PERTANIKA JOURNAL OF SOCIAL SCIENCES AND HUMANITIES

 

e-ISSN 2231-8534
ISSN 0128-7702

Home / Regular Issue / JSSH Vol. 45 (3) Aug. 2022 / JTAS-2410-2021

 

Relating Food Handlers’ Knowledge, Attitude, and Self-reported Practices on Food Safety and Hygiene to the Performance of Food Safety Assurance System: A Multiple Case Study in Government Hospital Kitchens

Suhaila Abdul-Rashid, Ungku Zainal Abidin Ungku Fatimah, Noor Azira Abdul-Mutalib, Syaliza Omar, Selamat Jinap and Maimunah Sanny

Pertanika Journal of Social Science and Humanities, Volume 45, Issue 3, August 2022

DOI: https://doi.org/10.47836/pjtas.45.3.12

Keywords: Food handlers, food safety assurance system, food safety output, government hospital kitchens

Published on: 8 August 2022

Government hospital kitchens in Malaysia have been certified with Good Manufacturing Practices (GMP) and Hazard Analysis Critical Control Point (HACCP) to ensure that cooked food is clean and safe for consumption. However, the performances of the Food Safety Assurance System (FSAS)-certified government hospital kitchens have not been evaluated. Although researchers in Malaysia have assessed the knowledge, attitude, and self-reported practices (KAP) on food safety (FS) and hygiene among food handlers, they did not relate the influence of food handlers’ KAP on the performance of the FSAS. The objective of the study was to relate food handlers’ KAP on FS and hygiene to the FSAS performance in government hospital kitchens in Selangor and Kuala Lumpur, Malaysia. Four government hospital kitchens implementing different kinds of FSAS certification were evaluated. Critical sampling locations were identified, and samples were taken and examined for Escherichia coli, Total Yeast and Mould Count (TYMC), Staphylococcus aureus, Total Plate Count (TPC), and Salmonella. The average scores of knowledges on FS and hygiene for ≤ 30 years age group, ≤ 5 years in the employment group, and food handlers with tertiary education were the highest and significantly different compared with the other groups. The FS output of government hospital kitchens implementing stringent FSAS was better (score of 2–3) than kitchens implementing less stringent FSAS (score of 2). The multinomial logistic regression analysis showed that the correlations among the overall percentage scores of KAP and the FS output were not significant (p > 0.05). Therefore, it appeared that food handlers’ KAP on FS and hygiene did not influence Salmonella, E. coli, and S. aureus levels and, therefore, the FSAS’ performance.

  • Abdul-Mutalib, N. A., Syafinaz, A. N., Sakai, K., & Shirai, Y. (2015). An overview of foodborne illness and food safety in Malaysia. International Food Research Journal, 22(3), 896-901.

  • Abdullah, N. B. A., & Ismail, A. F. (2021). Food poisoning outbreaks among school children in Terengganu and their associated factors. Sains Malaysiana, 50(4), 1027-1036. https://doi.org/10.17576/jsm-2021-5004-13

  • Adesokan, H. K., Akinseye, V. O., & Adesokan, G. A. (2015). Food safety training is associated with improved knowledge and behaviours among foodservice establishments workers. International Journal of Food Science, 2015, 328761. https://doi.org/10.1155/2015/328761

  • Akabanda, F., Hlortsi, E. H., & Owusu-Kwarteng, J. (2017). Food safety knowledge, attitudes and practices of institutional food-handlers in Ghana. BMC Public Health, 17, 40. https://doi.org/10.1186/s12889-016-3986-9

  • Allison, S. P. (2003). Hospital food as treatment. Clinical Nutrition, 22(2), 113-114. https://doi.org/10.1054/clnu.2002.0641

  • Baluka, S. A., Miller, R., & Kaneene, J. B. (2015). Hygiene practices and food contamination in managed food service facilities in Uganda. African Journal of Food Science, 9(1), 31-42. https://doi.org/10.5987/AJFS2014./1170|

  • Bou-Mitri, C., Mahmoud, D., El Gerges, N., & Jaoude, M. A. (2018). Food safety knowledge, attitudes and practices of food handlers in Lebanese hospitals: A cross-sectional study. Food Control, 94, 78-84. https://doi.org/10.1016/j.foodcont.2018.06.032

  • Carmo, L., Souza, D. R., Roberto, L., Sena, M. J., & Santos, D. A. (2003). An outbreak of staphylococcal food poisoning in the Municipality of Passos, MG, Brazil. Brazilian Archives of Biology and Technology, 46(4), 581-586. https://doi.org/10.1590/S1516-89132003000400012

  • Dablool, A., & Ghamdi, A. (2011). Enterotoxigenicity of Staphylococcus aureus isolated from food handlers during Hajj season in Saudi Arabia. Open Journal of Safety Science and Technology, 1(2), 75-78. https://doi.org/10.4236/ojsst.2011.12007

  • de Sousa, C. P. (2008). The impact of food manufacturing practices on food borne diseases. Brazilian Archives of Biology and Technology, 51(4), 815-823. https://doi.org/10.1590/s1516-89132008000400020

  • de Souza, C. P. (2003). Pathogenicity mechanisms of prokaryotic cells: An evolutionary view. The Brazilian Journal of Infectious Diseases, 7(1), 23-31. https://doi.org/10.1590/S1413-86702003000100004

  • Ercoli, L., Gallina, S., Nia, Y., Auvray, F., Primavilla, S., Guidi, F., Pierucci, B., Graziotti, C., Decastelli, L., & Scuota, S. (2017). Investigation of a staphylococcal food poisoning outbreak from a chantilly cream dessert, in Umbria (Italy). Foodborne Pathogens and Disease, 14(7), 407-413. https://doi.org/10.1089/fpd.2016.2267

  • Fernandes, F. P., Voloski, F. L. S., Ramires, T., Haubert, L., Reta, G. G., Mondadori, R. G., da Silva, W. P., dos Santos da Conceição, R. D. C., & Duval, E. H. (2017). Virulence and antimicrobial resistance of Salmonella spp. and Escherichia coli in the beef jerky production line. FEMS Microbiology Letters, 364(9), fnx083. https://doi.org/10.1093/femsle/fnx083

  • Food Standards Australia New Zealand. (2016). Compendium of microbiological criteria for food. FSANZ. http://www.foodstandards.gov.au/publications/Documents/Compedium%20of%20Microbiological%20Criteria/Compendium%20of%20Microbiological%20Criteria.pdf

  • International Commission on Microbiological Specifications for Foods. (2005). Microorganisms in foods. 2. Sampling for microbiological analysis: Principles and specific applications (2nd ed.). University of Toronto Press.

  • International Organization for Standardization. (2004). ISO 18593:2004 - Microbiology of food and animal feeding stuffs - Horizontal methods for sampling techniques from surfaces using contact plates and swabs. ISO. https://www.iso.org/standard/39849.html

  • International Organization for Standardization. (2017). ISO 6579-1:2017/AMD 1:2020 - Microbiology of the food chain - Horizontal method for the detection, enumeration and serotyping of Salmonella - Part 1: Detection of Salmonella spp. - Amendment 1: Broader range of incubation temperatures, amendment to the status of Annex D, and correction of the composition of MRSV and SC. ISO. https://www.iso.org/standard/76671.html

  • Jacxsens, L., Kussaga, J., Luning, P. A., Van der Spiegel, M., Devlieghere, F., & Uyttendaele, M. (2009). A Microbial Assessment Scheme to measure microbial performance of Food Safety Management Systems. International Journal of Food Microbiology, 134(1-2), 113-125. https://doi.org/10.1016/j.ijfoodmicro.2009.02.018

  • Kokkinakis, E. N., Fragkiadakis, G. A., Loakeimidi, S. H., Giankoulof, I. B., & Kokkinaki, A. N. (2008). Microbiological quality of ice cream after HACCP implementation: A factory case study. Czech Journal of Food Sciences, 26(5), 383-391. https://doi.org/10.17221/1126-CJFS

  • Laws of Malaysia. (1985). Food Regulations 1985. https://extranet.who.int/nutrition/gina/sites/default/filesstore/MYS%201985%20Food%20Regulations_0.pdf

  • Laws of Malaysia. (2009). Food Hygiene Regulations 2009. http://extwprlegs1.fao.org/docs/texts/mal91581.doc

  • Lee, H. K., Abdul Halim, H., Thong, K. L., & Chai, L. C. (2017). Assessment of food safety knowledge, attitude, self-reported practices, and microbiological hand hygiene of food handlers. International Journal of Environmental Research and Public Health, 14(1), 55. https://doi.org/10.3390/ijerph14010055

  • Lekhraj, R. (1983). A food poisoning outbreak due to Staphylococcus aureus, Kapar, Malaysia, 1983. Medical Journal of Malaysia, 38(4), 294-298.

  • Lund, B. M., & O’Brien, S. J. (2011). The occurrence and prevention of foodborne disease in vulnerable people. Foodborne Pathogens and Disease, 8(9), 961-973. https://doi.org/10.1089/fpd.2011.0860

  • Ministry of Health. (2018). Annual report food safety and quality 2018. Ministry of Health Malaysia. https://www.google.com/search?q=Annual+Report+Food+Safety+and+Quality+2018&oq=Annual+Report+Food+Safety+and+Quality+2018+&aqs=chrome..69i57j33i160l2.420j0j15&sourceid=chrome&ie=UTF-8

  • Murphy, R. Y., Martin, E. M., Duncan, L. K., Beard, B. L., & Marcy, J. A. (2004). Thermal process validation for Escherichia coli O157:HT, Salmonella, and Listeria monocytogenes in ground turkey and beef products. Journal of Food Protection, 67(7), 1394-1402. https://doi.org/10.4315/0362-028x-67.7.1394

  • Norhaslinda, R., Norhayati, A. H., & Mohd Adzim Khalili, R. (2016). Knowledge, attitudes and practices (KAP) on good manufacturing practices (GMP) among food handlers in Terengganu hospitals. International Journal of Pharmacy and Pharmaceutical Sciences, 8(11), 53-59. https://doi.org/10.22159/ijpps.2016v8i11.13000

  • Nyarugwe, S. P., Linnemann, A., Nyanga, L. K., Fogliano, V., & Luning, P. A. (2018). Food safety culture assessment using a comprehensive mixed-methods approach: A comparative study in dairy processing organisations in an emerging economy. Food Control, 84, 186-196. https://doi.org/10.1016/j.foodcont.2017.07.038

  • Oses, S. M., Luning, P. A., Jacxsens, L., Santillana, S., Jaime, I., & Rovira, J. (2012). Microbial performance of food safety management systems implemented in the lamb production chain. Journal of Food Protection, 75(1), 95-103. https://doi.org/10.4315/0362-028x.jfp-11-263

  • Pacholewicz, E., Sura Barus, S. A., Swart, A., Havelaar, A. H., Lipman, L. J. A., & Luning, P. A. (2016). Influence of food handlers’ compliance with procedures of poultry carcasses contamination: A case study concerning evisceration in broiler slaughterhouses. Food Control, 68, 367-378. https://doi.org/10.1016/j.foodcont.2016.04.009

  • Rajakrishnan, S., Hafiz Ismail, M. Z., Jamalulail, S. H., Alias, N., Ismail, H., Taib, S. M., Cheng, L. S., Zakiman, Z., Richai, O., Silverdurai, R. R., & Yusof, M. P. (2022). Investigation of a foodborne outbreak at a mass gathering in Petaling District, Selangor, Malaysia. Western Pacific Surveillance and Response Journal, 13(1). https://doi.org/10.5365/wpsar.2022.13.1.860

  • Rosmawati, N. N., Manan, W. W., Izani, N. N., & Nurain, N. N. (2014). Evaluation of environmental hygiene and microbiological status of selected primary school canteens. Health and the Environment Journal, 5(3), 110-127.

  • Salustiano, V. C., Andrade, N. J., Cardoso Brandao, S. C., Cordeiro Azeredo, R. M., & Kitakawa Lima, S. A. (2003). Microbiological air quality of processing areas in a dairy plant as evaluated by the sedimentation technique and a one-stage air sampler. Brazilian Journal of Microbiology, 34(3), 255-259. https://doi.org/10.1590/S1517-83822003000300015

  • Standards Malaysia. (2007). MS 1480 Food Safety according to Hazard Analysis and Critical Control Point (HACCP) system. Scribd Inc. https://www.scribd.com/document/416374529/Haccp-Standard-Ms-1480-2007

  • Standards Malaysia. (2012). MS ISO 22000 food safety management systems - Requirements for any organization in the food chain. Department of Standards Malaysia. https://www.jsm.gov.my/ms-iso-22000-2012-food-safety-management-systems-requirements-for-any-organisation-in-the-food-chain#.YtIwvXZBy5c

  • Standards Malaysia. (2013). Standards Malaysia requirements for the accreditation of bodies operating certification of Good Manufacturing Practice for food to MS 1514. https://www.jsm.gov.my/documents/10180/254499/ACB-GMP%2C%20Issue+1%2C%2018+June+2013.pdf/9504c303-7b5e-4efb-ab94-04dd926cde3f

  • Suhaila, A. R., Ariffin, H. F., Sanny, M., Ungku Fatimah, U. Z. A., Noor-Azira, A. M., & Hasni, M. I. F. (2020). Knowledge, attitude, and practice on food safety culture among kitchen employees of Malaysian government hospitals. ESTEEM Journal of Social Science and Humanities, 4, 180-195.

  • Sveum, W. H., Moberg, L. J., Rude, R., & Frank, J. F. (1992). Microbiological monitoring of the food processing environment. In C. Vanderzant & D. F. Splittstoeser (Eds.), Compendium of methods for the microbiological examination of foods (3rd ed., pp. 51-75). APHA Press.

  • Tan, S. L., Bakar, F. A., Abdul Karim, M. S., Lee, H. Y., & Mahyudin, N. A. (2013). Hand hygiene knowledge, attitudes and practices among food handlers at primary schools in Hulu Langat district, Selangor (Malaysia). Food Control, 34(2), 428-435. https://doi.org/10.1016/j.foodcont.2013.04.045

  • Valero, A., Rodríguez, M. Y., Posada-Izquierdo, G. D., Pérez-Rodríguez, F., Carrasco, E., & García-Gimeno, R. M. (2016). Risk factors influencing microbial contamination in food service centers. In H. A. Makun (Ed.), Significance, prevention and control of food related diseases (pp. 27-58). IntechOpen. https://doi.org/10.5772/63029

  • van Schothorst, M., Zwietering, M. H., Ross, T., Buchanan, R. L., & Cole, M. B. (2009). Relating microbiological criteria to food safety objectives and performance objectives. Food Control, 20(11), 967-979. https://doi.org/10.1016/j.foodcont.2008.11.005

  • Yousif, E. I., Ashoush, I. S., Donia, A. A., & Hala Goma, K. A. (2013). Critical control points for preparing chicken meals in a hospital kitchen. Annals of Agricultural Sciences, 58(2), 203-211. https://doi.org/10.1016/j.aoas.2013.07.004