cooking preferences was found to be the most influential model parameter (r = -0.39), followed by dose-response related variability (r = 0.22), and variability in the concentration of Salmonella spp. at the time of introduction at the processing facility (r = 0.11). Various mitigation strategy scenarios were tested, from which, "increasing the internal temperature of cooking" and "decreasing shelf life" were estimated to be the most effective in reducing the predicted risk of illness. Salmonella-related illnesses exhibit particularly high severity, making them some of the most prominent zoonotic diseases in the EU. Regular monitoring of this hazard in order to further highlight its related parameters and causes is a necessary procedure. This study not only provides an updated assessment of Salmonella spp. risk associated with chicken patties, but also facilitates the identification of crucial targets for scientific investigation and implementation of real-world intervention strategies.

Food Perceptions in Adults with and without ADHD

INTRODUCTION

Adults with attention-deficit/hyperactivity disorder (ADHD) have unhealthy eating habits, associated with overweight/obesity. We explored whether they present with different food-related benefit/risk perceptions, compared to those without ADHD.

METHODS

One hundred five university students with (n = 36) and without (n = 69) ADHD, aged 22-30, participated in the study. They rated the level of frequency and likelihood of food consumption, as well as the perceived attractiveness, convenience, and risk of 32 healthy and unhealthy food items.

RESULTS

The findings revealed significantly lower healthy/unhealthy food frequency consumption ratios for the ADHD group compared with the non-ADHD one but no differences in the ratios of estimated likelihood of food consumption and perceptions (attractiveness, convenience, and risk).

CONCLUSION

The results of this study demonstrated a discrepancy between the eating behavior (more unhealthy eating patterns in adults with ADHD compared with controls) and their food-related perceptions (same perceptions regarding the benefit and risk of foods in both groups).

Food safety knowledge, attitudes, and eating behavior in the advent of the global coronavirus pandemic

The objective of this study was to evaluate the relationships of food safety knowledge, attitude and eating behavior of consumers during national lockdowns in the advent of the COVID-19 pandemic. A total of 157 respondents completed the online survey using a structured questionnaire worldwide. Overall, the respondents exhibited good attitude and good knowledge towards public health including food safety especially on the importance of social distancing, mask wearing, well-balanced diet, physical exercise and personal hygiene, such as hand washing during the pandemic lockdowns. A Structural Equation Modeling (SEM) was used to test the relationships among food safety knowledge, attitude and behavior under the pandemic conditions. Results showed that attitude towards food safety under the coronavirus pandemic and lockdowns positively affected the eating behavior of the respondents, which exhibited a high β (0.686) among the variables tested (p<0.05). Food safety knowledge was apparently not affected by the food safety behavior of the respondents.

Changes in Lighting Source Can Produce Inaccurate Assessment of Visual Poultry Doneness and Induce Consumers To Eat Undercooked Ground Turkey Patties

Undercooked poultry is a potential source of foodborne pathogens, such as Salmonella and Campylobacter. The best way to avoid eating undercooked poultry is to use a food thermometer during cooking. However, consumers who cook poultry often use visual appearance for determining doneness, which relies on extrinsic factors, including lighting conditions. Because the United States recently mandated changes in lighting to promote energy conservation, this study evaluated the effect of lighting sources on consumer perceptions of doneness and willingness to eat cooked poultry patties. Consumers ( n = 104) evaluated validated photographs of turkey patties cooked to different end point temperatures (57 to 79°C) and rated the level of perceived doneness and willingness to eat each sample. Evaluations were conducted under different lighting sources: incandescent (60 W, soft white), halogen (43 W, soft white), compact fluorescent lamp (13 W, soft white), light-emitting diode (LED; 10.5 W, soft white), and daylight LED (14 W). Lighting changed perception of doneness and willingness to eat the patties, with some of the energy-efficient options, such as LED and halogen making samples appear more done than they actually were, increasing the willingness to eat undercooked samples. This poses a risk of consuming meat that could contain bacteria not killed by heat treatment. Recent changes in lighting regulations can affect lighting in homes that affects perceptions of poultry doneness, requiring that educators place extra emphasis on the message that properly using a meat thermometer is the only way to ensure meat is cooked to a safe end point temperature.

Restaurant Cooking Trends and Increased Risk for Campylobacter Infection

Perceived consumer preferences for rare chicken liver are increasing risk for campylobacteriosis.

In the United Kingdom, outbreaks of Campylobacter infection are increasingly attributed to undercooked chicken livers, yet many recipes, including those of top chefs, advocate short cooking times and serving livers pink. During 2015, we studied preferences of chefs and the public in the United Kingdom and investigated the link between liver rareness and survival of Campylobacter. We used photographs to assess chefs’ ability to identify chicken livers meeting safe cooking guidelines. To investigate the microbiological safety of livers chefs preferred to serve, we modeled Campylobacter survival in infected chicken livers cooked to various temperatures. Most chefs correctly identified safely cooked livers but overestimated the public’s preference for rareness and thus preferred to serve them more rare. We estimated that 19%–52% of livers served commercially in the United Kingdom fail to reach 70°C and that predicted Campylobacter survival rates are 48%–98%. These findings indicate that cooking trends are linked to increasing Campylobacter infections.

Explaining Consumer Safe Food Handling Through Behavior-Change Theories: A Systematic Review

Consumers often engage in unsafe food handling behaviors at home. Previous studies have investigated the ability of behavior-change theories to explain and predict these behaviors. The purpose of this review was to determine which theories are most consistently associated with consumers' safe food handling behaviors across the published literature. A standardized systematic review methodology was used, consisting of the following steps: comprehensive search strategy; relevance screening of identified references; confirmation of relevance and characterization of relevant articles; risk-of-bias assessment; data extraction; and descriptive analysis of study results. A total of 20 relevant studies were identified; they were mostly conducted in Australia (40%) and the United States (35%) and used a cross-sectional design (65%). Most studies targeted young adults (65%), and none focused on high-risk consumer groups. The outcomes of 70% of studies received high overall risk-of-bias ratings, largely due to a lack of control for confounding variables. The most commonly applied theory was the Theory of Planned Behavior (45% of studies), which, along with other investigated theories of behavior change, was frequently associated with consumer safe food handling behavioral intentions and behaviors. However, overall, there was wide variation in the specific constructs found to be significantly associated and in the percentage of variance explained in each outcome across studies. The results suggest that multiple theories of behavior change can help to explain consumer safe food handling behaviors and could be adopted to guide the development of future behavior-change interventions. In these contexts, theories should be appropriately selected and adapted to meet the needs of the specific target population and context of interest.

Development of the Consumer Refrigerator Safety Questionnaire: A Measure of Consumer Perceptions and Practices

Food preparation and storage behaviors in the home deviating from the "best practice" food safety recommendations may result in foodborne illnesses. Currently, there are limited tools available to fully evaluate the consumer knowledge, perceptions, and behavior in the area of refrigerator safety. The current study aimed to develop a valid and reliable tool in the form of a questionnaire, the Consumer Refrigerator Safety Questionnaire (CRSQ), for assessing systematically all these aspects. Items relating to refrigerator safety knowledge (n =17), perceptions (n =46), and reported behavior (n =30) were developed and pilot tested by an expert reference group and various consumer groups to assess face and content validity (n =20), item difficulty and consistency (n =55), and construct validity (n =23). The findings showed that the CRSQ has acceptable face and content validity with acceptable levels of item difficulty. Item consistency was observed for 12 of 15 in refrigerator safety knowledge. Further, all 5 of the subscales of consumer perceptions of refrigerator safety practices relating to risk of developing foodborne disease showed acceptable internal consistency (Cronbach's α value > 0.8). Construct validity of the CRSQ was shown to be very good (P = 0.022). The CRSQ exhibited acceptable test-retest reliability at 14 days with the majority of knowledge items (93.3%) and reported behavior items (96.4%) having correlation coefficients of greater than 0.70. Overall, the CRSQ was deemed valid and reliable in assessing refrigerator safety knowledge and behavior; therefore, it has the potential for future use in identifying groups of individuals at increased risk of deviating from recommended refrigerator safety practices, as well as the assessment of refrigerator safety knowledge and behavior for use before and after an intervention.

Risk Assessment of Escherichia coli O157 illness from consumption of hamburgers in the United States made from Australian manufacturing beef

We analyze the risk of contracting illness due to the consumption in the United States of hamburgers contaminated with enterohemorrhagic Escherichia coli (EHEC) of serogroup O157 produced from manufacturing beef imported from Australia. We have used a novel approach for estimating risk by using the prevalence and concentration estimates of E. coli O157 in lots of beef that were withdrawn from the export chain following detection of the pathogen. For the purpose of the present assessment an assumption was that no product is removed from the supply chain following testing. This, together with a number of additional conservative assumptions, leads to an overestimation of E. coli O157-associated illness attributable to the consumption of ground beef patties manufactured only from Australian beef. We predict 49.6 illnesses (95%: 0.0-148.6) from the 2.46 billion hamburgers made from 155,000 t of Australian manufacturing beef exported to the United States in 2012. All these illness were due to undercooking in the home and less than one illness is predicted from consumption of hamburgers cooked to a temperature of 68 °C in quick-service restaurants.

Fish consumption and its motives in households with versus without self-reported medical history of CVD: a consumer survey from five European countries

Background

The purpose of this study was to explore the cross-cultural differences in the frequency of fish intake and in motivations for fish consumption between people from households with (CVD+) or without (CVD-) medical history of cardiovascular disease, using data obtained in five European countries.

Methods

A cross-sectional consumer survey was carried out in November-December 2004 with representative household samples from Belgium, the Netherlands, Denmark, Poland and Spain. The sample consisted of 4,786 respondents, aged 18–84 and who were responsible for food purchasing and cooking in the household.

Results

Individuals from households in the CVD+ group consumed fish more frequently in Belgium and in Denmark as compared to those in the CVD- group. The consumption of fatty fish, which is the main sources of omega-3 PUFA associated with prevention of cardiovascular diseases, was on the same level for the two CVD groups in the majority of the countries, except in Belgium where CVD+ subjects reported to eat fatty fish significantly more frequently than CVD- subjects. All respondents perceived fish as a very healthy and nutritious food product. Only Danish consumers reported a higher subjective and objective knowledge related to nutrition issues about fish. In the other countries, objective knowledge about fish was on a low level, similar for CVD+ as for CVD- subjects, despite a higher claimed use of medical information sources about fish among CVD+ subjects.

Conclusion

Although a number of differences between CVD- and CVD+ subjects with respect to their frequency of fish intake are uncovered, the findings suggest that fish consumption traditions and habits – rather than a medical history of CVD – account for large differences between the countries, particularly in fatty fish consumption. This study exemplifies the need for nutrition education and more effective communication about fish, not only to the people facing chronic diseases, but also to the broader public. European consumers are convinced that eating fish is healthy, but particular emphasis should be made on communicating benefits especially from fatty fish consumption.

Consumer food safety knowledge, practices, and demographic differences: findings from a meta-analysis

Risk communication and consumer education to promote safer handling of food can be the best way of managing the risk of foodborne illness at the consumer end of the food chain. Thus, an understanding of the overall status of food handling knowledge and practices is needed. Although traditional qualitative reviews can be used for combining information from several studies on specific food handling behaviors, a structured approach of meta-analysis can be more advantageous in a holistic assessment. We combined findings from 20 studies using meta-analysis methods to estimate percentages of consumers engaging in risky behaviors, such as consumption of raw food, poor hygiene, and cross-contamination, separated by various demographic categories. We estimated standard errors to reflect sampling error and between-study random variation. Then we evaluated the statistical significance of differences in behaviors across demographic categories and across behavioral measures. There were considerable differences in behaviors across demographic categories, possibly because of socioeconomic and cultural differences. For example, compared with women, men reported greater consumption of raw or undercooked foods, poorer hygiene, poorer practices to prevent cross-contamination, and less safe defrosting practices. Mid-age adults consumed more raw food (except milk) than did young adults and seniors. High-income individuals reported greater consumption of raw foods, less knowledge of hygiene, and poorer cross-contamination practices. The highest raw ground beef and egg consumption and the poorest hygiene and cross-contamination practices were found in the U.S. Mountain region. Meta-analysis was useful for identifying important data gaps and demographic groups with risky behaviors, and this information can be used to prioritize further research.

Knowledge, attitude and practice regarding organic solvents among printing workers in Hong Kong

To find out the prevalence of good knowledge, appropriate attitude and safe practice among printing workers exposed to organic solvents in Hong Kong, and to see if safe practice was influenced by the knowledge of and the attitude towards the harmful effects of organic solvents as well as other factors. The survey was conducted in a sample of 501 male printing workers from 28 factories in Hong Kong. The knowledge of and attitude towards the harmful effects of organic solvents, as well as the good practices adopted by the workers when handling solvents were explored using a questionnaire. Multiple logistic regression analysis was conducted to identify the major factors that influenced the knowledge, attitude and practice of workers. The prevalence of good knowledge, appropriate attitude and safe practice was low, being 20.4%, 38.4% and 22.0% respectively. Good knowledge was positively associated with awareness of the relevant legislation and past drinking behavior and negatively associated with current smoking. Appropriate attitude depended on having good knowledge and younger age. Safe practice did not depend on knowledge and attitude, but was positively associated with being informed of safety precautions and being supplied with chemical information by supervisors. The majority of workers believed that their employers, the Government and other statutory bodies should be responsible for providing information on chemicals, but very few of them actually obtained information from these sources. More workers preferred publications and talks rather than television as the means of obtaining further knowledge on chemicals. Front line supervisors have a pivotal role to play in improving safe practices of workers by informing them of the necessary precautions and supplying the relevant chemical information.

Risk perception of the "mad cow disease" in France: determinants and consequences

Since 1996, when bovine spongiform encephalopathy (BSE) was assessed as a possible human transmissible disease, a variant of Creutzfeldt-Jakob disease (vCJD), French people have entered into a long period of fear and avoidance of beef and bovine byproducts, which produced an unprecedented collapse in the beef market. This article deals with the perceived risk of the "mad cow disease" (MCD) in the French general population. Two surveys were conducted on a representative sample of the adult population, the first one in 2000 during the peak of the crisis and the second one 13 months later in a quieter period. The main assumption we made was that changes in beef consumption are strongly related to the perceived risk of MCD, which we defined as people's cognitive and affective responses to hazard. Our objective was to identify the determinants and consequences of this perceived risk and to compare them in different sociopolitical contexts. The results issued from a bivariate and multivariate analysis show that: (i) the distribution of most of the variables significantly related to the perceived risk identified in the first survey had changed in the second survey, in relation with the reduction of worry and the resumption of national beef consumption; (ii) the propensity for self-protection through avoiding or ceasing beef eating was more related to feelings of worry than to subjective vCJD risk assessments; and (iii) the main determinant of less avoidance to beef products was the preference for beef, a feeling identified prior to emergence of the risk of MCD, remaining unchanged in various contexts.

Consumer perceptions of food safety risk, control and responsibility

Consumer perceptions of risk, control and responsibility related to microbial food safety in domestic food preparation have been investigated. Results showed that consumers demonstrated judgements of 'optimistic-bias' and the 'illusion of control', as well as notions of perceived invulnerability to food poisoning from self-prepared foods. Statistical associations between perceptions of personal risk, control and responsibility and risk and control attributed to 'other people' have been identified. Findings may have negative implications for the effectiveness of consumer food safety education initiatives. It is suggested that consideration of such judgements and associations during the development of future consumer food safety risk communication strategies may increase their effectiveness.

Consumer food handling in the home: a review of food safety studies

Epidemiological data from Europe, North America, Australia, and New Zealand indicate that a substantial proportion of foodborne disease is attributable to improper food preparation practices in consumers' homes. International concern about consumer food safety has prompted considerable research to evaluate domestic food-handling practices. The majority of consumer food safety studies in the last decade have been conducted in the United Kingdom and Northern Ireland (48%) and in the United States (42%). Surveys (questionnaires and interviews), the most frequent means of data collection, were used in 75% of the reviewed studies. Focus groups and observational studies have also been used. One consumer food safety study examined the relationship between pathogenic microbial contamination from raw chicken and observed food-handling behaviors, and the results of this study indicated extensive Campylobacter cross-contamination during food preparation sessions. Limited information about consumers' attitudes and intentions with regard to safe food-handling behaviors has been obtained, although a substantial amount of information about consumer knowledge and self-reported practices is available. Observation studies suggest that substantial numbers of consumers frequently implement unsafe food-handling practices. Knowledge, attitudes, intentions, and self-reported practices did not correspond to observed behaviors, suggesting that observational studies provide a more realistic indication of the food hygiene actions actually used in domestic food preparation. An improvement in consumer food-handling behavior is likely to reduce the risk and incidence of foodborne disease. The need for the development and implementation of food safety education strategies to improve specific food safety behaviors is reviewed in this paper.

A simple, spreadsheet-based, food safety risk assessment tool

The development and use of a simple tool for food safety risk assessment is described. The tool is in spreadsheet software format and embodies established principles of food safety risk assessment, i.e., the combination of probability of exposure to a food-borne hazard, the magnitude of hazard in a food when present, and the probability and severity of outcomes that might arise from that level and frequency of exposure. The tool requires the user to select from qualitative statements and/or to provide quantitative data concerning factors that that will affect the food safety risk to a specific population, arising from a specific food product and specific hazard, during the steps from harvest to consumption. The spreadsheet converts the qualitative inputs into numerical values and combines them with the quantitative inputs in a series of mathematical and logical steps using standard spreadsheet functions. Those calculations are used to generate indices of the public health risk. Shortcomings of the approach are discussed, including the simplifications and assumptions inherent in the mathematical model, the inadequacy of data currently available, and the lack of consideration of variability and uncertainty in the inputs and outputs of the model. Possible improvements are suggested. The model underpinning the tool is a simplification of the harvest to consumption pathway, but the tool offers a quick and simple means of comparing food-borne risks from diverse products, and has utility for ranking and prioritising risks from diverse sources. It can be used to screen food-borne risks and identify those requiring more rigorous assessment. It also serves as an aid to structured problem solving and can help to focus attention on those factors in food production, processing, distribution and meal preparation that most affect food safety risk, and that may be the most appropriate targets for risk management strategies.

Food safety knowledge and behavior of expanded food and nutrition education program participants in Arizona

Consumer education is one of the focus points to reduce foodborne illness within the food safety continuum "from farm to table." A survey was conducted to determine the food safety knowledge and practices of the U.S. Department of Agriculture's Expanded Food and Nutrition Education Program participants in Maricopa and Pima counties of Arizona. Two hundred sixty-eight surveys were completed between 1 January and 31 December 1998. Survey participants consisted of 222 (85%) females and 39 (15%) males with an average age and education level of 31.5 and 11.7 years, respectively. The racial characteristics of this group included 53% whites, 32% Hispanics, 22% African-Americans, and 7% other. A majority of the survey participants (67%) were either unsure or felt it was appropriate to let food cool to room temperature prior to refrigeration. In addition 56% were in disagreement with or unsure about the need to cool foods in shallow containers. Fifty-two percent of respondents reported having no previous formal food safety education; for those who had, work was the most common source. Television news was the primary source of current food safety information for 50% of respondents. The most commonly consumed high-risk (i.e., raw or undercooked animal food or food purchased from unlicensed vendor) food was unpasteurized dairy products. Women scored significantly better than men on food safety knowledge and practice test parameters. Participants over age 50 had significantly higher food safety practice scores than the youngest age group. The food safety knowledge score of whites was significantly higher than that of Hispanics. It was determined for all participants that the food safety knowledge score had a small, positive effect on food safety practice score.

Quantitative risk assessment for Escherichia coli O157:H7 in ground beef hamburgers

Quantitative Risk Assessment (QRA) is a methodology used to organize and analyze scientific information to estimate the probability and severity of an adverse event. Applied to microbial food safety, the methodology can also help to identify those stages in the manufacture, distribution, handling, and consumption of foods that contribute to an increased risk of foodborne illness, and help focus resources and efforts to most effectively reduce the risk of foodborne pathogens. The term Process Risk Model (PRM) is introduced in this paper to describe the integration and application of QRA methodology with scenario analysis and predictive microbiology to provide an objective assessment of the hygienic characteristics of a manufacturing process. The methodology was applied to model the human health risk associated with Escherichia coli O157:H7 in ground beef hamburgers. The PRM incorporated two mathematical submodels; the first was intended to described the behaviour of the pathogen from the production of the food through processing, handling, and consumption to predict human exposure. The exposure estimate was then used as input to a dose-response model to estimate the health risk associated with consuming food from the process. Monte Carlo simulation was used to assess the effect of the uncertainty and variability in the model parameters on the predicted human health risk. The model predicted a probability of Hemolytic Uremic Syndrome of 3.7 x 10(-6) and a probability of mortality of 1.9 x 10(-7) per meal for the very young. These estimates are likely high for all hamburger meals, but may be reasonable for the home-prepared hamburgers described by this model. The efficacy of three risk mitigation strategies were evaluated by modifying the values of the predictive factors and comparing the new predicted risk. The average probability of illness was predicted to be reduced by 80% under a hypothetical mitigation strategy directed at reducing microbial growth during retail storage through a reduction in storage temperature. This strategy was predicted to be more effective than a hypothetical intervention which estimated a plausible reduction in the concentration of E. coli O157:H7 in the feces of cattle shedding the pathogen and one aimed at convincing consumers to cook hamburgers more thoroughly. The conclusions of this approach are only accurate to the extent that the model accurately represents the process. Currently, uncertainty and ignorance about the hygienic effects of the individual operations during production, processing, and handling limit the applicability of a PRM to specify HACCP criteria in a quantitative manner. However, with continuous improvement through stimulated research, a PRM should encompass all available information about the process, food, and pathogen and should be the most appropriate decision-support tool since it represents current knowledge.

Use of predictive microbiology in microbial food safety risk assessment

Microbial risk assessment is a newly emerging discipline in the area of food safety. One of the difficulties associated with microbial risk assessment is in determining the number of microorganisms in food at a given time, i.e.. estimating exposure of an individual to the microorganism. Numbers of bacteria in food can change at all stages of food production and processing, depending on the nature of the food and the way it is handled, stored and processed. Predictive microbiology can be used to estimate changes in bacterial numbers, allowing exposure of an individual to a pathogen to be assessed. A survey was sent to scientists in the food industry to determine their perspective on the role of predictive microbiology in conducting microbial risk assessments. In this paper, responses to that survey are presented, as well as examples of the potential risk of foodborne illness from a cooked meat product contaminated with Staphylococcus aureus and hamburger contaminated with Salmonella.