Score regression model for self-reported food safety and hygiene practices
| Model | B | SE | δ | t | p |
|---|---|---|---|---|---|
| 1 (Constant) | 73.307 | 5.51 | 12.59 | 0.00 | |
| Knowledge score | 0.35 | 0.12 | 0.43 | 0.41 | 0.55 |
| Attitude score | 0.55 | 0.87 | 0.51 | 0.51 | 0.04* |
Socio-demographic profile of food handlers in preschool kitchens in Podgorica (n=113)
| Demographic variables | Category | n | % | Mean±SD % |
|---|---|---|---|---|
| Gender | Male | 2 | 1.8 | |
| Female | 111 | 98.2 | ||
| Institutions | Public | 97 | 85.8 | |
| Private | 16 | 14.2 | ||
| Age (Years) | <25 | 6 | 5.3 | 43.62±10.30 |
| 25-34 | 13 | 11.5 | ||
| 35-44 | 39 | 34.5 | ||
| 45-55 | 38 | 33.6 | ||
| >55 | 17 | 15.0 | ||
| Education level | Primary school | 3 | 2.7 | |
| Secondary school | 100 | 88.5 | ||
| High vocational school | 6 | 5.3 | ||
| University | 3 | 2.7 | ||
| Other | 1 | 0.9 | ||
| Working experience in food service (years) | <1 | 4 | 3.5 | 12.68±8.54 |
| 1-5 | 21 | 18.6 | ||
| 5-10 | 23 | 20.4 | ||
| 10-15 | 21 | 18.6 | ||
| 15-20 | 19 | 16.8 | ||
| >20 | 25 | 22.1 | ||
| Participation in training for safe food handling? | One time | 24 | 21.2 | |
| Multiple time | 62 | 54.9 | ||
| Never | 27 | 23.9 | ||
| Has HACCP been implemented in your establishments? | Yes | 94 | 83.2 | |
| No | 7 | 6.2 | ||
| Do not know | 12 | 10.6 | ||
| Did you attend and pass the hygiene minimum course, and get a certificate? | Yes | 16 | 14.3 | |
| No | 96 | 85.7 |
Impact of socio-demographic characteristics on food handlers’ knowledge, attitude, and self-reported practices regarding food safety and hygiene in preschool kitchens (n=113)
| Demographic | Food safety and food hygiene knowledge | Selfreported food hygiene practice | |||||
|---|---|---|---|---|---|---|---|
| Personal hygiene | Temperature control | Crosscontamination | Food storage | Equipment hygiene | Safe attitude | ||
| Age (years) | 0.74 | 0.96 | 0.66 | 0.96 | 0.48 | 0.26 | 0.10 |
| Educational level | 0.43 | 0.18 | 0.19 | 0.08 | 0.02* | 0.35 | 0.77 |
| Food service working experience | 0.42 | 0.20 | 0.54 | 0.47 | 0.40 | 0.76 | 0.43 |
| Participation in training | 0.82 | 0.76 | 0.29 | 0.03* | 0.52 | 0.24 | 0.44 |
| Previous working experience | 0.49 | 0.56 | 0.03* | 0.11 | 0.11 | 0.68 | 0.49 |
| Implementation of HACCP | 0.24 | 0.19 | 0.76 | 0.96 | 0.01* | 0.16 | 0.46 |
| Attending the “hygiene minimum” course certification | 0.03* | 0.74 | 0.11 | 0.00* | 0.67 | 0.61 | 0.46 |
Comparison between self-reported and observed hygiene practices of food handlers (n=113)
| Practices | Respondents, n (%) | |||
|---|---|---|---|---|
| Selfreported practices | Observed practices | t | p | |
| 1. Do you wash your hands with water and soap before preparing food? Yes | 113 (100) | 21 (18.6) | -13.80 | 0.00* |
| 2. Do you wash your hands with water and soap before eating? Yes | 112 (99.1) | 56 (49.6) | -0.06 | 0.00* |
| 3. Do you wash your hands with water and soap after using the bathroom? Yes | 113 (100) | 94 (83.1) | -21.28 | 0.00* |
| 4. Do you have short, neat nails, without nail polish? Yes | 109 (96.4) | 103 (91.2) | -2,11 | 0.00* |
| 5. Do you light a cigar while working? No | 111 (98.3) | 106 (93.8) | 2.74 | 0.00* |
| 6. Do you touch your nose while working, or sneeze into your hands? No | 108 (96.6) | 26 (23.0) | -1.23 | 0.01* |
| 7. Do you dry your hands after washing them properly (e.g. with a disposable towel or hand dryer)? Yes | 108 (96.6) | 75 (66.3) | -0.76 | 0.20 |
| 8. Do you wear a clean and suitable uniform before starting work? Yes | 112 (99.1) | 74 (65.4) | -0.72 | 0.93 |
| 9. Do you remove all adornments (earrings, rings, watches, and bracelets) before starting activities? Yes | 113 (97.0) | 101 (89.4) | -1.95 | 0.60 |
| 10. Is your hair completely covered while working? Yes | 111 (98.2) | 90 (79.7) | -0.26 | 0.61 |
| 11. Do you work when you have diarrhea? No | 100 (88.5) | 92 (81.5) | -0.94 | 0.68 |
| 12. Do you work when you have a cold? No | 91 (80.5) | 65 (57.5) | -1.31 | 0.00* |
| 13. Do you work when you have lesions on your hands? No | 95 (84.1) | 61 (54.1) | -0.06 | 0.39 |
| 14. Do you have a certified sanitary card? Yes | 102 (94.7) | 111 (98.2) | -0.42 | 0.38 |
| 15. Do you eat or drink in your working area? No | 86 (80.4) | 20 (17.8) | -0.87 | 0.02* |
| 16. Do you wear gloves when you handle ready-to-eat food or prepare sandwiches? Yes | 98 (91.6) | 16 (14.3) | 0.54 | 0.02* |
| 17. Do you separate raw (fresh salad) food from ready-to-eat food or serve it on the same plate? Yes | 94 (87.8) | 82 (73.2) | -1.51 | 0.30 |
| 18. Do you check the shelf life of food products while using them? Yes | 106 (99.0) | 108 (95.6) | -1.79 | 0.46 |
| 19. Do you keep ready-to-eat food at room temperature for over 4 hours? No | 99 (92.5) | 95 (84.8) | 0.96 | 0.37 |
| 20. Do you clean food contact surfaces before and after serving and preparing food? Yes | 102 (95.3) | 63 (56.3) | -4.16 | 0.00* |
Relationships between knowledge, attitude, and practice among food handlers in preschool kitchens
| Domain | r value | p-value |
|---|---|---|
| Knowledge and attitude | 0.19 | 0.04* |
| Knowledge and practice | 0.35 | 0.72 |
| Attitude and practice | 0.00 | 0.93 |
Food handlers’ attitudes towards food safety (n=113)
| Statements | Respondents, n (%) | Mean±SD% | ||||
|---|---|---|---|---|---|---|
| Strongly disagree | Disagree | Uncertain | Agree | Strongly agree | 95.72±4.53 | |
| Safe food handling is an important part of my job responsibilities. (Agree) | 0 (0.0) | 1 (0.9) | 0 (0.0) | 30 (26.5) | 82 (72.6) | |
| I think that it is good to maintain a high degree of personal cleanliness while working. (Agree) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 27 (23.9) | 86 (76.1) | |
| Learning more about food safety through training courses is important to me. (Agree) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 30 (26.5) | 83 (73.5) | |
| Cleaning my hands effectively can prevent foodborne diseases. (Agree) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 27 (23.9) | 86 (76.1) | |
| I should take leave and should not work on the food premises if I am suffering from foodborne illness. (Agree) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 25 (22.1) | 88 (77.9) | |
| The way we store food affects its safety (Agree) | 0 (0.0) | 4 (3.5) | 0 (0.0) | 28 (24.8) | 81 (71.7) | |
| Long fingernails could contaminate food with foodborne pathogens. (Agree) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 28 (24.8) | 85 (75.2) | |
| Food handlers should be medically examined every six months. (Agree) | 1 (0.9) | 0 (0.0) | 0 (0.0) | 21 (18.6) | 91 (80.5) | |
| Food handlers can be a source of foodborne outbreaks. (Agree) | 0 (0.0) | 2 (1.8) | 5 (4.4) | 33 (29.2) | 73 (64.6) | |
| Food handlers with wounds, bruises, or injuries on their hands must not touch or handle food. (Agree) | 2 (1.8) | 3 (2.7) | 0 (0.0) | 34 (30.1) | 74 (65.5) | |
| Expired food should not be consumed, even without changes in smell and taste. (Agree) | 1 (0.9) | 1 (0.9) | 2 (1.8) | 22 (19.5) | 87 (77.0) | |
| Foodborne outbreaks are natural life events. (Disagree) | 7 (6.2) | 14 (12.4) | 12 (10.6) | 30 (26.5) | 50 (44.2) | |
Knowledge of food handlers related to food safety and hygiene knowledge (n=113)
| Knowledge | Respondents, n(%) | Mean±SD % | ||
|---|---|---|---|---|
| Yes | No | Do not know | 77.25±2.69 | |
| Personal hygiene | 89.76±2.69 | |||
| Should you wash your hands before using gloves? Yes | 89 (82.4) | 16 (14.8) | 3 (2.8) | |
| Can the same gloves also be used for handling fruit and handling meat? No | 3 (2.8) | 105 (97.2) | 0 (0.0) | |
| Does hair contain different types of bacteria and can it be a source of food contamination? Yes | 96 (89.7) | 4 (3.7) | 7 (6.5) | |
| Temperature control | 69.60±0.91 | |||
| The procedure of freezing foods does not kill bacteria but rather slows down their growth. Yes | 84 (79.2) | 14 (13.2) | 8 (7.5) | |
| The correct method for thawing frozen meat is with water from a boiler or at room temperature overnight. No | 55 (50.9) | 40 (37.0) | 13 (11.5) | |
| Food may be stored at room temperature for 2 hours after cooking before storing in the refrigerator. Yes | 87 (80.6) | 17 (15.0) | 4 (3.5) | |
| The correct temperature range for a refrigerator storing food is 1 to 4 °C, and the freezer is below -18 °C. Yes | 99 (81.7) | 5 (4.6) | 4 (3.7) | |
| The optimum temperature range for bacteria growth is between 5-61 °C (danger zone). Yes | 76 (71.0) | 12 (11.2) | 19 (17.8) | |
| Cross-contamination | 71.84±0.85 | |||
| Vegetables should be chopped first and then washed. No | 10 (9.3) | 96 (88.9) | 2 (1.8) | |
| Do you use the same knife for raw and cooked meat or chopping vegetables? No | 5 (4.6) | 103 (95.4) | 0 (0.0) | |
| Bacteria cannot enter physically damaged canned food. No | 45 (41.7) | 52 (48.1) | 11 (10.2) | |
| Staff cannot eat or drink in the food preparation area. Yes | 36 (33.3) | 71 (65.7) | 1 (0.9) | |
| Do you use the same board for cutting raw meat and chopping vegetables? No | 6 (5.6) | 101 (93.5) | 1 (0.9) | |
| Food storage | 86.60±0.87 | |||
| Raw (fresh) food should be kept on the lower shelves of the refrigerator. Yes | 81 (75.0) | 19 (21.4) | 6 (5.6) | |
| Preparation of food in advance is likely to contribute to food-borne illnesses. Yes | 87 (80.6) | 14 (13.0) | 7 (6.5) | |
| Food samples are taken from each meal for quality control and stored in the refrigerator for 48 hours. Yes | 103 (95.4) | 4 (3.7) | 1 (0.9) | |
| Frozen food must not be refrozen after thawing. Yes | 103 (95.4) | 4 (3.7) | 1 (0.9) | |
| Equipment hygiene | 68.48±1.04 | |||
| Bacteria can grow on broken and cracked dishes. Yes | 100 (88.5) | 6 (5.6) | 2 (1.8) | |
| Washed dishes and equipment should be wiped with a dishcloth. No | 17 (15.9) | 88 (88.2) | 2 (1.8) | |
| Is the detergent sufficient to ensure the efficiency of the cleaning equipment? No | 45 (41.7) | 59 (54.6) | 4 (3.6) | |
| Refrigerators should be opened and checked often. No | 77 (71.3) | 21 (19.4) | 10 (8.9) | |
| Sinks used for washing raw materials can be used for washing hands. No | 6 (5.3) | 99 (91.7) | 3 (2.7) | |