hypoglycemia and pain in the bone, respectively, are symptoms of
foodborne illnesses.
3.8. Knowledge of important foodborne pathogens
About 40 and 20% of the correspondents had heard about
Salmonella and Hepatitis A, respectively (Table 7). Ten percent or
less of the correspondents had heard about Listeria monocytogenes,
Staphylococcus aureus, Bacillus cereus, Escherichia coli O157:H7,
Clostridium perfringens, Campylobacter jujuni, and Shigella.
3.9. General characteristics of study population and food safety
knowledge score
In general, food workers who enrolled in food safety training
course had significantly (P < 0.05) higher total food safety knowledge
score (48.34 out of 67 points) compared with the score (46.8)
of food workers who did not enroll in food safety training course
(Table 8). There was no significant association between the experience
of food workers and total food safety knowledge score; the
mean score of food workers who has experience in restaurants <4
years was 47.16 and the score of food workers who had experience
4 years was 47.23 (Table 9). Also, there were no significant association
between the other characteristics of food workers and the
total food safety knowledge score (data are not shown).
4. Discussion
Most of foodborne outbreaks resulted from poor practices
during food handling (EFSA, 2010). Food handlers have been
involved in outbreaks of foodborne diseases for decades, and there
is no sign that this trend is lessening (Greig, Todd, Bartleson, &
Michaels, 2007).
Our study showed that the overall knowledge of food handlers
on food safety concepts is fair. In details, food handlers had good
knowledge on “personal hygiene”, “cross contamination prevention
and sanitation”, and “symptoms of foodborne illnesses”, while they
had poor to fair knowledge on “foodborne pathogens”, “safe
storage, thawing, cooking and reheating of the foods”, and “health
problems that would affect food safety” aspects. However, the
overall food safety knowledge reported in our study is better than
that recorded in the literature. In our study the average percentage
of correct responseswas 69.4% which is higher than 43.4% (n ¼ 764)
reported for food handlers in Turkey (Bas¸ et al., 2006), 46% (n ¼ 159)
reported for food handlers in small and micro enterprises in South
Africa (Marais, Conradie, & Labadarios, 2007), and 56.5 and 62.5%
reported for food handlers in catering company (n ¼ 101) and small
businesses (n ¼ 79) in Portugal, respectively (Gomes-Neves, Araújo,
Ramos, & Cardoso, 2007; Martins et al., 2012). The differences in the
survey questions and the survey protocols may explain the differences
between the knowledge level reported in this study and that
in the previous studies.
The mean knowledge score of “personal hygiene” reported in
our study is greatly higher than 51.5 and 31.8% reported by Martins
et al. (2012) and Bas¸ et al. (2006), for the food handlers in Portugal
and Turkey, respectively. In our study, food handlers’ knowledge on
occasions of hand washing is lower than that reported by Garayoa
et al. (2011) for food handlers in Spain (correct responses were 93%)
and higher than that reported by Jianu and Chis¸ (2012) for food
handlers in Western Romania (correct responses were 68%). But
similar to our finding, DeBess, Pippert, Angulo, and Cieslak (2009)
reported that 39% of food workers in Oregon (USA) knew duration
of hand washing (20 s).
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