The Knowledge and Practices Toward Food Safety Measures at Home in the Lebanese Community

Hygienic measures practiced at home are highly related to the occurrence of food-borne diseases during food production, storage, and handling. Contaminated food remains a major cause of several diarrheal diseases, hospitalizations, and spikes in medical expenses. In our current study, we aimed to assess the knowledge of food safety and the food safety and hygiene practices at home among the Lebanese population. A cross-sectional study was conducted through an online questionnaire including two sections. The first section included socio-demographic characteristics of participants, whereas the second section included questions related to practices and knowledge about food safety, divided into five parts; personal hygiene practices, dry and cold storage, sanitizing and cleaning and food intoxication. A total of 1101 Lebanese above 18 years participated and provided their responses to the questionnaire. Overall, the majority of participants had fair knowledge about food safety where 96.8% of the participants answered correctly about preventing microbial growth on food. 77.9% of those participants acquired their knowledge about food safety from articles, workshops, or the internet. Moreover, females, people with children and those who cook for themselves scored significantly higher than others (68.8, 70.6, and 70%, respectively). In comparison to younger participants (67.8%), older participants (50+ and 30-49) scored higher at 69.7% and 68.9%, respectively. Higher scores were obtained for questions related to storing dried foods/meat and poultry products with percentages 91.4 and 87.8%, respectively. However, lower scores were noticed on questions related to washing raw chicken before handling and storing eggs (9.7 and 12.3%, respectively). Altogether, our results revealed the need for directed food safety awareness campaigns at the national level to educate the Lebanese community about domestic food handling practices. We believe these campaigns can significantly reduce related diseases and hospitalizations.

Assessment of the risk of contamination of enteral nutrition bottles based on the simulation of home use conditions and hygiene procedures

BACKGROUND

Home-prepared enteral formulations are supplied to patients through enteral nutrition bottles, via a gravity bag or other container, which may be inadequately sanitized and reused more times than recommended by the manufacturer. Such procedures increase the risk of contamination and can compromise the patient's clinical outcome. In light of this, the present study aimed to assess the risk of contamination of enteral nutrition bottles by simulating home use conditions and hygiene procedures.

METHODS

A simulation of bottle usage was conducted across the three categories of enteral nutrition (homemade enteral preparations, blended enteral preparations, and commercial enteral formulas) for 3 days, using three hygiene procedures reported by caregivers: use of detergent (DET); use of detergent and boiling water (DET+BW); and use of detergent and bleach (DET+BL). The microbiological contamination was determined by the analysis of aerobic mesophilic microorganisms.

RESULTS

The bottles that were used for 3 days, regardless of the enteral nutrition category, were within the acceptable limit for aerobic mesophilic microorganisms (between <4 and 8.0 colony-forming units [CFU]/cm2 ) when sanitized using the DET+BW and DET+BL procedures. The enteral nutrition bottles, when cleaned using the DET procedure during the 3 days of usage, showed low microbial contamination (between <4 and 3.0 CFU/cm2 ) in blended preparation and commercial formula only.

CONCLUSION

Thus, regardless of the enteral nutrition category, we found that the bottles can be used for 3 days, as long as the DET+BW or DET+BL hygiene procedure is applied and safe food handling measures are adopted.

Community Practices, Published Guidelines, and Evidence Base Surrounding Breast Milk Handling and Storage: A Qualitative Study

Background: Expressed breast milk (EBM) is the best alternative to direct breastfeeding. However, expressing breast milk requires good milk handling and storage practices to preserve EBM safety and integrity. Mothers require handling and storage guidance, and many seek this from the internet and online support groups. Aim: This study aimed at exploring EBM handling and storage practices within an online exclusively expressing community and comparing these with both internet resources and evidence-based research. Methods: A naturalistic observational design was used. Content analysis was undertaken on 10,000 posts from an Australian Facebook peer-support community for women who exclusively express breast milk. Women's questions, reported practices, and advice for EBM handling and storage were analyzed thematically and compared with both guidelines and evidence-based research. Findings: There were 460 posts on EBM handling and storage. Three key themes emerged: "How should I store my EBM?," "How long can I store my EBM?," and "How do I use my EBM?" The greatest consistency and agreement between recommendations and community practices were found for storage methods, whereas the least was found for storage times. EBM handling and storage practices were influenced by factors such as EBM value, convenience, and cost, leading to occasional deviations from consistent practice recommendations. Conclusion: To facilitate safe EBM handling and continuation of expression, guidelines should be updated so they are consistent, align with current evidence, and cater to mothers' cost, convenience, and milk wastage concerns. Health care providers can partner with women to evaluate online information to empower mothers in their decision making.

Development of educational package and participatory consumer groups to improve food handling practices in food establishments in Sri Lanka

Objectives

Improper food handling contributes to many foodborne diseases and food outbreaks globally leading to witnessed morbidities and mortalities. The study aims to develop an educational package and participatory consumer groups to improve food handling practices among food handlers and in food establishments in the Regional Director of Health Services area, Kalutara, Sri Lanka.

Methods

The study developed an educational package and participatory consumer groups to improve the food handling practices among food handlers and in food establishments. The critical knowledge gaps were identified during the first component of this study, which was conducted as a descriptive study, and the findings were further discussed in the Focus Group Discussion. Posters, info sheets, and workshops were used for educational packages, and four consumer groups were formed. The second component of the study following the development of the interventions was continued as a three-arm, non-randomized controlled community trial for 4 months in the Regional Director of Health Services, Kalutara.

Results

The educational package for food handlers was introduced as a package of a workshop, info sheets, posters to display at workplaces, and short refresher training two weekly to direct good food handling practices in food establishments. Consumer groups were strengthened to exercise their legal rights on their purchases and the ratings showed improvements in the hygiene levels with repeated consecutive visits.

Conclusions

The novel educational package and participatory consumer groups are designed and implemented to improve food handling practices among food handlers and in food establishments.

Evaluation of Food Safety Knowledge and Attitudes Among Adults in the United Arab Emirates

Background Food is handled by many individuals in large food setups, therefore increasing the chance of contamination that leads to foodborne diseases (FBDs). This study was purposed to evaluate adults' understanding of food safety, FBDs, and hygiene practices across various demographic groups in the United Arab Emirates (UAE) and to explore the link between their knowledge of food safety and their corresponding attitudes. Methods A cross-sectional study was conducted with 402 adults using a validated, self-administered questionnaire available in both printed and online formats. The study was carried out at Gulf Medical University and Thumbay hospitals and clinics over six months, beginning in December 2022 to June 2023. Data analysis was performed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). The chi-squared test was employed to examine the association between variables, and significant associations were further analyzed through logistic regression. Results Out of the 402 participants, the population was predominantly female 275 (67.9%), and from Southeast Asia 222 (55.4%), with students comprising the largest occupational group 186 (47%). Only 106 (26.36%) had received food safety training, and a mere 187 (46.51%) demonstrated adequate knowledge. Awareness levels varied, with the highest for raw food safety (64.02%) and the lowest for canned foods (40.79%). Demographic analysis revealed significant associations: males exhibited more inadequate knowledge 79 (62.2%) than females 136 (49.4%), and students showed higher inadequacy 104 (55.9%) compared to healthcare workers 31 (35.6%). Positive attitudes towards food safety were prevalent 226 (56.2%), and positive attitudes were found in women 157 (57.1%), individuals above 30 years of age 110 (50.5%), individuals working in healthcare 140 (62%), and married individuals 117 (60.9%). With a strong correlation (p<0.001), women were 1.68 times more likely to possess adequate knowledge than men (95% CI: 1.09, 2.59), and healthcare workers were 2.33 times more likely than students (95% CI: 1.37, 3.95). Conclusion The study reveals a low level of knowledge about food safety among adults in the UAE. Therefore, emphasis should be placed on increasing awareness of these concepts to reduce the burden of FBDs on the healthcare system.

Development of a food handling practices assessment tool based on the Sri Lanka food regulations

Objectives

Neither the current assessment tool of Sri Lanka for food establishments is based on prevailing Food Regulations 2011 nor did its focus cover serious adaptions for precautions upon prevention of the diseases. The study aims to develop a food handling practices assessment tool based on the Sri Lanka Food Regulations 2011 and to assess food handling practices using a developed tool in the Regional Director of Health Services area, Kalutara.

Methods

The study consisted of developing food establishments' assessment tool (FEAT) in accordance with Food (Hygiene-1742/26) Regulations of Sri Lanka 2011 and assessing the food establishments using the developed tool in the Regional Director of Health Services area, Kalutara, Sri Lanka. The development of FEAT was carried out to mark inspection scores for food establishments conforming to Food Regulations, others reviewed international food safety protocols and agreements following key informant interviews and focus group discussions. Fully developed FEAT was transferred to a mobile application for ease of use, and assessments were conducted among 421 food establishments in three Medical Officer of Health areas.

Results

FEAT contained 11 domains including 75 items with more than 100 assessment points including a guide to conducting an assessment of food handling, compared to the current version of the assessment tool in Sri Lanka. The majority of participants included in the qualitative assessment agreed to include a 1-5 scoring scale to report hygiene levels and to use hygiene regulation to develop FEAT as a legal basis. The highest percentage of food establishments (69.4%) in the "Good" category were in the Bandaragama Medical Officer of Health Area and the highest percentage of food establishments (54.5%) in the "very poor" category were in the Walallawita Medical Officer of Health Area. Food establishments taking precautionary measures, which are not assessed in the current tool, were good, but maintenance of processing area and installation of overhead structures and fitting were poor in food establishments in all three Medical Officer of Health Areas.

Conclusions

The novel food assessment tool FEAT is a completely valid instrument for food establishments. It is designed for easy administration and supports reliable assessments. Overall food handling practices of food establishments in the Kalutara Regional Director of Health Services area following assessment with FEAT were in the "satisfactory" category.

Biogenic Amine Content Analysis of Three Chicken-Based Dry Pet Food Formulations

The pet food market is constantly expanding, and more and more attention is paid to the feeding of pets. Dry foods stand out and are often preferred due to their long shelf life, ease of administration, and low cost. In this context, dry foods are formulated from fresh meats, meat meals, or a mix of the two. These raw materials are often meat not fit for human consumption; they might be subject to contamination and proliferation of microorganisms which, by degrading the organic component, can lead to the formation of undesirable by-products such as biogenic amines. These nitrogenous compounds obtained by decarboxylation of amino acids can therefore be found in high-protein foods, and their ingestion in large quantities can cause intoxication and be harmful. This study aims at analyzing the possible presence of biogenic amines in three different formulations of chicken-based kibbles for pets: one obtained from fresh meat, one from meat meal, and one from a mix of the two. This study is also focused on the presence of free amino acids as they represent the key substrate for decarboxylating enzymes. Mass spectrometry (Q-TOF LC/MS) was used to analyze the presence of biogenic amines and free amino acids. The results show that fresh-meat-based products have a lower content of biogenic amines, and at the same time a higher quantity of free amino acids; on the contrary, meat-meal- and mix-based products have a greater quantity of biogenic amines and a lower concentration of free amino acids, suggesting that there has been a higher microbial proliferation as proved by the total aerobic mesophilic bacteria counts. It is therefore clear that fresh-meat-based kibbles are to be preferred when they are used for preparing dry pet food due to the lowest concentration of biogenic amines.

Manipulation-specific cortical activity as mice handle food

Food handling offers unique yet largely unexplored opportunities to investigate how cortical activity relates to forelimb movements in a natural, ethologically essential, and kinematically rich form of manual dexterity. To determine these relationships, we recorded high-speed (1,000 fps) video and multi-channel electrophysiological cortical spiking activity while mice handled food. The high temporal resolution of the video allowed us to decompose active manipulation ("oromanual") events into characteristic submovements, enabling event-aligned analysis of cortical activity. Activity in forelimb M1 was strongly modulated during food handling, generally higher during oromanual events and lower during holding intervals. Optogenetic silencing and stimulation of forelimb M1 neurons partially affected food-handling movements, exerting suppressive and activating effects, respectively. We also extended the analysis to forelimb S1 and lateral M1, finding broadly similar oromanual-related activity across all three areas. However, each area's activity displayed a distinct timing and phasic/tonic temporal profile, which was further analyzed by non-negative matrix factorization and demonstrated to be attributable to area-specific composition of activity classes. Current or future forelimb position could be accurately predicted from activity in all three regions, indicating that the cortical activity in these areas contains high information content about forelimb movements during food handling. These results thus establish that cortical activity during food handling is manipulation specific, distributed, and broadly similar across multiple sensorimotor areas while also exhibiting area- and submovement-specific relationships with the fast kinematic hallmarks of this natural form of complex free-object-handling manual dexterity.

The Critical Role of Consumers in the Prevention of Foodborne Diseases: An Ethnographic Study of Italian Families

A high incidence of foodborne diseases occurs in the home setting because consumers adopt inappropriate preparation, consumption, and storage procedures. The present study applies an ethnographic approach to identify inadequate practices that could increase the incidence of foodborne diseases. Techniques related to the ethnographic approach were used: participant observation, kitchens mapping, collection of photographic material, and informal interviews in natural settings. A sample of 14 families was involved through the snowball sampling technique. This study identifies habitual practices and routine behaviour as the main risk factors. The inadequacies most frequently encountered related to the microbiological risks are incorrect handwashing, the presence in the kitchen spaces of objects unrelated to food preparation, the improper use of dishcloths and sponges, the inappropriate washing of utensils and food, the incorrect storage of food in the fridge, and the presence of children and pets without an adequate administration of the spaces. The practices that can expose consumers to chemical risk include food preservation through unsuitable containers/materials, food overcooking, and detergents contamination. The data underline the need to implement communicative and training interventions that give precise and targeted indications about correct safety practices in the home setting.

Hygienic Food Handling Practices and Associated Factors Among Food Handlers in Ethiopia: A Systematic Review and Meta-Analysis

BACKGROUND

The food handling practices of food handlers can have a significant impact on the hygienic status of the food. The aim of this study was to determine the prevalence and factors associated with hygienic food handling practices among food handlers in Ethiopia.

METHODS

PubMed, Science Direct, Google Scholar, and the Cochrane Library databases were used to find articles. Only cross-sectional studies that met the criteria for inclusion were considered. STATA version 16 statistical software was used to perform the meta-analysis. The study's heterogeneity was determined using Cochrane Q test statistics and the I ² test. A random effect model was used to calculate the pooled prevalence of hygienic food handling practices.

RESULTS

To estimate the pooled prevalence of hygienic food handling practices in Ethiopia, 9 out of 33 reviewed studies were included. The prevalence of hygienic food handling practices was found to be 48.36% (95% CI: 39.74-56.99) in this study. Factors associated with hygienic food handling practices included; lack of food safety training (OR = 5.38; 95% CI: 1.71, 16.89), negative attitude (OR = 3.28; 95% CI: 1.50, 7.13), lack of access to handwashing facilities (OR = 4.84; 95% CI: 1.72, 13.65), lack of regular medical checkup (OR = 5.37; 95% CI: 3.13, 9.23), and lack of secondary education (OR = 2.51; 95% CI: 1.46, 4.32) among food handlers.

CONCLUSION

In this study, the prevalence of hygienic food handling practices among Ethiopian food handlers was significantly low. Unhygienic food handling practices were attributed to a lack of food safety training, regular medical checkups, handwashing facilities, an unfavorable attitude toward food hygiene practices, and a lack of formal education. As a result, food handlers should receive ongoing food safety and hygiene training.

Food Safety Knowledge and Practices of Pregnant Women and Postpartum Mothers in Slovenia

Food safety during pregnancy and postpartum is important for preventing foodborne diseases, while pregnant women are considered vulnerable due to their immunomodulatory condition. The current study aimed to investigate the self-reported food safety knowledge and practices of pregnant women and postpartum mothers in Slovenia using an online questionnaire and to compare the results with nonpregnant women as a control group. The study was conducted with 426 women, of whom 145 were pregnant, 191 were not pregnant, and 90 were postpartum. The online questionnaire consisted of questions related to food safety risk perception, hand hygiene, food purchase, food storage, food preparation and handling of infant formula and breast milk. The results showed that women generally have basic knowledge of proper food handling and are aware of food safety, but some specific gaps were identified in food handling at home, especially concerning microbiological risks. However, the results showed that pregnant women performed better than the postpartum group, and both groups performed significantly better than the nonpregnant group. The media was most frequently cited as a source of food safety information, especially by the pregnant group. Trained health workers should also inform women on how to ensure food safety in the home environment.

[Mycobacterium bovis infection in an adolescent with prolonged febrile syndrome]

Bovine tuberculosis is an infectious, zoonotic disease, caused by Mycobacterium bovis. The bovine is the primary host. Other species can be infected (pigs, goats, horses, etc). Man can be infected by air (lung disease), clinically indistinguishable from that produced by Mycobacterium tuberculosis or by oral or cutaneous route (extrapulmonary forms: digestive, lymph node, skin). Contagion has been mainly related to contact with livestock and the consumption of unpasteurized dairy products. It was also reported the possible contagion between people. It is described the case of an adolescent patient, from the province of Buenos Aires, with prolonged febrile syndrome and abdominal lymph node conglomerate, with a history of ingestion of unpasteurized milk. We consider the importance of warning about the correct processing of food, especially at this time when new food trends (homemade dairy intake or bought at informal fairs) could put the health of the population at risk.

Improving Food Safety Culture in Nigeria: A Review of Practical Issues

As a developing nation and the most populous nation in Africa, Nigeria has enormous challenges connected with food safety culture. To produce and provide safe, secure and nutritious food, consumers and food businesses must abide by a set of shared values known as food safety culture. In Nigeria, food safety culture is a complex subject due to Nigeria’s heterogeneous and diverse nature, as demonstrated by its over 250 ethnic groups. As Nigeria becomes more urbanized and incomes continue to fluctuate at robust rates, few Nigerians are conscious of food safety issues. In addition, oversight from government regulators around food safety require improvement. Public engagement in food safety issues has not witnessed a promising trajectory in recent years. In this article, we provide a review of the food safety culture in Nigeria and its role and influence on various cases of food safety issues in Nigeria. Of interest to this paper are studies exploring consumer and food handler perceptions and behavior regarding food safety. In addition, keen attention is devoted to areas that are in need of additional research to help address practical and on-the-ground challenges associated with Nigeria’s food safety practices. This article suggests that improving food safety culture in Nigeria requires both applying the best management and communication approaches in different regions and understanding the local food safety practices.

Rabies virus in slaughtered dogs for meat consumption in Ghana: A potential risk for rabies transmission

Dog-mediated rabies is responsible for approximately 60,000 human deaths annually worldwide. Although dog slaughter for human consumption and its potential risk for rabies transmission has been reported, mainly in some parts of Western Africa and South-East Asia, more information on this and factors that influence dog meat consumption is required for a better understanding from places like Ghana where the practice is common. We tested 144 brain tissues from apparently healthy dogs slaughtered for human consumption for the presence of rabies viruses using a Lyssavirus-specific real-Time RT-PCR. Positive samples were confirmed by virus genome sequencing. We also administered questionnaires to 541 dog owners from three regions in Ghana and evaluated factors that could influence dog meat consumption. We interacted with butchers and observed slaughtering and meat preparation procedures. Three out of 144 (2.1%) brain tissues from apparently healthy dogs tested positive for rabies virus RNA. Two of the viruses with complete genomes were distinct from one another, but both belonged to the Africa 2 lineage. The third virus with a partial genome fragment had high sequence identity to the other two and also belonged to the Africa 2 lineage. Almost half of the study participants practiced dog consumption [49% (265/541)]. Males were almost twice (cOR = 1.72, 95% CI (1.17-2.52), p-value = .006) as likely to consume dog meat compared to females. Likewise, the Frafra tribe from northern Ghana [cOR = 825.1, 95% CI (185.3-3672.9), p-value < .0001] and those with non-specific tribes [cOR = 47.05, 95% CI (10.18-217.41), p-value < .0001] presented with higher odds of dog consumption compared to Ewes. The butchers used bare hands in meat preparation. This study demonstrates the presence of rabies virus RNA in apparently healthy dogs slaughtered for human consumption in Ghana and suggests a potential risk for rabies transmission. Veterinary departments and local assemblies are recommended to monitor and regulate this practice.

Salmonella, Food Safety and Food Handling Practices

Salmonellosis is the second most reported gastrointestinal disorder in the EU resulting from the consumption of Salmonella-contaminated foods. Symptoms include gastroenteritis, abdominal cramps, bloody diarrhoea, fever, myalgia, headache, nausea and vomiting. In 2018, Salmonella accounted for more than half of the numbers of foodborne outbreak illnesses reported in the EU. Salmonella contamination is mostly associated with produce such as poultry, cattle and their feeds but other products such as dried foods, infant formula, fruit and vegetable products and pets have become important. Efforts aimed at controlling Salmonella are being made. For example, legislation and measures put in place reduced the number of hospitalizations between 2014 and 2015. However, the number of hospitalizations started to increase in 2016. This calls for more stringent controls at the level of government and the private sector. Food handlers of "meat processing" and "Ready to Eat" foods play a crucial role in the spread of Salmonella. This review presents an updated overview of the global epidemiology, the relevance of official control, the disease associated with food handlers and the importance of food safety concerning salmonellosis.

A Scooping-Binding Robotic Gripper for Handling Various Food Products

Food products are usually difficult to handle for robots because of their large variations in shape, size, softness, and surface conditions. It is ideal to use one robotic gripper to handle as many food products as possible. In this study, a scooping-binding robotic gripper is proposed to achieve this goal. The gripper was constructed using a pneumatic parallel actuator and two identical scooping-binding mechanisms. The mechanism consists of a thin scooping plate and multiple rubber strings for binding. When grasping an object, the mechanisms actively makes contact with the environment for scooping, and the object weight is mainly supported by the scooping plate. The binding strings are responsible for stabilizing the grasping by wrapping around the object. Therefore, the gripper can perform high-speed pick-and-place operations. Contact analysis was conducted using a simple beam model and a finite element model that were experimentally validated. Tension property of the binding string was characterized and an analytical model was established to predict binding force based on object geometry and binding displacement. Finally, handling tests on 20 food items, including products with thin profiles and slippery surfaces, were performed. The scooping-binding gripper succeeded in handling all items with a takt time of approximately 4 s. The gripper showed potential for actual applications in the food industry.

A Closer Look at Changes in High-Risk Food-Handling Behaviors and Perceptions of Primary Food Handlers at Home in South Korea across Time

Food-handling behaviors and risk perceptions among primary food handlers were investigated by consumer surveys from different subjects in 2010 (N = 609; 1st survey will be called here “Year 2010”) and 2019 (N = 605; 2nd survey will be called here “Year 2019”). Year 2010 was characterized by consumers’ risk perception-behavior gap (i.e., consumers knew safe methods for food-handling, but responses regarding the behaviors did not support their confidence in food safety): they (1) did not wash/trim foods before storage, (2) thawed frozen foods at room temperature, and (3) exposed leftovers to danger zone temperatures. These trends were not improved and the gaps in Year 2010 remained in Year 2019. Year 2010 was also characterized by other common high-risk behaviors improved during 8 years for the following aspects: (1) 70.0% of consumers divided a large portion of food into smaller pieces for storage, but few consumers (12.5%) labeled divided foods with relevant information, and (2) they excessively reused kitchen utensils. Whereas in Year 2019, more consumers (25.7%) labeled food and usage periods for kitchen utensils were shortened. Consumers usually conformed to food safety rules in both Year 2010 and 2019: (1) separate storage of foods, (2) storage of foods in the proper places/periods, (3) washing fruits/vegetables before eating, (4) washing hands after handling potentially hazardous foods, and (5) cooking foods and reheating leftovers to eat. Our findings provided resources for understanding consumers’ high-risk behaviors/perceptions at home, highlighting the importance of behavioral control.

Home-Prepared Enteral Tube Feeding: Evaluation of Microbiological Contamination, Hygiene, and the Profile of the Food Handler

BACKGROUND

Little is known about the risk to patients' health when using home-prepared enteral tube feeding. The objective of this study was to explore the differences in hygiene conditions and microbial load of different types of home-prepared enteral tube feeding and explore associations between those differences and food handlers' characteristics.

METHODS

We evaluated 96 enteral formulations, considering 3 types used by adult patients: homemade enteral preparations (HEPs), blended enteral preparations (BEPs), and commercial enteral formulas (CEFs). Enteral formulations were collected from homes and microbiologically analyzed. Hygiene criteria were assessed using a checklist, applied during the handling stages. The profile of the food handler was reviewed using a questionnaire.

RESULTS

82.3% (79/96) exceeded acceptable bacterial counts, which was 10³ colony-forming units per gram for aerobic mesophilic microorganisms and for total coliforms (35 °C), Escherichia coli, Staphylococcus sp, and Staphylococcus coagulase-positive, if present in the enteral formulations. The number of inadequate samples was higher in HEPs and BEPs than in CEFs. Considering the hygiene criteria, the home-prepared enteral tube feedings did not differ significantly. There was a significant difference among hygiene conditions considering the variables "monthly family income" and "food training."

CONCLUSION

Regardless of the type of enteral formulations used by patients, when handled at home, there was a risk of contamination. However, contaminants present in enteral formulations can be easily controlled with improvements in hygiene measures as well as with greater guidance and control during the handling stages.

Hand warts among butchers in a supermarket in São Paulo

Background

Butchers are exposed to biological hazards as a function of their continuous handling of meat containing blood, fat and fluids. Biological hazards include contamination with viruses, such as the papillomavirus (HPV), especially HPV type 7, which is associated with the so-called "butcher's wart."

Objective

To investigate wart-like lesions among meat handlers.

Method

Cross-sectional descriptive study conducted at a supermarket in São Paulo in 2017. Twenty-four employees allocated to the meat handling section were interviewed and subjected to skin visual examination; lesions were photographed.

Results

Most participants were male (87.5%) and half of them (50.0%) were within age range 31 to 40 years old. Only one employee had started working in this section less than 2 years earlier. Wart-like lesions or scars with black dots on their center were found on the hands of 11 butchers (45.8%).

Conclusion

Almost half of the participants had history of hand warts. Most of the participants with lesions were male, aged up to 40, right-handed and had worked as meat handlers for 2 years at least. We might infer we found cases of wart-like occupational dermatosis among butchers at a supermarket in São Paulo.

Fate of Listeria monocytogenes in the Presence of Resident Cheese Microbiota on Common Packaging Materials

Literature data regarding the survival of microorganisms on materials used for food package purposes are scarce. The aim of the current study is to assess the survival of Listeria monocytogenes on different packaging materials for dairy products during extended storage at different temperatures. Three packaging materials (5 × 5 cm) were contaminated with a cocktail of five strains of Listeria monocytogenes suspended in a cheese homogenate, including the cheese's native microbial population. Contaminated samples were incubated at 37°, 12°, and 4°C and periodically analyzed up to 56 days. The evolution of the total viable count and pathogen population was evaluated. At 37°C, the results showed that Listeria monocytogenes was no longer detected on polyethylene-coated nylon (B) by day 4 and on polyethylene-coated parchment (A) and greaseproof paper (C) by day 7. Interestingly, the initial cell population (ranging between 2.5 and 2.7 log CFU/cm2) of Listeria monocytogenes increased to 3 log CFU/cm2 within 4 days of storage at 12°C on A and C. During storage, the number remained fairly constant at 12°C and 4°C on two materials (A-C) and decreased slowly on the third one (B). This study shows that survival of Listeria monocytogenes on packaging materials for dairy products will be higher when stored at 4 or 12°C compared to 37°C. The survival of Listeria monocytogenes on the packaging materials raises concerns of cross-contamination during food handling and preparation at catering and retail premises and within the home, highlighting the importance of treating the packaging materials as a potential source of cross-contamination. These initial findings may aid in quantifying risks associated with contamination of food packaging materials.

Food handlers and foodborne diseases: grounds for safety and public and occupational health actions

One of the causes of foodborne diseases is contamination during food preparation; food handlers carrying pathogens might be involved in the origin of this condition. This problem is more serious in health care facilities, since consumers of contaminated food are already ill. Therefore, operational procedures should be formulated to prevent incidents. We performed a review of scientific studies, legislation and regulations on this subject. The results indicate that the main causes of food contamination involving food handlers to be considered in strategies to reduce, or even eliminate foodborne diseases include: flaws in hand hygiene, intestinal parasites, lack of knowledge of good manufacturing practices (GMP) and of the etiologic agents of foodborne diseases, and lack of GMP monitoring. We conclude that standardized operational procedures should be developed, including clear and objective flowcharts (suggested here) to be managed by the safety and occupational medicine staff, in addition to providing training to food handlers on GMP and correct use of personal protective equipment and work clothes.

Feeding-Related Knowledge, Attitudes, and Practices among Grandparents in Singapore

Childhood obesity is a growing concern worldwide. Though multifactorial, the family environment exerts significant influence on children’s eating habits. Grandparents are increasingly involved as caregivers and they can significantly influence their grandchildren’s eating habits. Yet, literature on this topic is lacking. This exploratory sequential mixed methods study (qualitative interview and interviewer-administered questionnaire) aims to understand grandparents’ knowledge, attitudes, and practices on the feeding of their grandchildren in Singapore. A total of 11 interview participants and 396 questionnaire respondents with at least one grandchild, aged 12 years and below were included. Qualitative interviews informed the questionnaire development. Responses to interview questions about knowledge, attitudes, and practices revealed sub-themes such as knowledge on the impact of feeding, attitude toward feeding role, and challenges to feeding. Of the 396 participants, 35% were primary caregivers (defined as the person who spends the most time with the grandchild and performs most of the caregiving tasks). Nutritional knowledge was fair (median score 5/8), with misconceptions centered around healthy feeding practices. Grandparents who were primary caregivers, female, Malay, and younger than 70 years old believed that they played an important role in feeding their grandchild (p < 0.05). Overall, 47.2% of the grandparents rarely or never set a maximum limit on the amount of unhealthy food eaten, of which 77.1% are non-primary caregivers. In comparison, primary caregivers tend to set a maximum limit to the amount of unhealthy food their grandchildren eat and choose a wide variety of food (p < 0.05). These findings support the need for further improvement of grandparents’ feeding knowledge and practices as part of tackling childhood obesity.

Efficacy of Food Safety Training in Commercial Food Service

Proper food safety training is essential to decrease incidences and overall rates of foodborne illnesses and outbreaks. Though many commercial restaurants should provide proper food safety training to food handler employees, this training is not always offered or effective. Here, we summarize the results of a primary literature study concerning the effectiveness of food safety training in commercial settings. The literature chosen for review contained only studies with experimental food safety training, with before and after training data. Through evaluation of these studies, the best practice for ensuring effective training and follow-through were the use of food safety training programs, which incorporated both knowledge and behavior-based training. PRACTICAL APPLICATION: Food safety managers in food service establishments may consider reevaluating their current food safety training program to incorporate behavioral-based food safety training in addition to knowledge-based training.

Compliance With Recommended Food Safety Practices in Television Cooking Shows

OBJECTIVE

Examine compliance with recommended food safety practices in television cooking shows.

METHODS

Using a tool based on the Massachusetts Food Establishment Inspection Report, raters examined 39 episodes from 10 television cooking shows.

RESULTS

Chefs demonstrated conformance with good retail practices for proper use and storage of utensils in 78% of episodes; preventing contamination (62%), and fingernail care (82%). However, 50% to 88% of episodes were found to be out of compliance with other personal hygiene practices, proper use of gloves and barriers (85% to 100%), and maintaining proper time and temperature controls (93%). Over 90% failed to conform to recommendations regarding preventing contamination through wiping cloths and washing produce. In only 13% of episodes were food safety practices mentioned.

CONCLUSIONS AND IMPLICATIONS

There appears to be little attention to food safety during most cooking shows. Celebrity and competing chefs have the opportunity to model and teach good food safety practices for millions of viewers.

Food Safety in Feeding Services: A Requirement in Brazil

Access to food that is adequate in both quantity and quality is directly related to the health of a population. Unsafe food may cause an individual to experience varying degrees of illnesses known as food-borne disease. As their daily lives change, an increasing number of Brazilian people eat outside of their houses in restaurants, cafes, bakeries, and other dining establishments. Until August 2004, food services in Brazil followed the same standards recommended for other industries; these standards were determined by the Ministry of Health through Decree 326 in 1997 and completed in 2002 by the Brazilian Health Surveillance Agency through Resolution 275. On September 15, 2004, the Brazilian Health Surveillance Agency published RDC 216 that provided information about Technical Regulation of Good Practices specifically for food services. This legislation ensures safe production of the food at Brazilian food service sites through good practices and procedures. The purpose of this review is to describe the aspects related to safe food production and to discuss the main legislation for food services in Brazil.

Mitigation of Biofilm Formation on Corrugated Cardboard Fresh Produce Packaging Surfaces Using a Novel Thiazolidinedione Derivative Integrated in Acrylic Emulsion Polymers

Various surfaces associated with the storage and packing of food are known to harbor distinct bacterial pathogens. Conspicuously absent among the plethora of studies implicating food packaging materials and machinery is the study of corrugated cardboard packaging, the worldwide medium for transporting fresh produce. In this study, we observed the microbial communities of three different store-bought fruits and vegetables, along with their analog cardboard packaging using high throughput sequencing technology. We further developed an anti-biofilm polymer meant to coat corrugated cardboard surfaces and mediate bacterial biofilm growth on said surfaces. Integration of a novel thiazolidinedione derivative into the acrylic emulsion polymers was assessed using Energy Dispersive X-ray Spectrometry (EDS) analysis and surface topography was visualized and quantified on corrugated cardboard surfaces. Biofilm growth was measured using q-PCR targeting the gene encoding 16s rRNA. Additionally, architectural structure of the biofilm was observed using SEM. The uniform integration of the thiazolidinedione derivative TZD-6 was confirmed, and it was determined via q-PCR to reduce biofilm growth by ~80% on tested surfaces. A novel and effective method for reducing microbial load and preventing contamination on food packaging is thereby proposed.

Salmonella and eggs: from production to plate

Salmonella contamination of eggs and egg shells has been identified as a public health concern worldwide. A recent shift in consumer preferences has impacted on the egg industry, with a push for cage-free egg production methods. There has also been an increased desire from consumers for raw and unprocessed foods, potentially increasing the risk of salmonellosis. In response to these changes, this review explores the current literature regarding Salmonella contamination of eggs during the production processing through to food handling protocols. The contamination of eggs with Salmonella during the production process is a complex issue, influenced by many variables including flock size, flock age, stress, feed, vaccination, and cleaning routines. Currently there is no consensus regarding the impact of caged, barn and free range egg production has on Salmonella contamination of eggs. The literature regarding the management and control strategies post-collection, during storage, transport and food handling is also reviewed. Pasteurisation and irradiation were identified as the only certain methods for controlling Salmonella and are essential for the protection of high risk groups, whereas control of temperature and pH were identified as potential control methods to minimise the risk for foods containing raw eggs; however, further research is required to provide more detailed control protocols and education programs to reduce the risk of salmonellosis from egg consumption.

Prevalence and risk factors for intestinal parasites in food handlers, southern Brazil

In this study, the prevalence and risk factors for enteroparasites were determined in food handlers from Maringá, Paraná State, southern Brazil. Fecal and subungual materials of 150 street food vendors were analyzed by the methods of Lutz, Faust, and Mello, respectively. A questionnaire on hygiene and sanitary conditions of the workplace and of domicile was applied. The prevalence of enteroparasites was 28%, and the protozoa infection was more expressive (21.3%) than by helminths (6.7%), but without significant difference (p > 0.05). Entamoeba coli was the most frequent species occurring in 15.3%, while the prevalence of protozoa pathogenic was low (Giardia lamblia: 2.7% and Entamoeba histolytica: 0.7%). The subungual material presented negative results. The presence of pets in domiciles has increased twice the risk of infection. The working conditions of the majority of street food vendors were inappropriate. The results highlight the need for more rigorous programs of continuing education, parasitological examination every six months, and health surveillance. In this way, the quality of the service provided to the population can be improved and the transmission of food-borne diseases can be prevented.

Food safety in home kitchens: a synthesis of the literature

Although foodborne illness is preventable, more than 56,000 people per year become ill in the U.S., creating high economic costs, loss of productivity and reduced quality of life for many. Experts agree that the home is the primary location where foodborne outbreaks occur; however, many consumers do not believe the home to be a risky place. Health care professionals need to be aware of consumers' food safety attitudes and behaviors in the home and deliver tailored food safety interventions that are theory-based. Thus, the purpose of this paper is to synthesize/summarize the food safety literature by examining the following: consumers' perceptions and attitudes towards food safety and their susceptibility to foodborne illness in the home, work, and school; common risky food safety practices and barriers to handling food safely; and the application of theory-based food safety interventions. Findings will help healthcare professionals become more aware of consumers' food safety attitudes and behaviors and serve to inform future food safety interventions.

Gastroenteritis outbreak associated with unpasteurized tempeh, North Carolina, USA

During an investigation of an outbreak of gastroenteritis caused by Salmonella enterica serovar Paratyphi B variant L(+) tartrate(+), we identified unpasteurized tempeh as a novel food vehicle and Rhizopus spp. starter culture as the source of the contamination. Safe handling of uncooked, unpasteurized tempeh should be emphasized for prevention of foodborne illnesses.

Survey of food-hygiene practices at home and childhood diarrhoea in Hanoi, Viet Nam

A cross-sectional study was conducted to investigate the potential factors of food-hygiene practices of mothers on the prevalence of diarrhoea among their children. Mothers who had children aged 6 months-5 years were recruited in a hamlet in Viet Nam. The food-hygiene practices included hand-washing, method of washing utensils, separation of utensils for raw and cooked food, and the location where foods were prepared for cooking. A face-to-face interview was conducted, and data on 206 mothers were analyzed. The risk of diarrhoea was significantly higher among children whose mothers prepared food for cooking somewhere other than the table (typically on the ground) compared to children whose mothers prepared food on the table (adjusted odds ratio = 2.85, 95% confidence interval 1.11-7.28). The results indicate that food-hygiene practices of mothers, such as avoiding preparing food for cooking on the ground, has a potential impact in preventing diarrhoea among children in Viet Nam.

Vero cytotoxin-producing Escherichia coli O157 gastroenteritis in farm visitors, North Wales

An outbreak of Vero cytotoxin-producing Escherichia coli O157 (VTEC O157) gastroenteritis in visitors to an open farm in North Wales resulted in 17 primary and 7 secondary cases of illness. E. coli O157 Vero cytotoxin type 2, phage type 2 was isolated from 23 human cases and environmental animal fecal samples. A case-control study of 16 primary case-patients and 36 controls (all children) showed a significant association with attendance on the 2nd day of a festival, eating ice cream or cotton candy (candy floss), and contact with cows or goats. On multivariable analysis, only the association between illness and ice cream (odds ratio [OR]=11.99, 95% confidence interval [CI] 1.04 to 137.76) and cotton candy (OR=51.90, 95% CI 2.77 to 970.67) remained significant. In addition to supervised handwashing, we recommend that foods on open farms only be eaten in dedicated clean areas and that sticky foods be discouraged.

Endogenous N-nitroso compounds, and their precursors, present in bacon, do not initiate or promote aberrant crypt foci in the colon of rats

Processed meat intake is associated with increased risk of colorectal cancer. This association may be explained by the endogenous formation of N-nitroso compounds (NOC). The hypothesis that meat intake can increase fecal NOC levels and colon carcinogenesis was tested in 175 Fischer 344 rats. Initiation was assessed by the number of aberrant crypt foci (ACF) in the colon of rats 45 days after the start of a high-fat bacon-based diet. Promotion was assessed by the multiplicity of ACF (crypts per ACF) in rats given experimental diets for 100 days starting 7 days after an azoxymethane injection. Three promotion studies were done, each in 5 groups of 10 rats, whose diets contained 7%, 14%, or 28% fat. Tested meats were bacon, pork, chicken, and beef. Fecal and dietary NOC were assayed by thermal energy analysis. Results show that feces from rats fed bacon-based diets contained 10-20 times more NOC than feces from control rats fed a casein-based diet (all p < 0.0001 in 4 studies). In bacon-fed rats, the amount of NOC input (diet) and output (feces) was similar. Rats fed a diet based on beef, pork, or chicken meat had less fecal NOC than controls (most p < 0.01). No ACF were detected in the colon of bacon-fed uninitiated rats. After azoxymethane injection, unprocessed but cooked meat-based diets did not change the number of ACF or the ACF multiplicity compared with control rats. In contrast, the bacon-based diet consistently reduced the number of large ACF per rat and the ACF multiplicity in the three promotion studies by 12%, 17%, and 20% (all p < 0.01). Results suggest that NOC from dietary bacon would not enhance colon carcinogenesis in rats.

Complete compensation in skilled reaching success with associated impairments in limb synergies, after dorsal column lesion in the rat

Each of the dorsal columns of the rat spinal cord conveys primary sensory information, by way of the medullary dorsal column nucleus, to the ventrobasal thalamus on the contralateral side; thus the dorsal columns are an important source of neural input to the sensorimotor cortex. Damage to the dorsal columns causes impairments in synergistic proximal or whole-body movements in cats and distal limb impairments in primates, particularly in multiarticulated finger movements and tactile foviation while handling objects, but the behavioral effects of afferent fiber lesions in the dorsal columns of rodents have not been described. Female Long-Evans rats were trained to reach with a forelimb for food pellets and subsequently received lesions of the dorsomedial spinal cord at the C2 level, ipsilateral to their preferred limb. Reaching success completely recovered within a few days of dorsal column lesion. Nevertheless, a detailed analysis of high-speed video recordings revealed that rotatory limb movements (aiming, pronation, supination, etc.) were irreversibly impaired. Compensation was achieved with whole-body and alternate limb movements. These results indicate the following: (1) in the absence of the dorsal columns, other sensorimotor pathways support endpoint success in reaching; (2) sensory input conveyed by the dorsal columns is important for both proximal and distal limb movements used for skilled reaching; and (3) detailed behavioral analyses in addition to endpoint measures are necessary to completely describe the effects of dorsal column lesions.