Face masks as sources of cross-contamination during food preparation

Amid the COVID-19 pandemic, mask-wearing has become a common practice in the foodservice industry to prevent the spread of respiratory diseases. Like kitchen utensils, a mask may serve as a vehicle for cross-contamination of pathogens during food handling. The objective of this study was to quantify cross-contamination between tasks of handling contaminated chicken and chopping lettuce. Chicken breasts were inoculated with a high or a low level of nonpathogenic Escherichia coli surrogates (ca. 6 or 4 log CFU/ml) and sliced for 1, 5, or 10 min. During slicing, duplicate, single-use medical masks were touched each minute. One mask was immediately sampled, but the second mask was used to contaminate lettuce by touching the mask each minute while chopping the lettuce for 5 min. E. coli were enumerated from the second mask and lettuce. Masks touched while slicing both high- and low-inoculated chicken showed significant contamination (0.8-4.9 log CFU/cm2) after each slicing scenario of 1, 5, or 10 min (P > 0.05). Lettuce was significantly contaminated regardless of inoculation level (1.0-3.2 log CFU/g). Slicing time was a significant factor in some cases (P < 0.05), whereas inoculation level was not (P > 0.05). Data indicate masks can be a source of cross-contamination if not replaced appropriately.

Study to assess challenges faced in biomedical waste management by waste handlers during COVID 19 pandemic in a tertiary care hospital

IntroductionCoronavirus disease 2019 (COVID 19) saw an overhaul in the biomedical waste management (BMWM) practices) Waste handlers were at the brunt of these changes. If the challenges pertaining to BMWM at the ground level are better understood, more effective measures to overcome them can be formulated.MethodologyThis qualitative research using in-depth interviews was done on 17 participants during August to November 2021 in a tertiary care institute in Mumbai. Thematic analysis was conducted on the qualitative data obtained.ResultsThree major themes were generated from the transcripts. They are-challenges and concerns faced by BMW handlers, enablers/motivators, opportunities and future practices. Various challenges faced by waste handlers were- difficulties in segregation and transport of BMW, exhaustion from PPE usage and fear of acquiring and spreading COVID 19 from work, stigma faced from public, and handling COVID 19 deaths. Support from family and colleagues, incentives and a positive change in public perception enabled them to work.ConclusionsIt is of utmost importance to address challenges faced by waste handlers in BMWM. This will improve hygiene, workplace safety and reduce transmission of diseases. Onus should also be on periodic training in BMWM.

Study of likelihood of infection with COVID 19 based on source of exposure to infection among hospital staff

BACKGROUND: The corona virus disease - 19 (COVID - 19) pandemic has caused significant morbidity and mortality throughout the world, as well as major social, educational and economic disruptions. Hospital staff have maximum exposure making it extremely crucial to find a solution to reduce the disease burden among the hospital staff. A sample of 170 consecutive hospital staff infected with COVID in the months from May 2020 to December 2020 was studied. It was a retrospective study done by analysis of out-patient department (OPD) and indoor patient records in that time period. The purpose of this study was to assess different sources and types of exposure of hospital staff to COVID 19 infection and prevent episodes of infection in hospital staff. METHODS: Survey of 170 COVID positive staff at a tertiary hospital was conducted and their potential sources of infection were documented. Source of infection could be other staff in hospital, room mates, patients, patient relatives, family, personal protective equipment (PPE) donning and doffing errors. Types of interaction could be in covid or non-covid areas of the hospital or during clinical encounters or social encounters within the hospital. RESULTS: Nurses (46%) and doctors (29%) constitute 75% of the total heath care staff infections in the hospital. Desk job staff, attendants, food and beverage workers and drivers together constitute 25% of the total health care staff infections in the hospital. The most common sources of infection were found to be social interaction and patient interaction. The infections were acquired much more in the non-covid areas of the hospital than in the covid areas. 65% of infections were acquired within three days of exposure and 87% of total infections were acquired within 6 days of exposure. 77% of infections were acquired within the hospital premises in patient and social interaction cases. CONCLUSIONS: Staff acquisition of COVID was found to be significantly higher in non-covid than in covid areas. Social distancing measures, mask use, hand hygiene, attention to PPE would help in significant drop in new COVID infections in hospital.

COVID-19 knowledge, attitude, practices, and associated factors among Bangladeshi food handlers from various food industries.

Background and objectives: It is believed that preventive safety measures are the most effective way to avoid the COVID-19. The adherence of workers to these measures is largely determined by their knowledge, attitude, and practices (KAP). Because they are in close proximity to consumable items, workers in the food industry must be especially vigilant during this period. The purpose of this present study was to evaluate the COVID-19 knowledge, attitudes, and practices of food handlers in different food industries of Bangladesh. Study design: This was a cross-sectional study. Methods: This included the participation of 400 food handlers from 15 food industries. The information was collected from the participants through a questionnaire prepared in Google form. Different nonparametric tests and a linear regression model were performed for statistical analysis. Results: With a correct response rate of about 90% on average (knowledge 89.7%, attitude 93%, practices 88.2%), the participants showed an acceptable KAP (>80% correct response) regarding COVID-19. Education (p = 0.00) and working experiences (p = 0.01) had a significant association with the total KAP scores. Conclusion: Food handlers in the food industries of Bangladesh have adequate knowledge, a positive attitude, and the desired practices regarding the COVID-19 issue.

A Food Safety Knowledge and Food Hygiene Practices among Food Handlers in Karad City, in View, to Develop an Information Booklet

Introduction: Food safety and food hygiene are important as they ensure that the food you handle and produce is safe for consumption. If food safety and hygiene are not maintained, consumers could become seriously ill with food poisoning and food born illnesses. So food hygiene & food safety are important for protecting the consumer health. Material(s) and Method(s): Evaluative approach. Study was conducted in 50 food handlers in Karad city. Using one group pretest post-test design. Non-probability Purposive sampling technique was used. Sample size was 50 food handlers. On 1st day pre test included knowledge of food safety and food hygiene practices through structured questionnaires, effective information booklet was administered followed by post test on 7th day. The data was collected, tabulated and analyzed in terms of using the objective of study was to assess the food safety knowledge and food hygiene practice among food handlers in Karad. Result(s): In demographic variables found that in gender 50% were female and 50% were male 30-39 yrs of age were maximum samples were tertiary education level 58% , 52% having 1 -5 yr experience 66% were vaccinated and 54.2% food handlers were possessed training certification. The food handlers knowledge related to food safety hygiene in that maximum responses temperature control knowledge was 84%, fresh vegetables 90%, preparation of food 86%, rinsed container & equipment 80% & hand washing steps 84%. So it was increased in post test. The mean posttest knowledge score (31.08+3.02) was higher than the mean pretest knowledge score (16.50+4.40).This indicates the effectiveness of information booklet in increasing the level of knowledge of adolescent girls regarding reproductive health. So study concluded that information booklet was effective method to improve the food safety knowledge & food hygiene practices among the food handlers. Conclusion(s): Administration of information booklet on food safety & food hygiene practices was effective method for improving the knowledge on food safety & food hygiene practices among the food handlers. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Influence of biosafety protocols adopted for the prevention of SARS-CoV-2 in slaughterhouses and a positive effect on the reduction of Staphylococcus aureus presence in beef cuts

Staphylococcus aureus is a food quality indicator microorganism commonly found in human mucous membranes. With the emergence of the virus related to SARS-CoV-2, several prevention protocols were established. Therefore, this study assessed whether the adoption of SARS-CoV-2 protocols influenced the presence of S. aureus in beef samples. We analyzed the S. aureus results of 3654 beef samples between April and September 2019 and 2020. Mean percentages of the population of S. aureus were different between years (2.63%-2019;1.13%-2020), revealing that after the adoption of the SARS-CoV-2 protocols there was a decrease in the presence of S. aureus. Concomitantly, a significant difference was also presented in the annual means of S. aureus load counts (2.30 log of CFU/g in 2019, and 1.60 log of CFU/g in 2020), of the sets of beef samples analyzed. Therefore, we suggest that the measures used to prevent SARS-CoV-2 can continue to be applied even after the pandemic, especially in the stages that involve beef handling in slaughterhouses.

Dairy industry employee knowledge, attitudes and practices in response to COVID-19 policies in Jordan

Purpose This study examined the level of knowledge, attitudes and practices (KAP) of Jordanian dairy employees about coronavirus disease 2019 (COVID-19) characteristics and the effect of precautionary measures on food safety risk during the pandemic. Design/methodology/approach A cross-sectional study was conducted between Dec 17, 2020 and Feb 22, 2021, involving a total of 428 participants across 34 random chosen dairy facilities in Jordan. KAP related to COVID-19 were measured by 46 items, while 13 items were used to examine perceived notions regarding COVID-19 precautionary measures on food safety. Findings The results indicated that 32.2% of the respondents had sufficient knowledge, 60.3% had a good attitude, and 27.1% followed correct practices concerning COVID-19. Moreover, female respondents had higher total KAP scores of COVID-19 characteristics than males. Furthermore, older and more experienced respondents had higher total KAP scores than younger respondents. This study also observed that the total KAP scores were not affected by education, marital status, and job position. Characteristics and measures taken by the dairy industry were at large significantly associated with (p < 0.05) knowledge and practice of employees about COVID-19 attributes. Results of this study suggested that Jordanian dairy workers were not adequately aware about COVID-19. Originality/value No such study on dairy workers has been conducted previously to the best of the authors' knowledge. Moreover, studies which analyse the association of industry response and characteristics on the KAP of employees are very limited.

Cutting Board Hygiene Knowledge, Attitudes and Practices of Food Handlers at Home during Covid19 Pandemic in Selangor

The microbial quality of cutting boards used in the home kitchen indicates hygiene conditions and a potential source of public health risk. This study aimed to assess the hygiene knowledge, attitudes and practices on cutting boards among food handlers at home during the Covid19 pandemic in Selangor. One hundred home food handlers participated in the online survey using a validated self-administered questionnaire. Overall, findings indicate sufficient hygiene knowledge, attitudes and practices on cutting boards. These findings emphasize the need for educating home food handlers on food hygiene to improve their knowledge, behaviour and practices.

Risk assessment and preventive health behaviours toward COVID-19 amongst bushmeat handlers in Nigerian wildlife markets: Drivers and One Health challenge.

Over 70% of emerging infectious diseases are zoonotic and 72% of them have wildlife reservoirs with consequent global health impacts. Both SARS-CoV-1 and SARS-CoV-2 emerged certainly through wildlife market routes. We assessed wildlife handlers' zoonotic risk perceptions and preventive health behaviour measures toward COVID-19 during pandemic waves, and its drivers at wildlife markets using Health Belief Model (HBM) constructs. A cross-sectional study was conducted at purposively selected wildlife markets in Nigeria between November 2020 and October 2021. Descriptive, univariate, and multivariable logistic regressions analyses were performed at 95% confidence interval. Of the 600 targeted handlers in 97 wildlife markets, 97.2% (n = 583) participated. Consumers were the majority (65.3%), followed by hunters (18.4) and vendors (16.3%). Only 10.3% hunters, 24.3% vendors and 21.0% consumers associated COVID-19 with high zoonotic risk. Also, only few handlers practiced social/physical distancing at markets. Avoidance of handshaking or hugging and vaccination was significantly (p = 0.001) practiced by few handlers as preventive health behaviours at the markets. All the socio-demographic variables were significantly (p<0.05) associated with their knowledge, risk perceptions, and practice of preventive health behaviours toward COVID-19 at univariate analysis. Poor markets sanitation, hygiene, and biosecurity (OR=3.35, 95% CI: 2.33, 4.82); and poor butchering practices and exchange of wildlife species between shops [(OR=1.87; 95% CI: 1.34, 2.60) and (OR=2.03; 95% CI: 1.43, 2.88), respectively] were more likely to significantly influence COVID-19 emergence and spread at the markets. To tackle the highlighted gaps, collaborations between the public health, anthropologists, and veterinary and wildlife authorities through the One Health approach are advocated to intensify awareness and health education programmes that will improve perceptions and behaviours toward the disease and other emerging diseases control and prevention.

Seven days in medicine: 13-19 July

Covid-19 BMA calls for long term plan to keep cases low The BMA urged the UK government to develop a long term plan to keep covid cases at low levels after the latest Office for National Statistics survey showed that an estimated one in 19 people in England, one in 17 in Wales and Northern Ireland, and one in 16 in Scotland tested positive in the week to 6 July.1 Philip Banfield, BMA council chair, said, “There must be recognition from the government that heightened waves of infection lead to greater staff illness and absences, stretching health and care settings to the limit and beyond.” For adults over 40, consuming a small amount of alcohol (one to two small glasses of red wine) can provide some health benefits, such as reducing the risk of cardiovascular disease, said the study. Many factors contributed to the decline, including an increased number of children living in conflict and fragile settings, increased vaccine misinformation, and covid-19 related issues such as service and supply chain disruptions.8 NHS 111 Online service made no difference to call handlers’ workload The introduction of an online version of NHS 111 in England made no discernible difference to the workload of the existing telephone helpline service being provided to the public, a study published in BMJ Open concluded.

Online NHS 111 service made no difference to call handlers’ workload, study finds

When looking at the impact on the NHS urgent care system, results from the combined activity from the telephone service and online service suggested there was an increase in the overall number of recommendations to contact or attend urgent care services following the introduction of the online service. The authors concluded, “It was found that the online service has little impact on the number of triaged and total calls, suggesting that the workload for the telephone service has not increased or decreased as a result of introducing NHS 111 online. [...]there was evidence to suggest an increase in the overall number of disposition recommendations (ambulance, emergency department, and primary care) for telephone and online services combined following the introduction of the online service.”

Adherence to WHO vaccine storage codes and vaccine cold chain management practices at primary healthcare facilities in Dalocha District of Silt'e Zone, Ethiopia.

BACKGROUND: The main elements of effective vaccine cold chain management at the immunization service delivery point are well-trained vaccine cold chain handlers, vaccine storage equipment, and appropriate vaccine management procedures. Vaccine cold chain handlers must have enough expertise to provide the correct vaccine at the right time, maintain vaccine potency, and minimize vaccination failures. The study assessed knowledge of vaccine cold chain handlers on vaccine cold chain management, adherence to the WHO vaccine storage codes and vaccine cold chain management practice at primary health facilities in Dalocha district of Silt'e zone. METHOD: Institutional-based cross-sectional study was done at twenty-eight primary health facilities. One hundred forty primary health workers were drawn from four health centers and twenty-four health posts operating in Dalocha woreda of Silt'e zone, SNNPR, Ethiopia. A self-administered questionnaires and on-spot observation checklists were adapted from the WHO and WHO-UNICEF-effective vaccine management assessment tools to collect data from cold chain unit of the primary healthcare facilities. Data were entered to EPI data version 3.1; exported and analyzed using SPSS version 22. Statistical analysis was carried out to determine the level of knowledge, adherence to WHO cold chain management guideline and vaccine handling practice. The relationship that the knowledge of primary healthcare workers, primary healthcare workers training status, primary healthcare facilities' adherence to WHO vaccine storage codes, and length of work experience of primary health care workers have with the vaccine management practice were also explored RESULT: Above Half (54%) of the respondents have satisfactory knowledge of vaccine cold chain management. One hundred (71.4%) vaccine cold chain handlers did point correctly to the recommended range of temperature (2°C -8°C) for vaccine storage. Around two-thirds (63.6%) of them were aware of the twice-daily temperature recordings. Nearly half, (46.2%) of primary healthcare facilities have experienced poor adherence to the WHO storage practice codes. Around three-fifths of the observed primary healthcare facilities have registered undesirable vaccine management practices. The primary healthcare workers who received training on vaccine cold chain management (χ2 = 0.058, p=0.015), served at primary health care facilities for more five years (χ2 =18.545, p≤0.001), shown good adherence to WHO vaccine storage code (χ2 =18.545, p≤0.001), have sufficient knowledge on vaccine cold chain management (χ2=4.210, p≤0.031) were all significantly associated with desirable vaccine cold chain management practice. CONCLUSION: There is a gap in vaccine cold chain handlers' knowledge about vaccine cold chain management and less than desirable adherence to WHO vaccine storage codes at primary healthcare facilities in Dalocha district. The majority of the observed primary health facilities have registered poor vaccine management practices. Everyone who has a stake in the cold chain management of vaccines should do their share, individually and collectively, to guarantee that everyone reaps the benefits of an effective cold chain.

Food hygiene practice and its associated factors among food handlers working in food establishments during the COVID-19 pandemic in East Gojjam and West Gojjam Zones, North West Ethiopia.

OBJECTIVES: This study was aimed to assess the food hygiene practice and associated factors among food handlers working in food establishments during the COVID-19 pandemic in East Gojjam and West Gojjam Zones, North West Ethiopia. METHODS: A facility-based cross-sectional study was conducted among 845 food handlers working in 423 selected food establishments of East and West Gojjam Zones from 22 September to 2 November 2020. The food handlers were categorized as a cooker and a waiter based on their responsibility. A data collection tool was adapted from the literature and validated by conducting a pre-test prior to the study. Binary logistic regression was done to identify the factors associated with food hygiene practice among food handlers. RESULTS: The prevalence of poor food hygiene practices among food handlers working in food establishments was 51.2% (95% confidence interval = 47.8, 54.6%). Being both a cooker and waiter (adjusted odds ratio = 2.98; 95% confidence interval = 1.02, 8.66), availability of personal protective equipment (adjusted odds ratio = 2.67; 95% confidence interval = 1.75, 4.08), presence of pipe water in the kitchen (adjusted odds ratio = 2.73; 95% confidence interval = 1.84, 4.06), presence of a supervisor (adjusted odds ratio = 2.26; 95% confidence interval = 1.41, 3.62), and separate dressing room (adjusted odds ratio = 2.69; 95% confidence interval = 1.84, 3.93) were significantly associated with food hygiene practice among food handlers. CONCLUSION: The prevalence of poor food hygiene practices among food handlers working in food establishments during the COVID-19 pandemic was high. Therefore, improving food hygiene practice focusing on availing personal protective equipment, pipe water in the kitchen, and ensuring the presence of a supervisor as well as a separate dressing room in the food establishment is recommended.

Determinants of hygienic handling of food by consumers in the COVID-19 pandemic context: A cross-sectional study in Vietnam

The objectives of this research are trifold. The first is to unveil antecedents of food-handling behaviors in the context of the COVID-19 pandemic. The second is to investigate the consistency of impacts of proposed determinants across different handling behaviors. The third is to confirm whether or not the premise of intention as the sole direct determinant of behavior in the Theory of Planned Behavior (TPB) holds. As such, TPB served as the guiding theory, and Factor Analysis and Seemingly Unrelated Regression were used for data analysis. The results discuss the discrepancy of impacts between heterogeneous food-handling behaviors. The contribution of habit and information-seeking behavior across behaviors were confirmed, while the influence of income, minor, objective norm, perception of food risks, trust, perceived behavioral control, and intention was statistically significant but inconsistently differed between behaviors. The independent contributions of gender, age, education, subjective norm, and attitude were negligible. This paper's findings offer evidence to highlight the role of volitional predictors to anticipate safe food-handling behaviors to suggest suitable policy interventions to reinforce the last line of heath defense in the household, especially in the context of the COVID-19 pandemic.

Household waste generation, change in waste composition and the exposure to COVID-19 in Guyana and Nigeria.

The COVID-19 pandemic has disrupted humans' activities across the globe. Measures related to social/physical distancing and lockdown have led to a shift and increase in waste generated at households' level. This study examined waste generation, composition and the implications for exposure during COVID-19 pandemic lockdown in Guyana and Nigeria. The study adopted a mixed-method design to collect qualitative and quantitative data. Owing to adherence to social/physical distancing, an online Google Form survey was administered and phone interviews were conducted with waste managers in Nigeria and Guyana. Findings showed that the volumes of waste had increased and there was a mixture of Personal Protective Equipment (PPE) with the municipal waste. Also, the majority of the respondents in both countries were concerned that solid waste has the potential to contribute to contamination and spreading of the pandemic. A paired sample T-test analysis indicated an increase in the use of PPE. The values of t = 19.46 and t = 23.73 at p ≥ 0.05 in Nigeria and Guyana, respectively were significant. Waste mostly contaminated, as submitted by the respondents, were cans, bottles, plastics and all biodegradable wastes while the most probable point of contamination as noted by the waste managers occurred at the point of waste collection. Therefore, sorting of waste at household levels and training of personnel involved in waste management should be done with an emphasis on adherence to COVID-19 protocol and enforcement of same to prevent the spread of the virus.

A quasi-experimental study on the effect of health and food safety training intervention on restaurant food handlers during the COVID-19 pandemic.

The restaurant business has turned into a dynamic and ever-growing industry. So, food safety must be a priority for these establishments, especially during the COVID-19 pandemic. The aim of this study was to determine the effect of training intervention on the health and food safety knowledge, attitude, and self-reported practice (KAP) of restaurant food handlers during the COVID-19 pandemic. This quasi-experimental study was conducted on 159 restaurant food handlers in Tehran, Iran. The training intervention was developed based on the latest global guidelines. The KAP of the subjects was measured before and after the training. Fisher's exact test, paired t test, and repeated measures ANOVA were used for statistical analysis. Data analysis was done using the IBM_SPSS software. The total knowledge scores of participants were low (17.6%), moderate (35.2%), and good (47.2%) before training, which were changed to 5% (low), 23.9% (moderate), and 71.1% (good) after training. The total pretraining attitude scores were 0.6, 77.4, 18.2, and 3.8% that were changed to 0% (strongly negative), 49.1% (negative), 33.3% (positive), and 17.6% (strongly positive), respectively. Also, the self-reported practice scores of the participants before training were 1.3, 56, and 42.7 that were changed to 0% (weak), 26.4% (acceptable), and 73.6% (desirable) after the intervention, respectively. Paired t test results showed a statistically significant increase in all scores. The interaction of training with age and education was statistically significant in increasing the knowledge and attitude scores of the participants by the repeated measures ANOVA. Improving the KAP of food handlers by health and food safety training can improve the status of restaurants and minimize the outbreak of pandemic diseases, including COVID-19, which is an effective step in community health. Thus, it is an urgent need for policymakers to design an online system of continuous food safety training for food handlers.

Food safety practices of food handlers at home engaged in online food businesses during COVID-19 pandemic in the Philippines.

This study was conducted to assess the self-reported and observed food safety practices (FSP) of food handlers, who deliver food products that are prepared and cooked at home during the COVID-19 pandemic in the Philippines. 751 participated in the online survey who were selected using criterion sampling. A questionnaire developed by the researcher was used to gather data with Cronbach Alpha of 0.91. t-test, ANOVA, and Fleiss kappa were performed to treat data. There were no significant differences between self-reported FSP in four dimensions and demographic characteristics, except for age, where a significant difference exists between the FSP of the four age groups along food preparation (F â€‹= â€‹4.530, ρ <0.01). The FSP in the four dimensions obtained a weighted x ¯ and σ of 1.72 â€‹± â€‹0.69 which is interpreted as Sometimes Practiced. The food handlers at home inadequately and inappropriately practiced the protocols in keeping the food safe to eat. The observed reports showed that the food handlers at home do not meet food safety standards as indicated in the weighted x ¯ and σ in the four dimensions 1.63 ± 0.11, with a description of Sometimes Practiced. Observed practices further show very poor adherence to guidelines. Test for inter-rater reliability yielded almost perfect agreement (κ â€‹= â€‹0.81, ρ <0.05). There exists a significant difference with the FSP in personal hygiene (t â€‹= â€‹0.964, ρ <0.05), cross-contamination prevention and sanitation (t â€‹= â€‹0.815, ρ <0.05), food preparation (t â€‹= â€‹0.753, ρ <0.05), and food delivery (t â€‹= â€‹0.794, ρ <0.05). Government and non-government agencies should work together towards educating the food handlers at home on effective ways to learn about food safety concepts so they could become advocates of safer food practices.