Food Control 37 (2014) 210e217

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Food Control
journal homepage: www.elsevier.com/locate/foodcont

Knowledge, attitudes and practices of food handlers on food safety in food service operations at the Universiti Kebangsaan Malaysia
Norrakiah Abdullah Sani*, Oi Nee Siow
School of Chemical Sciences and Food Technology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor, Malaysia

a r t i c l e i n f o
Article history: Received 10 March 2012 Received in revised form 8 September 2013 Accepted 17 September 2013 Keywords: Knowledge Attitudes and practices Food safety Food handlers Food service operation

a b s t r a c t
This study was conducted to determine the level of knowledge, attitudes and practices of food handlers in food service operation at the main campus of Universiti Kebangsaan Malaysia (UKM) regarding food safety. Data were collected from 112 food handlers through questionnaires which consisted of questions about knowledge, attitudes and practices. The results showed that there was signicantly positive correlation among the three levels and respondents possess good scores for knowledge (19.68 3.87) about personal hygiene, foodborne diseases and temperature control of food; for attitudes (89.26 8.66) on safe food handling, and for practices (90.02 8.23), specically for appropriate hand washing, use of gloves in food preparation and prevention of food hazards. About 73.2% of respondents never attend any training related to food safety and majority show poor knowledge of pathogens associated with diseasecausing agents as well as critical temperatures for storage of ready-to-eat foods. Therefore, effective and ongoing training on food safety and hygiene must be given to all food service employees to ensure the safety of food provided. 2013 Published by Elsevier Ltd.

1. Introduction FAO and WHO (2002) reports that millions of people become ill and many die from unsafe food intake. Every year, more than onethird of the total population in developing countries will be affected by foodborne illness. European Food Safety Authority (EFSA, 2010) reported that in year 2010 alone, approximately 48.7% of foodborne diseases are associated with the catering or food service establishments which prove the importance of basic food safety practices in these areas. Foods can be mishandled during preparation, processing or storage (Mederios, Hillers, Kendall, & Mason, 2001). In foodservice environments, various factors may be causing foodborne diseases include foods from unsafe sources, inadequate cooking, contaminated equipment, and poor personal hygiene (Egan et al., 2007). Other additional factors are improper holding times or temperatures during food processing, for instance of ready-to-eat foods (RTE), they are often prepared in advance before consumption and subjected to temperatures abuses during serving and distribution, thus allowing bacterial growth (Rosset, Cornu, Noel, Morelli, & Poumeyrol, 2004). Good personal hygiene and proper food

* Corresponding author. Tel.: 60 3 89214053; fax: 60 3 89213232. E-mail address: norra@ukm.my (N. Abdullah Sani). 0956-7135/$ e see front matter 2013 Published by Elsevier Ltd. http://dx.doi.org/10.1016/j.foodcont.2013.09.036

handling practices can minimise the transfer of pathogens from food handlers to consumers (Evans et al., 1998). Mishandling food may be implicated in 97% of all food-borne illness associated with catering outlets (Egan et al., 2007). Food handlers participate in the nal stage of the prevention of foodborne diseases; they must take signicant steps to reduce the number of pathogenic microorganisms to the minimum level in food (Medeiros et al., 2004). In spite of food handlers having the skills and knowledge to handle food safely, yet human handling errors have been associated with most incidence of food poisoning (Ehiri & Morris, 1996; Greig, Todd, Bartleson, & Michaels, 2007). Hence, to reduce the risk of cross-contamination, serious attention should be given to train and supervise food handlers to ensure proper hand washing, adequate cleaning and good sanitation procedures (Sneed, Strohbehn, Gilmore, & Mendonca, 2004). The trends of food poisoning cases in Malaysia tend to increase each year. For example, food poisoning cases is on the rise as evident by the incidence rate of 26.04% in 2006 and this value doubled with an incidence rate of 53.19% for the following year of 2007 (MOH, 2006; 2007). In addition, a total of 3625 of 81,686 food premises were closed in 2006 because their cleanliness was not in accordance to Part II of the Food Regulations 1983 (MOH, 2006). Most of the food poisoning associated with outbreaks in institutions, with 62% of the cases in schools, followed by academic institutions (17%) and social/festive gatherings contributed for 8%

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211

(MOH, 2007). The sources identied as the cause of food poisoning cases in Malaysia include insanitary food handling procedures, inadequate clean water and unhygienic working environments (MOH, 2006). Effective food safety trainings from supporting organization as well as adequate resources will strengthen food handling and workplace safety practices. Apart from enough knowledge and stringent enforcements, the right attitude of food handlers can also reduce outbreaks of foodborne illness. Most published studies that evaluated the training of handlers in cafeterias based on questionnaire regarding Good Manufacturing Practices (GMP) veried the success of training by discovery of improvements in hygienic conditions and microbiological quality of the foods they prepared (Acikel et al., 2008; Veiros, Proena, Santos, Kent-Smith, & Rocha, 2009). These studies globally concluded that training of food handlers is imperatively to be proposed (Santana, Almeida, Ferreira, & Almeida, 2009). Food handlers should master all the skills and have the knowledge needed to ensure the safety of foods they prepare for consumption. Many studies about the knowledge and practices of food handlers have been conducted worldwide (Bas, Ersun, & Kivan, 2006; Gomes-Neves, Arajo, Ramos, & Cardoso, 2007; Jev snik, Valentina, & Raspor, 2008; McIntyre, Vallaster, Wilcott, Henderson, & Kosatsky, 2013; Sharif & Al-Malki, 2010; Tokuc, Ekuklu, Berberlu, Bilge, & Dedeler, 2009; Walker, Pritchard, & Forsythe, 2003). og However there are no studies which examined the knowledge, attitudes and practices of food safety among food handlers in our local universities. Meals prepared in universities should receive special attention since the foods are consumed daily by the students and as previously stated, most of the implicated food poisonings occurred in food premises of schools and academic institutions. This point increases the importance of this study. The main objective of this study was to investigate the level of knowledge, attitudes and practices among food handlers from eleven cafeterias in the main campus of the Universiti Kebangsaan Malaysia (UKM) regarding food safety. 2. Materials and methods 2.1. Research population and data collection This study was conducted in a total of eleven cafeterias and canteens of the main campus of the Universiti Kebangsaan Malaysia (UKM) at Bangi, Selangor from October 2009 until April 2010. A total of 112 food handlers participated and data were collected through questionnaires and face to face interviews were given for those who were illiterate. Respondents were given ample time (w15 min) to answer the questionnaire. 2.2. Questionnaire design The questionnaires that consisted of 4 parts were developed based on comprehensive food safety literature reviews. Questionnaires were modied and tested for suitability through the Cronbach alpha test, with reliability coefcient of 0.70 (Santos, 1999). The questionnaires on KAP of food handlers in UKM on food safety have a copyright certication for intellectual property protection (CCI-UKM Statutory Declaration of Copyright, 2013). Part I was used to collect data on respondents age, gender, race, years of work experience and education, eld of duty, injection of Typhim IV and whether the respondent participated in any food safety training. Part II included 12 questions that tested respondents on their knowledge of personal hygiene (3 items), cross contamination (3 items), foodborne diseases (1 item), critical temperatures (4 items) and agent of foodborne illness (1 item).

Table 1 Demographic characteristics of the respondents (n 112). Characteristics Age (years) <20 21e30 31e40 41e50 >50 Male Female Malay Chinese Indian Indonesia Bangladesh Myanmar Thailand No formal education Primary Secondary Others Chef Washing utensils Cutter Server Others Permanent Part-time Contract <1 1e5 6e10 >10 Yes No Training/course/workshop Audio-visual materials Mass media Others Yes No Yes No
a

(n)% 12.5 58.9 16.1 8.0 4.5 74.1 25.9 67.9 2.7 0.9 19.6 2.7 3.6 2.7 3.6 21.4 63.4 11.6 30.4 8.9 9.8 31.3 19.6 65.2 15.2 19.6 10.7 68.8 11.6 8.9 26.8 73.2 22.3 21.4 18.8 37.5 83.0 17.0 50.9 49.1

Gender Race

Educational level

Responsibility

Type of staff

Working experience (years)

Participation in food safety trainings/courses Source of knowledge about HACCP

Desire to know about HACCP Typhim Vi injection

a

(14) (66) (18) (9) (5) (83) (29) (76) (3) (1) (22) (3) (4) (3) (4) (24) (71) (13) (34) (10) (11) (35) (22) (73) (17) (22) (12) (77) (13) (10) (30) (82) (25) (24) (21) (42) (93) (19) (57) (55)

(n) % e (number of respondents) percentage of respondents.

Each question consisted of three optional answers of yes, no and do not know in order to reduce the probability of respondents in selecting the correct answer by chance. Three additional questions related to refrigerator and storage temperatures for both hot and cold ready-to-eat foods were asked. Correct answers were scored 2 points, incorrect or do not know answers were given 0 point. The score range for this part was between 0 and 30 wherein scores below 15 are categorized as poor. Twenty questions in Part III were designed to assess the attitudes of respondents in terms of safe food handling and prevention of foodborne illness. The contents in the questionnaire were summarized in Table 2. Part IV focused on the respondents practice during food handling. It contained 20 questions about personal hygiene (5 items), hand washing (4 items), gloves usage (2 items), food safety control and management of raw materials (9 items). The items for both Part III and IV were rated on a 5-point Likert scale ranging from 1 (strongly disagree/never- 1 point) to 5 (strongly agree/always- 5 points) were assigned for positive items and vice versa points for items that in negative form. The scores given were ranged between 0 and 100 wherein scores below 50 were considered poor.

2.3. Statistical analysis The statistical analysis of data was performed using the SPSS software for Windows, version 20.0. The socio-demographic

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characteristics of respondents and their scores respective to knowledge, attitudes and practices were summarized using descriptive statistics. Spearmans correlation coefcient was used to test the association between knowledge, attitudes and practices scores of the respondents. Findings with a p-value < 0.05 were considered to be statistically signicant. 3. Results and discussion 3.1. Demographic characteristics of respondents The socio-demographic characteristics for 112 respondents are summarized in Table 1. Most of the respondents were males (74.1%) with 58.9% aged between 21 and 30 years old. From these respondents, only 4.5% were over the age of 50 years. Majority of the respondents were Malays (67.9%) and Indonesians (19.6%). Only four respondents did not have formal education and 71 respondents (63.4%) were secondary school leavers. A total of 31.3% were staff involved in the service area and 30.4% were chefs. Most respondents were regular employees in their food service operations (65.2%). Approximately 68.8% have been in this sector for 1e5 years while only 10 people (8.9%) have worked for over 10 years. It was found that 73.2% of respondents did not attend any training related to food safety. However, many of the respondents (37.5%) knew about the HACCP system through conversations with friends and managers. Ninety three respondents (83.0%) indicated an interest to know about the HACCP system in detail if given the chance. About 50.9% of the respondents received Typhim Vi injections when they were rst hired. 3.2. Food safety knowledge Fig. 1 shows the overall knowledge level of respondents with respect to food safety. Majority of the respondents (96.4%) answered questions related to personal hygiene correctly. Only half of the respondents knew the answer for questions about cross-contamination (44.6%), temperature and time control (58.7%) as well as the denition of foodborne illness (66.1%). The results for the 5 categories of knowledge exhibited by respondents were presented in Table 2. Most of them (98.2%) knew that it was necessary to always wash their hands when handling foods and avoid touching their body parts like hair after washing their hands (92.9%). About 97.3% stated that they knew washing hands properly can reduce the risk of contamination. Study by Haapala and Probart (2004) also reported that their participants acquired more correct answers with the questions that are related to the washing of hands, thus, indicating good knowledge with respect

to this theme. On the other hand, more than half of the respondents gave correct answer to the negatively formed question of correct cleaning procedures of equipment increase risk of infection transmission. This indicated that they really read thoroughly on the given questions. However, about 58.9% of them gave wrong answer or did not know that running water with temperature of 21  C is an acceptable method for thawing of frozen food. Furthermore, approximately 71.4% of respondents did not know that Staphylococcus aureus is an agent of foodborne disease. The reason of asking respondents about this question was to assure that they know about foodborne pathogens and were concerned with the outbreaks that occurred throughout the world (A & Abushelaibi, 2012). Additionally, S. aureus is considered as the third most important cause of foodborne diseases in the world (Normanno et al., 2005), where recently, isolation of methicillinresistant S. aureus (MRSA) strains from several food producing animals have been reported, mainly due to contamination by infected food handlers during further preparation (de Boer et al., 2009). Hence, this indicated that most of the respondents in this survey lacked the knowledge regarding this particular matter. Tokuc et al. (2009) also reported that their respondents showed poor knowledge in matters related to foodborne pathogens. Same results were acquired from a study by Ansari-Lari, Soodbakhsh, and Lakzadeh (2009) which stated that more than half of their respondents did not know that Salmonella, Hepatitis A and B as well as S. aureus are the pathogens-causing disease. According to Sharif and Al-Malki (2010), over 50% of the Taif University students lack the knowledge that raw eggs and raw white cheese have high risk for food poisoning. This implies the need to enhance food safety knowledge among food handlers which might be related to lack of training since majority of the respondents (73.2%) never attended any food safety training as demonstrated in Table 1. Previous research found that food safety training increased knowledge regarding food safety issues (Lynch, Elledge, Grifth, & Boatright, 2003). Training and education may be an effective tool to increase food safety knowledge and awareness of hygiene among food handlers and thus improve food safety practices (Gillespie, Little, & Mitchell, 2000). Nevertheless, more knowledge does not always lead to positive changes in food handling behaviors (AnsariLari et al., 2009; Kassa, 2001). There is a general consensus that food handlers need to have sufcient knowledge of food safety and be able to apply such knowledge during food preparation (Mortlock, Peters, & Grifth, 1999). However, wrong knowledge might decrease the level of conscious on food handling and thereafter practicing a false idea of safety (Martins, Hogg, & Otero, 2012). Thus, transferring knowledge into areas of food handling practices is of

100 90 80

96.4

Percentage (%)

70 60 50 40 30 20 10 0 Personal hygiene Cross-conta mination

44.6

66.1 58.7

28.6

Foodborne disease definition

Time and temperature Staphylococcus aureus control a gent

Types of Knowledge
Fig. 1. Respondents correct answers (%) according to different knowledge categories.

N. Abdullah Sani, O.N. Siow / Food Control 37 (2014) 210e217 Table 2 Responses of respondents regarding ve categories of food safety knowledge (n 112). Category Item Answers,a n (%) Correct 1. Personal hygiene a. Employees must wash their hands often b. Washing hands properly reduce risk of contamination c. Employees should avoid touching their hair after washing hands contamination 98.2 97.3 Incorrect 1.8 2.7

213

92.9

7.1

2. Cross-

c. Cross

3. Denition of foodborne diseases 4. Time and temperature control

5. Staphylococcus aureus related to foodborne diseases Total

a b

transmitting infection to consumers b. Correct cleaning procedures of equipment increase risk of infection transmission contamination is the transfer of harmful microorganisms to food from other foods or non foodcontact surfaces Foodborne illnesses are diseases that transmitted to people by food a. Important factors to control growth of bacteria are time and temperature b. Temperature danger zone for foods is 5  C e60  C c. Running water with temperature of 21  C is an acceptable method for thawing frozen food d. Ready-to-eat foods that keep in room temperature for prolonged of time will cause growth of microorganism Staphylococcus aureus agent 28.6

a. Use of gloves reduce the risk of 97.3 30.4

respondents thought that hot RTE foods are safe to be kept at temperatures below 60  C; while 67.0% stated that cold RTE foods can be kept in temperatures above 5  C for long periods of time. This nding shows that majority of respondents (64.3%) did not know the correct temperature danger zones for RTE foods is 5  Ce 60  C (Table 2). This result was supported by Bas et al. (2006) who stated that many of their respondents lacked of knowledge about critical temperatures for RTE foods, acceptable refrigerator temperature ranges and cross-contamination. Similar ndings by Buccheri, Mammina, Giammanco, Giammanco, and Casuccio (2010) reported that food handler proportions as high as 82.0% and 24.2% did not know the critical temperature of storing hot and cold RTE foods respectively. These ndings once again support the importance of food safety trainings as described by Hanashiro, Morita, Matt, Matt, and Torres (2005) in which education could be one of the most effective interventions to achieve safe foods and would result in effective performance of hygienic practices (Egan et al., 2007). 3.3. Food safety attitudes Apart from the knowledge, attitude is also a crucial factor that may inuence food safety behavior and practice, thus decrease the occurrence of foodborne diseases. From the survey conducted (Table 3), attitudes of the food handlers were favorable with total mean scores of 89.26 8.66. Most respondents agreed that handling food safely is important when the mean scores were 4.75 0.56 (highest score 5). About 89.2%, 83.0% and 87.5% respondents stated that they strongly concurred to increase their knowledge about food safety; safe food is more important than tasty food and food handlers need to know the proper temperatures for both refrigerators and freezers, respectively. However, only 76.8% said that they will attend food safety trainings if allowed (4.08 1.17). Others did not want to attend or were unsure by given reasons that they had no time to do so or are unable to understand the given texts during the training. This is a potential problem facing by all supervisors and managers. They should make training as a compulsory program for all staffs and must understand their handlers behavior as well as how this behavior interacts with their beliefs and levels of knowledge in order to increase the effectiveness of the program (Nieto-Montenegro, Brown, & LaBorde, 2008). The statement of food handlers with abrasion or cuts on ngers and hands should not be handling foods was approved by 82.8% of the respondents in this study. Comparatively, Tokuc et al. (2009) found that almost all (93.2%) of their food staffs were aware of the danger in touching food with cut hands or ngers. But the most signicant result was from Angelillo, Viggiani, Greco, and Rito (2001) who found that 99% of their food staffs did not touch food with cut hand or ngers. Many respondents were unsure about whether defrosted foods should only be refrozen once since lowest mean scores, 4.04 1.07 was from this statement. According to Abdul-Mutalib et al. (2012), about 83% of the respondents are uncertain about refreezing defrosted food. Repeated thawing and refreezing food will increase the number of microorganism in the food item and hence might cause hazards. Studies by Buccheri et al. (2007) and Tokuc et al. (2009) also report similar results with regards to thawing and refreezing food. About 93.7% agreed that using caps, masks, protective gloves and adequate clothing reduce the risk of food poisoning. This result was paralleled to the study by Buccheri et al. (2010), where they have also found that more than 90% of their respondents believe that the use of protective clothing, gloves and proper storage of foodstuffs are vitally important in reducing food spoilage and health hazards to consumers. Approximately 97.4% respondents in this study mentioned that they would use different

2.7 69.6

58.9

41.1

66.1

33.9

80.4

19.6

35.7

64.3

41.1

58.9

77.7

22.3

71.4

19.68 3.87

(n) % e (number of respondents) percentage of respondents. Total (Mean standard deviation) score of the respondents.

priority concern and it is clear that much more have to be discovered about food handlers attitudes toward food safety issues as well as their potential to inuence practices (Ko, 2013). Many of the food handlers were not aware of the importance of basic temperature control requirements in controlling microbial growth in food and if it is inadequately performed will lead to the proliferation of microbial hazards and thereafter food borne diseases (Adams & Moss, 2008; WHO, 2006). As seen in Fig. 2, 82.1% of

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100 90

Percentage (%)

80 70 60 50 40 30 20 10 0 Storage for refrigeration (1-4oC) Storage for hot RTE foods (>60oC) Storage for cold RTE foods (<5oC)
17.9 34.8 33

Temperature for Food Storage

Fig. 2. Knowledge of respondents about safety food storage temperature (5 Ce60  C).

clean clothes to wipe dining tables and food utensils. But this is totally contrasted with observation done by Abdul-Mutalib et al. (2012) where more than 40% of their respondents wear jewelery while working and use the same towel to clean many places. Sharif and Al-Malki (2010) have found that over 50% of Taif University students have negative attitude on food poisoning and they believe there is no risk from eating raw egg or drinking raw milk of she camel. Many respondents in this study also will le for a leave if they were unwell. Codex Alimentarius Commision (2003) stated that sick food handlers who are known or suspected of having any disease that might be transmitted by food are not allowed to work nor deal with foods. 3.4. Food safety practices Personal hygienic practice is extremely vital to ensure production of safe food to consumers. The respondents responses in terms of four types of practices have been summarized in Fig. 3. It was found that respondents have poor personal hygiene practices whereby only 46.6% maintained safe practices, such as wearing uniforms, aprons, caps and suitable covered shoes; and not smoking, coughing, sneezing or wearing jewelery that can contaminate foods while working. Azanza, Gatchalian, and Ortega (2000) also found similar results in their study that only half of the street vendors (53.7%) in the Philippines knew that wearing accessories could cause bacterial contamination. This was contradicts with study by akiroglu & Uar (2008) that reported 82.9% of their staffs wore caps, masks and gloves while handling food and 84.2% indicated that they did not wear jewelery during food production. According to the Codex Alimentarius Commision (2003), improper food handling is a major cause of foodborne diseases and poor hand hygiene is an important risk factor in the occurrence of food contamination. Food handlers should always wash their hands at every stage of food production, particularly before handling foods, after eating, after touching contaminated materials, after using the washroom, etc. In addition, food handlers should not smoke, sneeze, spit, cough, eat, handle money or engage in any activity that may contaminate foods. Although 86.4% respondents in this study said that they always wash their hands with soap and water but not many of them were observed in doing so when in actual practice. As a matter of fact, handlers who directly prepare RTE foods should wash their hands thoroughly using soap under hot running water and dry with a single-use towel; hand sanitizers may be used as a proper step in hand washing and wear waterproof gloves which

have been cleaned and disinfected during food handling (CDC, 2010). In present study, 63.4% stated that they wore protective gloves to prevent cross-contamination. However, only a few of them who assigned for certain tasks such as serving RTE chicken rice or some Malay foods were observed to wear gloves while preparing food. Similarly, study by Manning and Snider (1993) also revealed food handlers admitted that they did not used gloves while handling food. They also reported that 81% of respondents in their study expressed awareness of the importance of hand washing, but only 2% observed with the practice. This self-reported study showed that respondents have satisfactory practices in the prevention and control of food contamination hazards wherein 70.3% practiced the use of clean equipment, working in the proper environment and were concerned about food hygiene and prevention of cross-contamination between raw and cooked foods. However, the validity of such behaviors could not be conrmed since this study did not involve the observation on food handlers for their food preparation activities in the kitchens. Study by Giritlioglu, Batman, and Tetik (2011) found that 29.3% of their respondents did not know that raw and cooked food should be kept separately as keeping them together is the most prevalent cause of food poisoning (Egan et al., 2007). Sharif and Al-Malki (2010) have found that the response to practice questionnaires indicates good hygienic practice except that 76% of the Taif University students eat by hand rice and soup meal from one bowl shared by several persons. According to McIntyre et al. (2013), FOODSAFE trained food handlers in British Columbia, Canada, reported signicantly better hand washing practices and attitudes compared with the untrained food handler group. 3.5. Association among knowledge, attitudes and practices of food safety Summary of correlation for the levels of knowledge, attitudes and practices was shown in Table 4. A signicant positive correlation was observed between knowledge with attitudes (rs 0.356, p < 0.05), knowledge with practices (rs 0.583, p < 0.05) and attitudes with practices (rs 0.361, p < 0.05). These ndings indicated that food safety knowledge level of food handlers will inuence their attitudes and practices in handling food safely. However, these results were in contrast with other study who found that although food service employees had good knowledge of food safety, respondents seldom applied this knowledge when handling foods (Clayton, Grifth, Price, & Peters, 2002). Pilling, Brannon, Shanklin, Howells, and Roberts (2008) also stated that

N. Abdullah Sani, O.N. Siow / Food Control 37 (2014) 210e217 Table 3 Food safety attitudes exhibited by respondents (n 112). Item 1. Safe food handling is an important part of my job responsibility 2. I think that responsibility of food handlers is ensure food is safe to be served 3. Knowledge about food safety is important to me 4. I am willing to obtain more food safety knowledge 5. I am willing to attend training regarding food hygiene/safety 6. I believe good personal hygiene can prevent foodborne illness 7. I am willing to change my food handling practices when I know they are incorrect 8. Producing safe food is more important than tasty food 9. I think cafeteria owner should educate employees on personal hygiene continuously 10. I believe food safety knowledge will benet to my personal life 11. I will take leave when sick, fever or catch cold 12. Using caps, masks, protective gloves and adequate clothing reduce the risk of food poisoning 13. Washing hand before handling raw or cooked foods reduces risk of food poisoning 14. Food handlers with abrasion or cuts on ngers and hands should not handling foods 15. Improper storage of foods is hazardous to health 16. Raw foods should be kept separately from cooked foods 17. Defrost foods may be refrozen only once 18. It is important to know the temperature of chillers and freezers to reduce risk of food safety 19. It is necessary to check temperature settings of chillers and freezers regularly 20. I use different clean clothes to mop dining tables and food utensils Total mean score of attitudes for the respondents
a b a

215

Mean SD 4.75 0.56 4.66 0.53 4.65 0.52 4.37 0.77 4.08 1.17 4.63 0.70 4.46 0.73 4.27 0.91 4.55 0.70

Table 4 Correlation among knowledge, attitudes and practices level of respondents (N 112). Level Knowledge e Attitudes Attitudes e Practices Practices e Knowledge Spearmans rho 0.356** 0.583** 0.361** Sig. 0.000 0.000 0.000

98.2 67.9 98.3 89.2 76.8 93.7 94.7 83.0 92.9

** Correlation is signicant at the 0.01 level (2-tailed).

93.8 91.1 93.7

4.54 0.77 4.57 0.60 4.54 0.68

91.9

4.59 0.73

82.8

4.24 1.10

91.1 90.2 75.0 87.5

4.46 0.84 4.50 0.79 4.04 1.07 4.31 0.90

91.1

4.38 0.93

knowledge delivered by training courses cannot be translated into desired changes in attitudes and behavior. Thus, nding from Phillip and Anita (2010) suggested that some managers are proactive and support the food handlers to transfer the acquired knowledge into safe food handling practices by providing them with resources and support needed to assist in the transition. Motivation from supervisors and management as well as the support and facilities (e.g., provision for hand sinks, soap, and towels) given to staff are utmost important to the success of food safety training. Supervisors and managers should serve as role models by always conforming to the personal and general hygiene themselves, because if management is not taking these themes seriously, then staff members will not do so either (Educational Foundation of the National Restaurant Association, 1992). Additionally, training should include procedures to prevent food contamination, risks of foodborne pathogens, perception of good handling practices and personal hygiene, proper sanitation of food, utensils and the environment and ensure that food handlers are kept updated about the required procedures in maintaining the quality and safety of the food produced (Campos et al., 2009). Since there were studies pointed out that hygiene knowledge education alone was not sufcient to enhance the hygienic attitude and practices of food handlers (Chang, Lee, & Kwak, 2003; Walker et al., 2003), hence, hands-on training materials should be equipped and the training program should be angled towards handlers viewers with various activities. If continuous and specic-goal oriented training is provided to food handlers, sanitation practices such as health checking, adequate hand-washing, observation of proper personal hygiene, prevention of cross-contamination and correct sanitation procedures could be easily improved (Park, Kwak, & Chang, 2010). 4. Conclusions The ndings of this study indicates that food handlers in eleven food services at the main campus of the Universiti Kebangsaan Malaysia have good levels of knowledge (19.68 3.87), attitudes (89.26 8.66) and practices (90.02 8.23) regarding safe food handling. However, majority of the respondents were not aware of

97.4

4.66 0.53 89.26 8.66

Percentage of respondents that agreed with the statement. Mean SD e Mean standard deviation.

100 90 80 86.4 70.3 63.4

Percentage (%)

70 60 50 40 30 20 10 0 Hand washing 0.2 0.7 1.3 11.4 3.1 1.3 7.6

Never
46.6 30.8 24.6 7 .5 11.8 13.6 7.4 1.2 Control and prevention of hazards 7 .5

Rarely Sometimes Often Always

3.2

Using of gloves

Personal hygiene

Types of Practices
Fig. 3. Frequency of respondents compliance to different types of practices related to food safety.

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the storage and holding temperature of RTE foods, in which the consequences of lacking such knowledge will lead to cross contamination and increased harmful microbial growth in foods. Although there was a positive association among the level of knowledge, attitudes and practices of the respondents, nevertheless via the observation, it can be seen that many of them did not always apply the knowledge they have learned when in actual practices of handling foods. Therefore, effective and compulsory food safety training on a regular and ongoing basis should be conducted for all food service employees in order to minimize the prevalence of foodborne hazards. There are a few limitations in this study. The data were relied on self-reporting from food handlers that might exhibited bias as no conrmation could be taken during the completion of questionnaires by respondents, who may have misinterpreted the statement and response choices. This methodology also may not reect true practices and behavior of the food handlers in actual kitchen settings. Furthermore, with limited population of food handlers since the study only focused on cafeterias in the Universiti Kebangsaan Malaysia in Bangi campus, these results should not be generalized to the entire territory or country and other operations as well. Further research is needed so that the comparison of the scores of other food handlers in all universities in Malaysia can be made in order to see the overall scenario of the cafeterias operations and thus compliance to the food safety standards and practices. Moreover, it would be worthwhile if future research involving the collaboration from government agencies such as the Ministry of Health or other related agencies so that larger respondents from universities can be surveyed and therefore increased the effectiveness of the food safety study. Acknowledgments Authors would like to acknowledge funding assistance from UKM-GUP-KRIB-14/2008, UKM-OUP-NBT-29-137/2011, UKM-GUP2011-181 and DPP-2013-047 for this project. The cooperation of food handlers at residential colleges and canteens of the Universiti Kebangsaan Malaysia is also appreciated. References
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